title: Effects of perceived discrimination on mental health and mental health services utilization among gay, lesbian, bisexual and transgender persons.
abstract: OBJECTIVE
  Previous research has found that lesbian, gay, bisexual and transgender (LGBT) individuals are at risk for a variety of mental health disorders. We examined the extent to which a recent experience of a major discriminatory event may contribute to poor mental health among LGBT persons.
  
  
  METHODS
  Data were derived from a cross-sectional strata-cluster survey of adults in Hennepin County, Minnesota, who identified as LGBT (n=472) or heterosexual (n=7,412).
  
  
  RESULTS
  Compared to heterosexuals, LGBT individuals had poorer mental health (higher levels of psychological distress, greater likelihood of having a diagnosis of depression or anxiety, greater perceived mental health needs, and greater use of mental health services), more substance use (higher levels of binge drinking, greater likelihood of being a smoker and greater number of cigarettes smoked per day), and were more likely to report unmet mental healthcare needs. LGBT individuals were also more likely to report having experienced a major incident of discrimination over the past year than heterosexual individuals. Although perceived discrimination was associated with almost all of the indicators of mental health and utilization of mental health care that we examined, adjusting for discrimination did not significantly reduce mental health disparities between heterosexual and LGBT persons.
  
  
  CONCLUSIONS
  LGBT individuals experienced more major discrimination and reported worse mental health than heterosexuals, but discrimination did not account for this disparity. Future research should explore additional forms of discrimination and additional stressors associated with minority sexual orientation that may account for these disparities.
authors.affiliation: Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, One Veterans Drive, Minneapolis, MN 55417, USA. Diana.Burgess@va.gov
authors.forename: Diana
authors.initials: D
authors.lastname: Burgess
authors.forename: Alisia
authors.initials: A
authors.lastname: Tran
authors.forename: Richard
authors.initials: R
authors.lastname: Lee
authors.forename: Michelle
authors.initials: M
authors.lastname: van Ryn
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D019964:Mood Disorders / Q000453:epidemiology*; D010465:Perception; D011287:Prejudice; D019529:Sexuality / Q000523:psychology*; D012907:Smoking / Q000453:epidemiology*