Sexual Minority Women in Treatment for Serious Mental Illness: A Literature Review

Abstract

The treatment of the seriously mentally ill tends toward homogeneity and often does not focus on unique needs. The aim of this article is to review the literature specifically relevant to the treatment of sexual minority women in ongoing, outpatient care for serious mental illness (SMI). Medical and psychosocial databases (2000–2015) were searched by entering search terms focused on treatment issues in both qualitative and quantitative studies relevant to this topic. The emphasis in the literature was found to be the extent and severity of minority stress experienced by sexual minority women in psychiatric treatment. Chief therapeutic concerns were establishment of a therapeutic relationship, conflicts over whether or not to disclose sexual orientation to staff and to family and to fellow patients, depression and self-harm, abuse of substances, difficulties with intimacy, domestic clashes with partners and relatives, and legal questions unique to this population. Women who suffer from SMI and who, at the same time, belong to an additional stigmatized group, are exposed to double discrimination that needs to be recognized and effectively targeted.

KEYWORDS:

• serious mental illness
• sexual minority
• disclosure
• stigma