A mixed-method study exploring the mental health problems of a diverse LGB community in the UK: a focus on the experiences of BAME LGB individuals

Mental health inequalities among Black, Asian and Minority Ethnic (BAME) people from lesbian, gay and bisexual (LGB) communities remain under-researched. Existing literature in the UK highlights increased rates of mental illness in both LGB (predominantly White) and BAME (predominantly heterosexual) communities. Both groups experience disadvantages and discrimination within society which contributes to their poor mental health (Pascoe & Richman, 2009) albeit; It is not known whether these findings are relevant across the LGB BAME community. This study is the first in the UK to explore the mental health problems of LGB BAME people using a mixed-method approach as well as simultaneously exploring gender differences within the BAME LGB group. The aim of the study is to generate knowledge and understanding of poor mental health among BAME LGB people in the UK. In stage 1, semi-structured interviews with 23 key informants scoped the current psycho-social challenges among LGB BAME communities. Data were analysed using thematic analysis and guided by the minority stress framework yielding the following themes: (1) Stress-induced by conflicting sociocultural norms, (2) interpersonal inhibitors of coming out, (3) Methods of coping (4) service access mediates inequalities in mental health (5) lived experiences of ‘coming out’. LGB BAME individuals are exposed to stressors due to their intersecting sexual, gender, religious, and cultural identities. Findings from stage 1, informed the online questionnaire developed using the Qualtrics survey tool and utilised in stage 2 to assess the prevalence of mental illness in a diverse LGB population. 289 White LGB (N = 188) and BAME LGB (N = 101) individuals participated in a cross-sectional survey and completed validated measures of poor mental health: depression, psychological distress, and suicidality; stressful experiences: discrimination, rejection, victimization, internalised homophobia, concealment motivation and degree of outness; and coping: help-seeking and substance use. Independent sample T-tests and Chi-Square analysis indicate higher experiences of minority stress and substance use among BAME LGB participants. However, no differences on CESD-10, Suicide, and Kessler psychological distress scale, were found between BAME and White LGB sample. Regression models found risk factors to mental health differed among BAME and White LGB groups. Additionally, quantitative data makes a critical contribution to address the gap in knowledge on the mental health problems of LB BAME women by integrating the intersectional framework with Minority Stress Theory (Meyer, 2003), this study contrasts the experiences of LGB BAME men and women and recognises the interlocking nature of social categories to foreground LB BAME women and poor mental health. The frequency of self-harm and suicide risk behaviour was significantly higher among LB BAME women than GB BAME men and White LGB men and women. Using comparative analysis, the quantitative data demonstrated the way in which gender and ethnicity interact and serve as meaningful categories to predict poor mental health and stress by ethnicity (e.g. BAME vs White) and gender (e.g. BAME men VS BAME women). This study contributes to the knowledge gap around the unique experiences of BAME LGB people and sets the scene for new research directions on social, psychological experiences and coping resources for LGB BAME individuals.