Messih, ‘Mental Health in LGBT Refugee populations’, 2017
- Category: Literature
- Source: Academic
- Subject: Sexual Orientation/Sexuality, Gender Identity, Refugee/Asylum
- Place: International, Americas, Other
- Year: 2017
- File: appi.ajp-rj.2016.110704
- URL: https://psychiatryonline.org/doi/10.1176/appi.ajp-rj.2016.110704
Mark Messih, ‘Mental Health in LGBT Refugee populations’, The American Journal of Psychiatry, 2017, Vol. 11, Issue 7
Abstract
Within the United States and globally, there has been a shift toward acceptance of lesbian, gay, bisexual, and transgender (LGBT) individuals. Despite these advances, many nations continue to stigmatize, criminalize, and legitimize abuse of these communities (1). Global statistics reflect high levels of violence targeting individuals based on sexual orientation and/or gender identity (2). Concurrently, the number of refugees seeking asylum within the United States is rising. In 2013, 69,909 refugees applied for asylum, an increase from 58,159 in 2012 (3). A total of 3.8%–10.0% of refugees entering the United States identify as LGBT (4), translating to approximately between 2,656 and 6,991 LGBT refugees. Studies have examined mental illness and service provision in refugees and on mental health in LGBT populations. Increasingly, researchers are looking at the intersection of these areas (5), focusing on mental illness in LGBT refugee communities. In the present article, the most commonly cited psychiatric conditions facing LGBT asylum seekers are presented. Next, the role of psychiatrists in the asylum-seeking process is reviewed. Finally, guidelines informed by existing literature are put forward to inform clinical care. Researchers working in psychiatry, psychology traumatology, social justice, and ethics have explored this topic in recent years. The present article examines mental illness grouped according to the “phases of exile” (6), that is, pre-flight, migration, and postmigration.
Literature on LGBT refugees has focused on the reported trauma experienced by this community and examined how this correlates with posttraumatic stress disorder (PTSD), anxiety, and depression. More broadly, literature on refugee mental illness has focused in a similar area but is growing to look at other illnesses with which patients may present. Refugees show increased rates of schizophrenia, autism, and generalized anxiety disorder (7). According to the Centers for Disease Control and Prevention, refugees have an increased prevalence of depression, somatization, traumatic brain injuries, and panic attacks (8). Furthermore, refugee stressors can be organized into four categories: traumatic stress, resettlement stress, acculturation stress, and isolation stress (see Table 1).