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. 2019 Sep;144(3):e20183367.
doi: 10.1542/peds.2018-3367. Epub 2019 Aug 19.

Mental Health, Drug, and Violence Interventions for Sexual/Gender Minorities: A Systematic Review

Robert W S Coulter  1   2   3   4 , James E Egan  1   2 , Suzanne Kinsky  1   2   5 , M Reuel Friedman  2   6 , Kristen L Eckstrand  7 , Jessica Frankeberger  1 , Barbara L Folb  1   8 , Christina Mair  1 , Nina Markovic  2   9 , Anthony Silvestre  2 , Ron Stall  1   2 , Elizabeth Miller  1   4
Affiliations

Mental Health, Drug, and Violence Interventions for Sexual/Gender Minorities: A Systematic Review

Robert W S Coulter et al. Pediatrics. 2019 Sep.

Abstract

Context: Compared with cisgender (nontransgender), heterosexual youth, sexual and gender minority youth (SGMY) experience great inequities in substance use, mental health problems, and violence victimization, thereby making them a priority population for interventions.

Objective: To systematically review interventions and their effectiveness in preventing or reducing substance use, mental health problems, and violence victimization among SGMY.

Data sources: PubMed, PsycINFO, and Education Resources Information Center.

Study selection: Selected studies were published from January 2000 to 2019, included randomized and nonrandomized designs with pretest and posttest data, and assessed substance use, mental health problems, or violence victimization outcomes among SGMY.

Data extraction: Data extracted were intervention descriptions, sample details, measurements, results, and methodologic rigor.

Results: With this review, we identified 9 interventions for mental health, 2 for substance use, and 1 for violence victimization. One SGMY-inclusive intervention examined coordinated mental health services. Five sexual minority-specific interventions included multiple state-level policy interventions, a therapist-administered family-based intervention, a computer-based intervention, and an online intervention. Three gender minority-specific interventions included transition-related gender-affirming care interventions. All interventions improved mental health outcomes, 2 reduced substance use, and 1 reduced bullying victimization. One study had strong methodologic quality, but the remaining studies' results must be interpreted cautiously because of suboptimal methodologic quality.

Limitations: There exists a small collection of diverse interventions for reducing substance use, mental health problems, and violence victimization among SGMY.

Conclusions: The dearth of interventions identified in this review is likely insufficient to mitigate the substantial inequities in substance use, mental health problems, and violence among SGMY.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Flow diagram of literature searches and review process results. The specific reasons for exclusion of records at the title and abstract screening level were not recorded. ERIC, Education Resources Information Center; LGBT, lesbian, gay, bisexual, and transgender.
See this image and copyright information in PMC

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