Barriers and facilitators to mental health care access and engagement for LGBTQA+ people with psychosis: A scoping review.

LGBTQA+ individuals are at increased risk of experiencing psychosis and face barriers in accessing appropriate and timely mental health support. This scoping review maps the existing literature to identify barriers and facilitators to access and engagement to care for LGBTQA+ people across the psychosis spectrum. Select databases and grey literature were searched up to May 2024. Following screening according to pre-determined eligibility criteria, 37 papers were included in this review. A total of 89 barriers and 63 facilitators to mental health care were identified. Using inductive thematic analysis, five themes were developed to synthesise these items: (1) service-related factors, (2) stigma, (3) social networks, (4) personal factors, and (5) psychosis-related factors. These findings illustrate the complex interplay of factors affecting pathways to care in this population and highlight the significance of intersectionality. Improving LGBTQA+ and psychosis competencies in the public and in services that support these populations may enable earlier detection of psychosis and provision of effective care. Scoping review registration: This protocol is registered in Open Science Framework Registries (https://doi.org/10.17605/OSF.IO/AT6FC).