Experiences of Queer People of Color in Mental Health Care and Substance Use Treatment: A Systematic Review

Objective: Queer people of color (e.g., lesbian, gay, bisexual, pansexual, transgender people of color; QPOC) have specific mental health and substance use treatment needs due to the intersectional oppression they face. To improve service access and develop responsive interventions, we need to understand QPOC experiences. This systematic review integrates research on QPOC experiences regarding mental health and substance use treatment services. Method: We searched six bibliographic databases. Studies were included if they focused on QPOC, reported findings about mental health or substance use services, and were completed during 2000-2020. We used the Mixed Methods Appraisal Tool for quality appraisal. Narrative thematic synthesis was used for the 18 included studies. Results: Pretreatment themes included stress-based presenting problems and barriers to and facilitators of service access (e.g., mistrust, community referrals). Treatment foci for QPOC consisted of client factors (e.g., interest in culture-based practices), provider/agency factors (e.g., cultural humility), and the client-provider relationship (e.g., goodness-of-fit). Posttreatment outcomes ranged from negative (e.g., dissatisfaction, premature drop) to positive (e.g., identity-integration, social connection, symptom improvement). Conclusions: This review highlights critical issues in the treatment continuum that must be addressed by practitioners, systems, and policies to advance mental health equity for QPOC.