Navigating Mental Health Frontiers: A Scoping Review of Accessibility for Rural LGBTIQA+ Communities

Area of Science:

• Public Health
• Mental Health Services Research
• Rural Health Disparities

Background:

• Mental healthcare access for LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual, and others) populations in rural settings is inequitable.
• Existing societal progress towards inclusivity has not translated into equal mental health care access in rural areas.
• Rural LGBTQIA+ individuals encounter unique obstacles including limited services, workforce shortages, and travel burdens, worsening mental health inequities.

Purpose of the Study:

• To examine the specific obstacles faced by LGBTQIA+ individuals in accessing mental healthcare in rural areas.
• To identify discrepancies in the approachability, acceptability, availability, affordability, and appropriateness of rural mental health services for this population.
• To highlight the need for targeted interventions to enhance rural mental health access for sexual and gender minorities.

Main Methods:

• Systematic review following the Joanna Briggs Institute methodology.
• Extensive literature search across SCOPUS, EBSCO Host (All), and Ovid databases, yielding 2373 articles.
• Selection of 21 articles from five countries, predominantly utilizing qualitative interviews and quantitative online surveys, analyzed through the Lévesque framework.

Main Results:

• Analysis revealed complex challenges for LGBTQIA+ individuals in rural mental healthcare settings.
• Key barriers identified include geographical isolation, discrimination, lack of LGBTQIA+-attuned professionals, societal stigma, and economic constraints.
• Significant discrepancies were found in the approachability, acceptability, availability, affordability, and appropriateness of services.

Conclusions:

• Rural LGBTQIA+ populations experience substantial barriers to accessing and engaging with mental health services.
• Geographical isolation, discrimination, and a deficit of culturally competent professionals exacerbate mental health inequities.
• Purposeful, targeted interventions are essential to improve the accessibility and quality of rural mental healthcare for sexual and gender minorities.