McDermott Elizabeth, Kaley Alex, Kaner Eileen, Limmer Mark, McGovern Ruth, McNulty Felix, Nelson Rosie, Geijer-Simpson Emma, Spencer Liam
School of Social Policy, University of Birmingham, Birmingham, UK.
School of Health and Social Care, University of Essex, Colchester, UK.
J Ment Health. 2024 Dec;33(6):768-778. doi: 10.1080/09638237.2023.2245894. Epub 2023 Aug 17.
LGBTQ+ young people have elevated rates of poor mental health in comparison to their cisgender heterosexual peers. School environment is a key risk factor and consistently associated with negative mental health outcomes for LGBTQ+ adolescents.
To examine how, why, for whom and in what context school-based interventions prevent or reduce mental health problems in LGBTQ+ adolescents.
A realist review methodology was utilised and focused on all types of school-based interventions and study designs. A Youth Advisory Group were part of the research team. Multiple search strategies were used to locate relevant evidence. Studies were subject to inclusion criteria and quality appraisal, and included studies were synthesised to produce a programme theory. Seventeen studies were included in the review.
Eight intervention components were necessary to address LGBTQ+ pupils mental health: affirmative visual displays; external signposting to LGBTQ+ support; stand-alone input; school-based LGBTQ support groups; curriculum-based delivery; staff training; inclusion policies; trusted adult. Few school-based interventions for this population group were identified.
The programme theory indicates that "to work" school-based interventions must have a "whole-school" approach that addresses specifically the dominant cis-heteronormative school environment and hence the marginalisation, silence, and victimisation that LGBTQ+ pupils can experience.
与性别认同与出生时性别一致的异性恋同龄人相比， LGBTQ+ 青少年心理健康状况较差的比例更高。学校环境是一个关键风险因素，并且一直与 LGBTQ+ 青少年的负面心理健康结果相关。
研究基于学校的干预措施如何、为何、针对谁以及在何种背景下预防或减少 LGBTQ+ 青少年的心理健康问题。
采用了现实主义综述方法，重点关注所有类型的基于学校的干预措施和研究设计。一个青年咨询小组是研究团队的一部分。使用了多种搜索策略来查找相关证据。研究需符合纳入标准并进行质量评估，对纳入的研究进行综合以形成一个项目理论。该综述纳入了 17 项研究。
解决 LGBTQ+ 学生心理健康问题需要八个干预要素：肯定性的视觉展示；指向 LGBTQ+ 支持的外部标识；独立授课；校内 LGBTQ+ 支持小组；基于课程的授课；教职工培训；包容政策；可信赖的成年人。针对这一人群的基于学校的干预措施很少被发现。
该项目理论表明，基于学校的干预措施若要“起作用”，必须采取“全校”方法，专门应对占主导地位的顺性别异性恋规范的学校环境，以及 LGBTQ+ 学生可能经历的边缘化、沉默和受害情况。
