Sexual Minority Use of Mental Health Care Services in a Nationally Representative Survey

Background: Research has convincingly shown that sexual minorities are at increased risk for several stress-related mental disorders when compared to their heterosexual counterparts (Cochran & Mays, 2009). However, little is known about their patterns of mental healthcare utilization. Objectives: We investigate sexual orientation and gender-related differences in self-reported mental healthcare visits and recent psychopharmaceutical use among individuals interviewed in the 2001-2008 National Health and Nutrition Examination Survey (NHANES). Methods: Using multiple years of the continuous NHANES, we identified 11,890 respondents for our study population. Using both sexual orientation and sexual behavior, we classified respondents into 3 groups: gay/lesbian/bisexual (n=409), homosexually experienced heterosexuals (n=340), and exclusive heterosexuals (n=11,141). We then used logistic regression methods to evaluate differences in patterns of mental health treatment while accounting for demographic confounding. Results: Sexual minorities were more likely to have seen a mental health professional in the past year and were also more likely to have taken a prescription psychopharmaceutical in the past 30 days than their heterosexual counterparts. Conclusions: Sexual minorities are more likely to use mental health services compared to heterosexuals in the U.S. This greater prevalence of use is also observed among those without observable mental health need. This suggests that sexual minorities may be utilizing the mental healthcare system to address issues of stigmatization, apart from usual reasons for seeking care.