Racial/ethnic differences in unmet needs for mental health and substance use treatment in a community-based sample of sexual minority women

J Clin Nurs. 2016 Dec;25(23-24):3557-3569. doi: 10.1111/jocn.13477. Epub 2016 Sep 26.


Aims and objectives: To examine the unmet needs for mental health and substance use treatment among a diverse sample of sexual minority women (lesbian, bisexual).

Background: Sexual minority women are more likely than heterosexual women to report depression and hazardous drinking. However, relatively little is known about sexual minority women's use of mental health or substance use treatment services, particularly about whether use varies by race/ethnicity.

Design: Cross-sectional analysis of existing data.

Methods: Analyses included data from 699 Latina, African American and white sexual minority women interviewed in wave 3 of the 17-year Chicago Health and Life Experiences of Women study. Using logistic regression, we examined the associations among sexual identity, race/ethnicity, use of mental health and substance use treatment, as well as potential unmet need for treatment.

Results: Overall, women in the study reported high levels of depression and alcohol dependence, and these varied by sexual identity and race/ethnicity. Use of mental health and substance use treatment also varied by race/ethnicity, as did potential unmet need for both mental health and substance use treatment.

Conclusions: Our findings that suggest although use of treatment among sexual minority women is high overall, there is a potentially sizable unmet need for mental health and substance use treatment that varies by race/ethnicity, with Latina women showing the greatest unmet need for treatment.

Relevance to clinical practice: Nurses and other healthcare providers should be aware of the high rates of depression and hazardous drinking among sexual minority women, understand the factors that may increase the risk of these conditions among sexual minority women, the potentially high unmet need for mental health and substance use treatment - perhaps particularly among Latina women and be equipped to provide culturally sensitive care or refer to appropriate treatment services as needed.

Keywords: Sexual minority women; alcohol use; alcohol use treatment; bisexual women; depression; lesbian women; mental health treatment; unmet need.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Ethnicity / psychology*
  • Female
  • Gender Identity
  • Healthcare Disparities / ethnology*
  • Humans
  • Logistic Models
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Sexual and Gender Minorities / psychology*
  • Substance-Related Disorders / ethnology*
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / therapy*
  • Young Adult