Mental Illness Discrimination and Support Experienced by People Who Are of Color and/or LGB: Considering Intersecting Identities

• Published in: American journal of orthopsychiatry 2019, Vol.89 (1), p.16-26
• Main Authors: Holley, Lynn C., Oh, Hyunsung, Thomas, De'Shay
• Format: Article
• Language: English
• Subjects: Adult; Attitude of Health Personnel; Bisexuality; Communities; Cultural identity; Discrimination; Ethnic groups; Ethnic Groups - psychology; Ethnic Identity; Ethnicity; Families & family life; Family Members; Female; Gays & lesbians; Health problems; Heterosexism; Homosexuality; Human; Humanization; Humans; Intersectionality; Interviews as Topic; Lesbianism; Male; Male Homosexuality; Mental Disorders; Mental Disorders - psychology; Mental health; Middle Aged; Peer Relations; Peer Support; Prejudice; Psychological Theory; Qualitative research; Racial differences; Racism; Sexual and Gender Minorities - psychology; Sexual Orientation; Sexuality; Social Identification; Social Support; Stereotypes; Stigma; Test Construction; Young Adult
• ISSN: 0002-9432; 1939-0025
• DOI: 10.1037/ort0000360

Little is known about mental illness discrimination toward and supports for people with mental health conditions (MHCs) who are of color and/or lesbian, gay, or bisexual (LGB). Informed by an intersectionality framework that facilitates an understanding of intragroup dynamics, this exploratory qualitative study used in-depth interviews to ask 20 people with MHCs and family members of people with MHCs who also identified as of color and/or LGB about their experiences (a) with mental illness discrimination and supports within their identity communities and (b) in peer- and family-run programs. Participants of color reported that their racial−ethnic communities commonly deny that MHCs exist and shame people with MHCs, and LGB participants said that LGB communities often exclude and stereotype them. Interactions with others with MHCs and affirmation of lesbian and gay identities serve as recovery supports within identity communities. Peer- and family-run programs provide a sense of humanization and education, respectively but are sites of heterosexism and may not address the needs of people of color; identity-specific programs are therefore desired. We describe variations in experiences related to race, ethnicity, and sexuality intersections; no differences in descriptions of mental illness discrimination in the focal identity communities emerged between people with MHCs versus family members. Implications include that efforts are needed to address discrimination in identity communities and peer- and family-run programs, and service providers need to recognize that identity intersections affect experiences with discrimination and supports. Public Policy Relevance Statement Little is known about the experiences of people of color or lesbian, gay, and bisexual people with mental illness discrimination or support within their racial−ethnic communities, sexuality communities, or peer- and family-run programs. This exploratory study found that mental illness discrimination was common, that supports were often inadequate within these identity communities, and that participants desired identity-specific peer- and family-run programs. Policymakers in public behavioral health systems can consider developing identity-specific peer- and family-run programs and antidiscrimination campaigns tailored to address the beliefs, attitudes, and behaviors of different identity communities.