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Mental health among UK inner city non-heterosexuals: the role of risk factors, protective factors and place

Published online by Cambridge University Press:  12 August 2015

C. Woodhead ,
B. Gazard ,
M. Hotopf ,
Q. Rahman ,
K. A. Rimes  and
S. L. Hatch
C. Woodhead*
Affiliation:
Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
B. Gazard
Affiliation:
Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
M. Hotopf
Affiliation:
Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Q. Rahman
Affiliation:
Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
K. A. Rimes
Affiliation:
Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
S. L. Hatch
Affiliation:
Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
*
*Address for correspondence: Dr Charlotte Woodhead, Department of Applied Health Research, 1-19 Torrington Place, London, WC1E 7HB. (Email: c.woodhead@ucl.ac.uk)
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Abstract

Background.

Sexual minorities experience excess psychological ill health globally, yet the UK data exploring reasons for poor mental health among sexual minorities is lacking. This study compares the prevalence of a measure of well-being, symptoms of common mental disorder (CMD), lifetime suicidal ideation, harmful alcohol and drug use among inner city non-heterosexual and heterosexual individuals. It is the first UK study which aims to quantify how much major, everyday and anticipated discrimination; lifetime and childhood trauma; and coping strategies for dealing with unfair treatment, predict excess mental ill health among non-heterosexuals. Further, inner city and national outcomes are compared.

Methods.

Self-report survey data came from the South East London Community Health study (N = 1052) and the Adult Psychiatric Morbidity Survey (N = 7403).

Results.

Adjustments for greater exposure to measured experiences of discrimination and lifetime and childhood trauma had a small to moderate impact on effect sizes for adverse health outcomes though in fully adjusted models, non-heterosexual orientation remained strongly associated with CMD, lifetime suicidal ideation, harmful alcohol and drug use. There was limited support for the hypothesis that measured coping strategies might mediate some of these associations. The inner city sample had poorer mental health overall compared with the national sample and the discrepancy was larger for non-heterosexuals than heterosexuals.

Conclusions.

Childhood and adult adversity substantially influence but do not account for sexual orientation-related mental health disparities. Longitudinal work taking a life course approach with more specific measures of discrimination and coping is required to further understand these associations. Sexual minorities should be considered as a priority in the design and delivery of health and social services.

Keywords

Cross cultural psychiatrydiscriminationepidemiologymental healthminority issues
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 25 , Issue 5 , October 2016 , pp. 450 - 461
Copyright
Copyright © Cambridge University Press 2015 

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