Equitable access to mental health support for LGBTQ+ young people: an intersectional youth rights approach

Abstract

The global burden of young people’s poor mental health has stimulated increased attention on improving access to mental health services. However, young people are reluctant to seek help for mental health problems, and this is most often framed as an individual deficit. The power relations that disadvantage youth, such as age, gender, sexual orientation, race/ethnicity, and poverty, are rarely included in research. Our U.K. study made power central through a feminist intersectional youth-rights approach to improving accessibility for LGBTQ+ youth to mental health support. Using a case-study theory-driven evaluation methodology across 12 mental health support sites, data were collected via (a) interviews with LGBTQ+ youth, parents, and staff; (b) documentary review; and (c) nonparticipant observation. Data analysis involved a multiphase “explanation-building” analytical technique. We found that to improve access, power must be addressed across four domains: (a) structurally through provision of well resourced, legitimated services; (b) culturally by building cultural safety for LGBTQ+ identities; (c) disciplinary by designing services that not burden youth; and (d) interpersonal through open relationships that provide comfortable engagement. Equitable access requires policy and practice to take a feminist intersectional youth-rights approach that tackle the multiple power relations that make LGBTQ+ youth hesitant about help-seeking.

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