Knowledge and attitudes of mental health providers towards LGBTQ+ individuals: A mixed methods systematic review.

Introduction. Lesbian, gay, bisexual, transgender and queer (LGBTQ+) people are less likely to access health care and utilize mental health services than their cisgender, heterosexual counterparts. Additionally, they are more likely to report an unmet need for care due to experiences of heterosexism and cisgenderism in healthcare settings. According to the Culturally Competent Compassion Model, deficiencies in skills and knowledge, as well as negative attitudes and behaviors among healthcare professionals, are linked to reduced likelihood of LGBTQ+ individuals seeking healthcare services. Similar mechanisms could also expand onto mental health settings, with detrimental effects on LGBTQ+ people, who have higher rates of mental disorders than the general population. For these reasons, a mixed methods systematic review was conducted to address knowledge gaps and attitudes of mental health providers (MHP) towards the LGBTQ+ individuals and their effects on service utilization. Methods. The review was conducted in compliance with the PRISMA guidelines. Empirical qualitative and quantitative studies investigating knowledge and attitudes of MHP towards the LGBTQ+ population were searched using a predefined algorithm in 5 databases (PsycInfo, PsycArticles, PubMed, Scopus, Web of Science). Retrieved articles underwent a screening process and, after the application of predetermined inclusion and exclusion criteria, 32 articles were identified. Results. Identified articles are consistent in showing generally positive attitudes towards the LGBTQ+ individuals among MHP as well as being comfortable in working with LGBTQ+ patients. On the other hand, retrieved literature highlighted several gaps regarding MHP knowledge when working with LGBTQ+ patients, including feelings of being inadequately skilled, lack of competence, and low clinical preparedness in addressing specific needs of the LGBTQ+ patients, inadequacy of available training and the desire of further LGBTQ+ education. Discussion. MHP generally hold positive attitudes towards LGBTQ+ individuals but lack the knowledge and skills to address their specific needs effectively. Efforts to promote inclusivity and cultural competence at organizational and educational levels are thus crucial to improving care for LGBTQ+ patients, as addressing knowledge gaps may reduce disparities in access to mental health services for this population.