PUB - Publikationen an der Universität Bielefeld

Introduction LGBTQI + refugees and asylum seekers experience enormous distress during their lifespan. Ill-effects of socio-cultural stigma, systemic violence, and forced migration due to sexual orientation, gender identity or expressions, and sex characteristics (SOGIESC) are not their only challenge. The cumbersome asylum process in host countries negatively affects their mental health and well-being. The objective of this systematic review was to retrieve, critically evaluate and synthesize the evidence from qualitative data relating to mental health conditions of LGBTQI + forced migrants before, during, and after resettlement. Methods Seven Databases (Web of Science, PubMed, Taylor, and Francis online as well as MEDLINE, PSYNDEX, PsycINFO, and PsycArticles via EBSCO) were queried with relevant search terms between January and April 2020. To be included in the analysis, studies had to be qualitative and published in peer-reviewed journals between 2002 and 2020. Of 410 records, 23 of them met the inclusion criteria. Two low-score records were removed after critical evaluation with the CASP (Critical Appraisal Skills Program). Data from 21 studies were extracted. Qualitative meta-aggregation was implemented as the data synthesis strategy. Results Four emerged themes were linked to distress: Violence/discrimination, mental healthcare access barriers, asylum system challenges, and unaddressed mental health difficulties. Coping strategies and support resources were two other relevant themes across and within the data. Conclusions Experiencing violence and deprivation of equitable mental health services in countries of origin due to SOGIESC status, difficulties in the asylum process, limited care in detention centers, cultural and financial barriers in host countries, and finally, discrimination based on multiple marginalized identities explain how the mental health condition of LGBTQI + forced migrants is inextricably intertwined with structural discrimination. Policy Implications Host countries need to ensure migrant and local communities are aware of state equality and LGBTQI + anti-discrimination policies. Service providers in both asylum and health systems need to be trained for affirmative, culturally sensitive, and intersectional approaches in their practice and avoid treating queer clients against their expectations and stereotypes. Also, they should address the authentic accounts of resilience and resistance of LGBTQI + forced migrants.