title: Pragmatic help seeking: How sexual and gender minority groups access mental health care in a rural state.
abstract: OBJECTIVE
  This qualitative study examined how lesbian, gay, bisexual, and transgender (LGBT) people in rural areas of the poor and multiethnic state of New Mexico access secular (professional and lay) and sacred (indigenous and Christian) mental health care resources.
  
  
  METHODS
  In-depth, semistructured interviews were used to document the help-seeking processes of 38 rural LGBT people.
  
  
  RESULTS
  Obtaining assistance was complicated by the ideal of self-reliance and the view of mental illness as a sign of weakness. Financial considerations and a lack of and community-based LGBT social networks also exerted substantial influence on help seeking. Many LGBT people would strategically remain silent about their sexuality or gender status and rely on their family ties to access the range of secular and sacred resources that are most commonly available in medically underserved rural communities.
  
  
  CONCLUSIONS
  Although persons from sexual and gender minority groups often experience positive outcomes as a result of help seeking, some LGBT people remain vulnerable to anti-LGBT sentiments that persist within secular and sacred sectors of rural health care systems.
authors.affiliation: Behavioral Health Research Center of the Southwest, 612 Encino Place, N.E., Albuquerque, New Mexico 87102, USA. cwillging@bhrcs.org
authors.forename: Cathleen E
authors.initials: CE
authors.lastname: Willging
authors.forename: Melina
authors.initials: M
authors.lastname: Salvador
authors.forename: Miria
authors.initials: M
authors.lastname: Kano
mesh_terms: D001727:Bisexuality / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006716:Homosexuality / Q000706:statistics & numerical data*; D006801:Humans; D001523:Mental Disorders / Q000208:ethnology* / Q000628:therapy; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data*; D009516:New Mexico; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D019035:Rural Health Services / Q000706:statistics & numerical data*; D014189:Transsexualism