Improving LGBTQ+ youth mental health through integration of care: a Foucauldian Discourse Analysis of qualitative data from Queer Futures 2 study

通过整合护理改善 LGBTQ 青少年心理健康：对酷儿未来 2 研究定性数据的福柯话语分析

• 批准号: ES/X013324/1
• 负责人: Rachael Eastham
• 金额: $ 14.58万
• 依托单位: Lancaster University
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FX013324%2F1
• 关键词: Improving; LGBTQ+; youth; mental; health

The mental health of children and young people is a global priority. In the UK, the new NHS policy that integrates care is proposed to improve services and tackle health inequalities. Understanding barriers and facilitators to integration will help support mental health service delivery in line with this strategy. Success here is important for LGBTQ+ young people who experience poor mental health compared to young people that are cis-gender (i.e. whose gender aligns with their sex assigned at birth) and heterosexual (i.e. 'straight'). This situation for LGBTQ+ young people's is an inequality. It is explained by the fact that LGBTQ+ young people experience discrimination and marginalisation that impact their mental health. Subsequently, they are often unable to use existing mainstream mental health support services due to fear of judgment or having their sexual orientation shared with their parents/carers without their consent. Despite the evidence, many providers are unaware of LGBTQ+ young people's needs and how to help them. The Queer Futures 2 study identified different types of service that provide mental health support for LGBTQ+ young people e.g. schools, NHS and LGBTQ+ youth services. However, we also identified these services can differ in the how they understand LGBTQ+ young people and their needs. For example, some NHS providers reported that they did not consider specialist care was necessary for LGBTQ+ young people as NHS services are 'open to all.' But we know this is not perceived to be the case from the perspective of LGBTQ+ young people. Further, LGBTQ+ youth services reported how statutory services like social services, lacked understanding about LGBTQ+ identities conflating being LGBTQ+ with safeguarding issues and thus responding in ways that can be damaging to LGBTQ+ youth. Successful integration of care requires shared organisational priorities and good communication. However, what this means in the context of LGBTQ+ young people's mental health is so far unexplored. This proposed secondary analysis presents an opportunity to understand the relationships, communication and power dynamics across the LGBTQ+ youth mental health support sector. This is important to ensure that the best type of mental health support is available to LGBTQ+ young people. This will help address this significant health inequity. The way this project will achieve this understanding is by using a research method called Foucauldian Discourse Analysis to analyse the Queer Futures 2 qualitative data set which includes:- 41 interviews with staff from LGBTQ+ youth mental health services;- 45 interviews with LGBTQ+ youth;- Document data from 12 services e.g. policy and referral forms; and- Non-participant observation data.This method is suitable because it will help us think about the different meanings and power dynamics across the support system. The analysis will be co-designed by the research team and project steering group. The research team comprises academics and staff from LGBTQ+ mental health support services from Queer Futures 2. The project steering group will involve individuals invited to reflect different types of support relevant to the conversation about integration of care for LGBTQ+ youth mental health including: the national LGBTQ+ campaigning organisation Stonewall, LGBTQ+ young people, NHS mental health providers and education providers.The findings about barriers and facilitators to LGBTQ+ youth mental health integration of care will be used to co-design a 'speaking the same language' digital resource (e.g. animation) that will focus on aligning understanding and communication about LGBTQ+ youth and their mental health needs. This resource will be shared via national LGBTQ+ and clinical networks e.g. Stonewall, LGBT Consortium; and on the Queer Futures 2 website for free. We will also write a report, two articles for academic journals and visit conferences to share what we lear

儿童和青少年的心理健康是全球的优先事项。在英国，提出了整合护理的新 NHS 政策，以改善服务并解决健康不平等问题。了解融合的障碍和促进因素将有助于支持根据这一战略提供心理健康服务。对于 LGBTQ+ 年轻人来说，与顺性别（即其性别与出生时指定的性别一致）和异性恋（即“异性恋”）年轻人相比，他们的心理健康状况较差，在这里取得成功非常重要。这种情况对于 LGBTQ+ 年轻人来说是一种不平等。这是因为 LGBTQ+ 年轻人遭受歧视和边缘化，影响了他们的心理健康。随后，由于害怕受到评判或未经父母/照顾者同意而与父母/照顾者分享自己的性取向，他们往往无法使用现有的主流心理健康支持服务。尽管有证据，但许多提供者并不了解 LGBTQ+ 年轻人的需求以及如何帮助他们。 Queer Futures 2 研究确定了为 LGBTQ+ 年轻人提供心理健康支持的不同类型的服务，例如：学校、NHS 和 LGBTQ+ 青少年服务。然而，我们还发现这些服务在理解 LGBTQ+ 年轻人及其需求的方式上可能有所不同。例如，一些 NHS 提供者报告称，他们认为 LGBTQ+ 年轻人不需要专科护理，因为 NHS 服务“向所有人开放”。但我们知道，从 LGBTQ+ 年轻人的角度来看，情况并非如此。此外，LGBTQ+ 青年服务机构报告称，社会服务等法定服务机构缺乏对 LGBTQ+ 身份的了解，将 LGBTQ+ 身份与保护问题混为一谈，从而以可能损害 LGBTQ+ 青年的方式做出反应。护理的成功整合需要共同的组织优先事项和良好的沟通。然而，这对于 LGBTQ+ 年轻人的心理健康意味着什么，目前尚未被探索。这项拟议的二次分析提供了一个了解 LGBTQ+ 青少年心理健康支持部门的关系、沟通和权力动态的机会。这对于确保 LGBTQ+ 年轻人获得最佳类型的心理健康支持非常重要。这将有助于解决这种严重的健康不平等问题。该项目实现这一理解的方式是使用一种名为福柯话语分析的研究方法来分析酷儿未来 2 定性数据集，其中包括：- 对 LGBTQ+ 青少年心理健康服务工作人员的 41 次访谈；- 对 LGBTQ+ 青少年的 45 次访谈；-来自 12 项服务的文档数据，例如政策和转介表格； - 非参与者观察数据。这种方法很合适，因为它将帮助我们思考整个支持系统的不同含义和权力动态。该分析将由研究团队和项目指导小组共同设计。研究团队由 Queer Futures 2 的 LGBTQ+ 心理健康支持服务机构的学者和工作人员组成。项目指导小组将邀请个人反映与 LGBTQ+ 青少年心理健康护理整合对话相关的不同类型的支持，包括：国家 LGBTQ+运动组织 Stonewall、LGBTQ+ 年轻人、NHS 心理健康提供者和教育提供者。有关 LGBTQ+ 青少年心理健康整合护理的障碍和促进因素的调查结果将用于共同设计“说同一种语言”数字资源（例如动画），重点是协调对 LGBTQ+ 青少年及其心理健康需求的理解和沟通。该资源将通过国家 LGBTQ+ 和临床网络共享，例如石墙、LGBT 联盟；并在 Queer Futures 2 网站上免费提供。我们还将撰写一份报告、两篇学术期刊文章并参观会议以分享我们所学到的知识