Reducing LGBTQ+ adolescent mental health inequalities: A realist review of school-based interventions

Elizabeth McDermott*, Alex Kaley, Eileen Kaner, Mark Limmer, Ruth McGovern, Felix McNulty, Rosie Nelson, Liam Spencer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Background
LGBTQ+ young people have elevated rates of poor mental health in comparison to their cisgender heterosexual peers. School environment is a key risk factor and consistently associated with negative mental health outcomes for LGBTQ+ adolescents.

Aims
To examine how, why, for whom and in what context school-based interventions prevent or reduce mental health problems in LGBTQ+ adolescents.

Methods
A realist review methodology was utilised and focused on all types of school-based interventions and study designs. A Youth Advisory Group were part of the research team. Multiple search strategies were used to locate relevant evidence. Studies were subject to inclusion criteria and quality appraisal, and included studies were synthesised to produce a programme theory. Seventeen studies were included in the review.

Results
Eight intervention components were necessary to address LGBTQ+ pupils mental health: affirmative visual displays; external signposting to LGBTQ+ support; stand-alone input; school-based LGBTQ support groups; curriculum-based delivery; staff training; inclusion policies; trusted adult. Few school-based interventions for this population group were identified.

Conclusions
The programme theory indicates that “to work” school-based interventions must have a “whole-school” approach that addresses specifically the dominant cis-heteronormative school environment and hence the marginalisation, silence, and victimisation that LGBTQ+ pupils can experience.
Original languageEnglish
Number of pages11
JournalJournal of Mental Health
Early online date17 Aug 2023
DOIs
Publication statusE-pub ahead of print - 17 Aug 2023

Keywords

  • lGBtQ+
  • youth
  • adolescent
  • schools
  • mental health

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