LGBTQ+ Peer Mental Health Support Preferences: Perspectives of Sexual Minority Women and the Professionals Who Support Them

Background and Purpose: Sexual minority women (SMW; e.g. lesbian, bisexual, queer, or non-heterosexual people who identify as women, including those who are cisgender, transgender, and gender expansive) experience mental health disparities, such as higher rates of anxiety and depression symptoms, relative to their heterosexual counterparts. Peer mental health support interventions are a promising, but under-researched approach to mitigate these disparities. In the formative stage of a community-engaged program development project in Upstate New York called LGBTQ SOLACE (Support, Opportunities for Learning, and Community Empowerment), we explored the needs, desires, and preferences for peer mental health support initiatives for SMW. Research questions were 1) What kinds of peer mental health support do sexual minority women desire and do their care providers recommend? and 2) What is the preferred delivery of these activities or services, in terms of group size, composition, location, leadership, and other programmatic logistics?

Methods: Semi-structured audio individual interviews were conducted with a purposive sample of 18 helping professionals who work with SMW in Upstate New York, most of whom provide 1x1 or small group mental health services within private practices or community-based agencies. Additionally, seven focus groups were conducted with a total of 48 self-identified SMW who reported past or current experiences of depression and/or anxiety. Focus group sessions were tailored to those living rurally, transgender and gender expansive women, queer and transgender women of color, bisexual and pansexual women, respectively, along with general focus groups. Focus groups and interviews were audio recorded, automatically transcribed, then audited and corrected by research assistants. The focus group and interview data were combined for analysis in Dedoose and thematically analyzed (Braun & Clarke, 2006) by three members of the research team.

Results: There was notable diversity in the needs and preferences for the types of and delivery of peer mental health support activities for SMW along demographic lines. The kinds of peer mental health support desired by SMW or recommended by their care providers included 1) Supporting and receiving support from other LGBTQ+ people; 2) Quality connections with other LGBTQ+ people; 3) Seeking and building a sense of LGBTQ+ community; and 4) Desiring specific group activities. Preferences for the delivery of these activities included 1) Financial and insurance accessibility; 2) Mixed preferences for meeting location and delivery modality, 3) Mixed preferences for group size; 4) Similarity of Group Members; and 5) Groups as a “safe space”. Those living rurally, living with disabilities, SMW of color, transgender and gender expansive SMW reported access and safety needs critical to their ability to take part in peer mental health support initiatives.

Conclusions and Implications: Flexible and varied opportunities for engaging in these initiatives, including both in person and Zoom-based options, are clearly needed to ensure accessibility to the diverse community of SMW. These findings both expand the research literature on LGBTQ+ peer support and will shape the development of a new LGBTQ+ specific peer mental health support training and community capacity-building initiative for SMW in Upstate New York.