Queer conversations: improving access to, and quality of, mental health services for same-sex-attracted clients

Lesbian, gay and bisexual (LGB) people have a higher prevalence of psychiatric problems. This is considered as a consequence of marginalisation of homosexuality. Despite much research and literature on lesbian and gay mental health, important questions remain largely unexplored regarding public mental health services (PMHS) for LGB. Two such questions are: Do clients feel able to disclose issues regarding sexual orientation to psychiatric services? How do PMHS services enable or hinder this? Foucauldian discourse analysis was used to explore these questions. Interviews were conducted with 13 same-sex-attracted male clients and 12 LGB staff in PMHS in New Zealand. Findings were that staff in PMHS rarely ask clients about sexual orientation. Correspondingly many clients report considerable difficulty disclosing their sexual orientation in PMHS, even when it is relevant to their mental health issues. The social and systemic conditions which create this barrier to effective treatment for LGB clients are explored. Practical suggestions are made for how staff in PMHS can raise the topic of sexual orientation with clients thereby improving access to and quality of treatment to LGB clients