Recommendations for the assessment of sexual and gender minority status in serious mental illness research and clinical care.

Sexual and gender minority (SGM) groups experience exposure to minority stress, including discrimination, prejudice, microaggressions, and internalized stigma. Despite the sizable portion of the United States' population that identifies as SGM, relatively little research has been done to comprehensively understand the mental health consequences of SGM stress-particularly as they relate to serious mental illnesses (SMIs)-and SGM status is rarely reported in published studies. This article provides an overview of SGM research among people with SMIs as well as other relevant disorders. Findings show that sizable gaps remain in our knowledge of whether SGM groups experience higher rates or greater severity of SMIs, including schizophrenia-spectrum and bipolar disorders, though findings related to depressive and trauma-related disorders may be able to inform research and treatment for those with SMIs. To increase our understanding of potential mental health disparities for those with SMIs, researchers are encouraged to include measures to assess SGM identity, report upon this demographic information within their manuscripts, and examine differences in rates and severity of SMIs between these groups. Clinicians are encouraged to incorporate demographic questions into their standard intake batteries and initiate discussion of SGM status and minority stressors early on in treatment to promote more positive outcomes for this group. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Consumer and relationship factors associated with shared decision making in mental health consultations.

OBJECTIVE: This study explored the association between shared decision making and consumers' illness management skills and consumer-provider relationships. METHODS: Medication management appointments for 79 consumers were audio recorded. Independent coders rated overall shared decision making, minimum level of shared decision making, and consumer-provider agreement for 63 clients whose visit included a treatment decision. Mental health diagnoses, medication adherence, patient activation, illness management, working alliance, and length of consumer-provider relationships were also assessed. Correlation analyses were used to determine relationships among measures. RESULTS: Overall shared decision making was not associated with any variables. Minimum levels of shared decision making were associated with higher scores on the bond subscale of the Working Alliance Inventory, indicating a higher degree of liking and trust, and with better medication adherence. Agreement was associated with shorter consumer-provider relationships. CONCLUSIONS: Consumer-provider relationships and shared decision making might have a more nuanced association than originally thought.

Why are you here again? Concordance between consumers and providers about the primary concern in recurring psychiatric visits.

Patient-centered care has become increasingly important over the last decade, both in physical and mental health care. In support of patient-centered care, providers need to understand consumers׳ primary concerns during treatment visits. The current study explored what primary concerns were brought to recurring psychiatric visits for a sample of adults with severe mental illness (N=164), whether these concerns were concordant with those recognized by providers, and which factors predicted concordance. We identified 17 types of primary concerns, most commonly medications and symptoms, with only 50% of visits showing evidence of at least partial agreement between consumers and providers. Contrary to expectations, consumer demographics, activation, trust, and perceptions of patient-centeredness were not predictive, while greater preferences for autonomy predicted poorer agreement. Our findings highlight the need for interventions to promote a shared understanding of primary concerns in recurring psychiatric visits. Further attention is needed to ensure the provision of patient-centered care such that consumer concerns are acknowledged and addressed within recurring psychiatric visits.