Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA.
Northeastern University, College of Professional Studies, Boston, MA, USA; KAYAK Software Corporation, Cambridge, MA, USA.
Soc Sci Med. 2020 Feb;246:112727. doi: 10.1016/j.socscimed.2019.112727. Epub 2019 Dec 13.
Drawing on theoretical accounts of LGBTQ minority stress and models of social integration and immigrant health, the present study examines sexual and gender minority status - heretofore overlooked in crossnational frameworks of immigrant health - as an important determinant of asylum seeker mental health. With the goal of spurring intervention development among this population, this study also aims to characterize LGBTQ asylum seekers' interest in interventions aimed at alleviating minority stress, barriers to social integration, and associated mental distress.
Respondents (n = 308) completed an online survey which included the Refugee Health Screener (RHS-15), and a battery of measures of minority stressors and barriers to social integration.
Most respondents (80.20%) screened positive for mental distress. Consistent with minority stress theory, loneliness (OR = 1.14, 95% CI = 1.11, 1.16) and LGBTQ identity disclosure (OR = 3.46, 95% CI = 1.85, 6.50) were strongly associated with screening positive for mental distress. Consistent with theories of immigrant social integration, those who had been granted asylum (OR = 0.36, 95% CI = 0.25, 0.53) or had higher English language proficiency (OR = 0.35, 95% CI = 0.21, 0.60) were less likely to screen positive. In an exploratory analysis, the association between transgender identity and mental distress approached significance (OR = 3.60, 95% CI = 1.00, 7.2). As preliminary justification for applying these findings to practice, most of those who screened positive for distress were interested in receiving mental health counseling (70.45%). Most participants wanted more LGBTQ friends (83.1%), wanted to mentor an LGBTQ newcomer (83.8%), and were interested in joining an LGBTQ community center (68.2%).
This study demonstrates that LGBTQ asylum seekers are highly likely to experience mental distress that is influenced by unique social factors, including barriers to social integration, and are motivated to participate in interventions aimed at addressing their mental health needs.
借鉴 LGBTQ 少数群体压力的理论解释以及社会融合和移民健康模型,本研究探讨了性和性别少数群体身份——迄今为止在移民健康的跨国框架中被忽视——作为寻求庇护者心理健康的一个重要决定因素。本研究旨在为这一人群的干预措施的发展提供动力,同时也旨在描述 LGBTQ 寻求庇护者对缓解少数群体压力、社会融合障碍和相关精神困扰的干预措施的兴趣。
受访者(n=308)完成了一项在线调查,其中包括难民健康筛查器(RHS-15)和一系列少数群体压力源和社会融合障碍的测量工具。
大多数受访者(80.20%)的精神困扰筛查呈阳性。与少数群体压力理论一致,孤独感(OR=1.14,95%CI=1.11,1.16)和 LGBTQ 身份披露(OR=3.46,95%CI=1.85,6.50)与精神困扰筛查呈阳性密切相关。与移民社会融合理论一致,那些获得庇护(OR=0.36,95%CI=0.25,0.53)或英语水平较高(OR=0.35,95%CI=0.21,0.60)的人不太可能筛查呈阳性。在一项探索性分析中,跨性别认同与精神困扰之间的关联具有统计学意义(OR=3.60,95%CI=1.00,7.2)。作为将这些发现应用于实践的初步依据,大多数筛查呈阳性的精神困扰者都有兴趣接受心理健康咨询(70.45%)。大多数参与者希望有更多的 LGBTQ 朋友(83.1%),希望指导一位 LGBTQ 新来者(83.8%),并对加入一个 LGBTQ 社区中心感兴趣(68.2%)。
本研究表明,LGBTQ 寻求庇护者很可能经历精神困扰,这种困扰受到独特的社会因素的影响,包括社会融合障碍,并且有动力参与旨在满足其心理健康需求的干预措施。