"Being There" vs "Being Direct:" Perspectives of Persons with Serious Mental Illness on Receiving Support with Physical Health from Peer and Non-Peer Providers.

Individuals with serious mental illness (SMI) face significant health disparities and multiple barriers to engaging in health behavior change. To reduce these health disparities, it is necessary to enhance the support individuals with SMI receive through the collaboration of different healthcare providers. This study explored how people with SMI living in supportive housing perceived receiving support from peer and non-peer providers for their physical health. Qualitative interviews were conducted with 28 participants receiving a peer-led healthy lifestyle intervention in the context of a randomized trial in supportive housing agencies. Interviews explored participants' experiences working with the healthy lifestyle peer specialist and a non-peer provider who assisted them with health. Interviews were audio recorded, transcribed, and analyzed using strategies rooted in grounded theory. Participants viewed their relationships with peer and non-peer providers positively, but described differences in the approach to practice, power dynamics present, and how they identified with each provider. Participants described peers as process-oriented while non-peer staff as task-oriented, focusing on accomplishing concrete objectives. Each provider sought to boost participants' motivation, but peers built hope by emphasizing the possibility of change, while non-peer providers emphasized the consequences of inaction. Participants related to peer staff through shared experiences, while identifying the importance of having a shared treatment goal with their non-peer provider. Overall, participants appreciated the unique roles of both peer and non-peer staff in supporting their health. Study findings have implications for integrating the use of peer-based health interventions to improve the health of people with SMI.

Mental health and substance use among sexual minority women who report childhood sexual abuse: A systematic literature review.

OBJECTIVE: A growing body of literature provides evidence that sexual minority women (SMW; e.g., lesbian, bisexual) are at greater risk of negative mental health and substance use outcomes than are heterosexual women. While minority stress may partially explain these disparities, it does not fully account for them. Therefore, it is necessary to identify how other risk factors (i.e., childhood sexual abuse [CSA]) contribute to SMW's increased risk of negative mental health and substance use outcomes. METHOD: We conducted a systematic literature review to identify and synthesize the state of knowledge about CSA and mental health and substance use outcomes among SMW. Two independent reviewers screened 347 articles identified in searches of five databases (Web of Science, PsycInfo, CINAHL, PubMed, and Embase). Eligible articles were peer-reviewed, reported quantitative or mixed methods results focused on mental health or substance use outcomes among adult SMW with a history of CSA. RESULTS: Twenty-four papers were included in the review. Findings clearly show that SMW report higher rates of CSA than heterosexual women. Findings also suggest that CSA may mediate the relationship between minority sexual identity and some negative outcomes. CONCLUSIONS: Future studies should include minority stress factors, a broader range of mental health outcomes (apart from substance use and suicide), and more nuanced measures of CSA. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Understanding Factors Associated with Suicidality Among Transgender and Gender-Diverse Identified Youth.

Purpose: Individuals who identify as transgender and gender-diverse (TGD) experience heightened rates of mental health challenges compared with cisgender people (including both heterosexual and lesbian, gay, and bisexual individuals). Furthermore, adolescence has been identified as a critical period for intervention as the majority of suicide attempts occur during this time period. However, no study to date has synthesized prior literature to understand the correlates of suicidal behavior among TGD youth, which is an essential step needed to inform intervention development and reduce suicidal behaviors in this community. Methods: Three databases were searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method to assess eligibility for study inclusion. Five studies met full inclusion criteria. Results: Analyses revealed a consistent relationship across studies between suicidal behaviors and symptoms of depression, gender-based victimization, and bullying, and lack of parental support. Conclusions: Consistent with minority stress theory, this systematic review demonstrates that identification as TGD is associated with increased environmental stressors, highlighting the importance of considering both individual and contextual factors in the development of mental health interventions for TGD youth. Given the significance of findings related to the association between both depression and gender-based victimization and suicidal behavior, it is critical to advocate for the destigmatization of noncisgender identities through policy-level change.