Clark Kristen D, Jewell Jaylyn, Sherman Athena D F, Balthazar Monique S, Murray Shawn B, Bosse Jordon D
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Department of Nursing, College of Health and Human Services, University of New Hampshire, Durham, New Hampshire, USA.
Int J Ment Health Nurs. 2025 Feb;34(1):e13455. doi: 10.1111/inm.13455. Epub 2024 Oct 22.
Lesbian, gay, bisexual, transgender, queer and other diverse sexual orientations and gender identity groups (LGBTQ+) face high rates of poor mental health. In the most severe and emergent of instances, inpatient psychiatric care may be required. LGBTQ+ people report experiences of mistreatment in healthcare settings broadly, such as denial of healthcare services and harassment from healthcare providers and other patients. However, little is known about the experiences of LGBTQ+ people in inpatient psychiatric care settings, specifically. The purpose of this review was to assess the existing literature for descriptions of LGBTQ+ people's experiences within inpatient psychiatric care. We searched multiple databases (i.e., PubMed, PsychINFO, CINAHL, Web of Science and Google Scholar) for peer-reviewed articles that described the experiences of LGBTQ+ people within inpatient psychiatric care that were published in English. The included articles (N = 14) were analysed using a conceptual model of stigma and organised within those strata (structural, interpersonal and individual stigma) across the inpatient experience, (admission, inpatient unit, and discharge). Themes identified included: noninclusive intake tools and pervasive misgendering during the admission process; lack of healthcare infrastructure, inadequate training and lack of cultural humility, pervasive discrimination and victimization, silencing of LGBTQ+ patients, and feelings of fear and shame while on inpatient units, and lack of community resources during the discharge process. Clinicians should consider the perspectives and experiences of LGBTQ+ people to enact identity-affirming care practices that may increase mental healthcare engagement and improve long-term mental health outcomes.
女同性恋、男同性恋、双性恋、跨性别、酷儿及其他多元性取向和性别认同群体（LGBTQ+）面临着心理健康状况不佳的高风险。在最严重和紧急的情况下，可能需要住院精神科护理。LGBTQ+群体广泛报告了在医疗环境中遭受虐待的经历，比如被拒绝提供医疗服务，以及受到医疗服务提供者和其他患者的骚扰。然而，对于LGBTQ+群体在住院精神科护理环境中的经历，具体情况却知之甚少。本综述的目的是评估现有文献中对LGBTQ+群体在住院精神科护理中的经历的描述。我们在多个数据库（即PubMed、PsychINFO、CINAHL、科学网和谷歌学术）中搜索了以英文发表的、描述LGBTQ+群体在住院精神科护理中的经历的同行评审文章。对纳入的文章（N = 14）使用污名概念模型进行分析，并按照住院经历（入院、住院部和出院）的这些层次（结构污名、人际污名和个体污名）进行组织。确定的主题包括：入院过程中不包容的入院工具和普遍的性别错称；缺乏医疗基础设施、培训不足和缺乏文化谦逊、普遍的歧视和受害情况、LGBTQ+患者被噤声、在住院部时的恐惧和羞耻感，以及出院过程中缺乏社区资源。临床医生应考虑LGBTQ+群体的观点和经历，以实施肯定身份的护理措施，这可能会增加精神卫生保健的参与度并改善长期心理健康结果。
