PHILIPPINES WOMEN’S UNIVERSITY

1743 Taft Ave, Malate, Manila, 1004 Metro Manila

Graduate Studies

Annotated Bibliographies
Submitted to the Graduate Studies Committee on the
Written Comprehensive Examination (WCW)
School of Arts and Sciences

By
JENNIFER P. INDEPENSO
Student No: 2021T0541
Master of Arts major in Psychology
With Specialization in Clinical Psychology
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 TABLE OF CONTENTS

PART I : MENTAL HEALTH STIGMA AND DISCRIMINATION (First choice for thesis)

1 - 15 items ------------------------------------------------------------------------------ 3

PART II: MENTAL HEALTH INTERVENTIONS AND SUPPORT PROGRAMS FOR

DEPRESSION

16 - 30 items ---------------------------------------------------------------------------- 14

PART III: SEXUAL GENDER AND IDENTITY ISSUES, EDUCATION, AND

AWARENESS

31 - 45 items --------------------------------------------------------------------------- 25

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PART 1: MENTAL HEALTH STIGMA DISCRIMINATION

1. Bharadwaj, P., Pai, M. M., & Suziedelyte, A. (2017). Mental health stigma. Economics
Letters, 159, 57-60. https://doi.org/10.1016/j.econlet.2017.06.028. In this article, the
authors delve into the presence and implications of stigma associated with mental health.
They achieve this by comparing self-reports from surveys regarding mental health
diagnoses and drug utilization against administrative data detailing prescription drug use
in a sizable sample of more than 250,000 individuals in Australia. The primary objective
of the article is to empirically establish the existence of stigma in the realm of mental
health—a distinctive method that supplements prior investigations focused on stigma in
relation to different health conditions and HIV. Utilizing a distinctive dataset, the authors
scrutinize the under-reporting of mental illness based on self-reported diagnoses and drug
usage. The outcomes reveal noteworthy disparities between survey responses and
administrative records. Additionally, the authors considers alternative interpretations and
scrutinizes whether specific demographic traits correlate with the under-reporting of
mental health conditions, implying that stigma might influence reporting decisions. These
findings underscore the substantial influence of stigma on the disclosure of mental health
conditions, offering valuable insights for future studies examining discrimination concerns
and intrinsic motivations within this context. The relevance of this article lies in its
potential to inform future studies on discrimination concerns and intrinsic motivations in
the context of mental health. It contributes to the broader understanding of the social
dynamics influencing mental health disclosure and can guide efforts to create more
supportive and inclusive environments for individuals dealing with mental health
challenges.

2. Bracke, P., Delaruelle, K., & Verhaeghe, M. (2019). Dominant cultural and personal
stigma beliefs and the utilization of mental health services: a cross-national
comparison. Frontiers in Sociology, 4. https://doi.org/10.3389/fsoc.2019.00040. This
article discusses the impact of cultural and personal stigma beliefs on seeking professional
help for mental health problems across 28 European countries. The authors highlights the
prevalence of negative stereotypes and the macro-social dimension of "structural stigma."
And it aims to address methodological limitations in existing research and differentiate
between cultural and personal stigma beliefs. It mentions various studies exploring the
connection between stigma and mental health service utilization, presenting both
supporting and contrasting results. Despite discrepancies, there's a consensus that stigma
acts as a barrier to seeking professional mental health care. Bracke, Delaruelle, Verhaeghe
(2019) formulates hypotheses at the individual and cultural levels, suggesting that
individuals with stigmatizing beliefs are less likely to seek help, and citizens in countries
with strongly stigmatizing cultures are also less likely to use professional mental health
care services. They also considers societal supply and individual need as determinants of
mental health service utilization, accounting for differences in service supply and

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 accessibility. They proposes that the association between the need for mental health
services and their utilization varies between countries and may be influenced by cross-
national differences in stigma beliefs. It explore the relationship between stigma and the
utilization of mental health services in the European population. It also employs multi-level
techniques, distinguishing between individual and cultural stigma. The authors of this
article strategically underscore the prevalence of negative stereotypes and the macro-social
dimension of "structural stigma," emphasizing the societal impact on individuals. Their
primary goal is to address methodological limitations in current research, particularly by
differentiating between cultural and personal stigma beliefs. Drawing on a range of studies,
this article both supporting and conflicting findings regarding the link between stigma and
the utilization of mental health services, ultimately establishing a consensus that stigma
acts as a significant impediment to seeking professional mental health care.

3. Bryan, C. J. and Morrow, C. E. (2011). Circumventing mental health stigma by

embracing the warrior culture: lessons learned from the defender's edge program..
Professional Psychology: Research and Practice, 42(1), 16-23.
https://doi.org/10.1037/a0022290. This article delves into the challenges linked to mental
health issues among military personnel, particularly those who have undergone combat
operations, focusing on veterans of Operation Iraqi Freedom (OIF) and Operation Enduring
Freedom (OEF). It underscores the prevalence of problems like PTSD, depression, and
suicide and questions the effectiveness of expanded mental health services by the
Department of Defense (DOD) and Department of Veterans Affairs (VA). Bryan, and
Marrow (2011) argues that mental health stigma is a significant obstacle for military
personnel seeking care, exploring the clash between the warrior culture's emphasis on
strength and self-reliance and the mental health culture's encouragement of seeking help.
They introduce the concept of military culture, highlighting values such as strength and
resilience that clash with traditional mental health approaches. It criticizes existing mental
health outreach efforts for not addressing cultural disparities and introduces the Defender's
Edge Program (DEFED) as a novel approach. DEFED, designed for United States Air
Force (USAF) Security Forces personnel, reframes mental health as a performance
enhancement program within the SF culture, emphasizing resilience and health. They
highlights high program acceptability and increased voluntary mental health service access
among SF members. However, it notes a lack of evidence regarding DEFED's effectiveness
in terms of mental health outcomes, emphasizing the need for rigorous evaluation. The
authors identifies barriers to wider dissemination and evaluation, pointing to conflicts with
the structure of the mental health system and proposing "lessons learned" from DEFED's
experience. These lessons include adopting strengths-based, positive psychology
approaches, aligning mental health concepts with the audience's training background,
recognizing the potential for personal growth associated with combat, and relocating
services closer to the warrior's environment. This article is relevant for shedding light on

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 the complexities of mental health issues within the military, questioning the effectiveness
of existing services, and proposing a novel approach through DEFED. However, the need
for rigorous evaluation of DEFED's effectiveness and the acknowledgment of systemic
barriers indicate areas for further research and development in the field of military mental
health.

4. Chatmon, B. N. (2020). Males and mental health stigma. American Journal of Men's
Health, 14(4), 155798832094932. https://doi.org/10.1177/1557988320949322. Chatmon
(2020) discusses the prevalence of mental health issues in American males and highlights
the tendency to overlook these problems despite their serious consequences, such as high
rates of depression, suicide, alcohol-related deaths, and drug misuse. This article delves
into the role of stigma as a significant obstacle preventing men from seeking mental health
treatment, particularly focusing on how sociocultural factors contribute to the acculturation
of stigma related to mental health issues in men. According to the author, the concept of
stigma is thoroughly examined, considering various perspectives including social stigma,
self-stigma, professional stigma, and cultural stigma. The impact of culture on individuals'
beliefs and values, especially within the Black community, is emphasized. The historical
context of medical mistreatment and resulting distrust in the healthcare system in this
community is discussed as a factor contributing to the reluctance to acknowledge mental
health issues and seek help. He emphasizes the necessity for strategic initiatives to address
the negative effects of mental health stigma, especially among underrepresented groups. It
calls for a deeper understanding of the role of culture in mental illness to develop effective
interventions considering cultural influences. In addressing mental health disparities and
societal norms, this article recommends reviewing guidelines for psychological practice,
providing cultural competency training for physicians, implementing stigma reduction
campaigns, diversifying mental health providers, and promoting diverse role models of
positive masculinity. It emphasizes that mental health-related discrimination negatively
impacts access to mental healthcare, and it calls for a redefinition of manhood and a cultural
transformation to make males more comfortable expressing themselves. The author also
acknowledges the heightened risk factors during situations like the COVID-19 pandemic,
where isolation may exacerbate mental health problems, underscoring the importance of
overcoming barriers to mental health resources for those less likely to seek professional
help. The acknowledgment of heightened risk factors during situations like the COVID-19
pandemic adds a timely and contemporary perspective to the discussion. The article's
emphasis on overcoming barriers to mental health resources for those less likely to seek
help underscores the urgency of addressing mental health disparities. This article is highly
relevant, offering a comprehensive exploration of mental health issues, stigma, and societal
norms among American males. Its recommendations provide actionable steps for
improving mental health outcomes and addressing disparities in mental healthcare.

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5. Corrigan, P. W., Mittal, D., Reaves, C., Haynes, T., Han, X., Morris, S. B., … &
Sullivan, G. (2014). Mental health stigma and primary health care decisions.
Psychiatry Research, 218(1-2), 35-38. https://doi.org/10.1016/j.psychres.2014.04.028
This article addresses the impact of mental illness stigma on healthcare decisions,
particularly focusing on providers' attitudes and actions towards patients with serious
mental illnesses. The authors of this article aims to investigate whether provider decisions
exacerbate health outcomes for these individuals, and it explores the role of stigma in
healthcare decisions. It involves a sample of nurses, physicians, and psychologists from
mental health and primary care clinics in five VA hospitals in the US. The participants were
presented with a vignette of a patient with schizophrenia and multiple health issues,
including arthritis-related chronic low back pain. The study assesses the relationship
between mental illness stigma, providers' comfort with seeking mental health care, and
their healthcare decisions for the patient. The results suggest that providers who endorse
stigmatizing attitudes about mental illness are more likely to doubt the patient's adherence
to treatment. This skepticism about adherence, in turn, influences two healthcare decisions:
the likelihood of referring the patient to a specialist and the likelihood of refilling the
patient's prescription for pain medication. The authors also finds that providers who are
more comfortable seeking mental health care themselves tend to be less stigmatizing. Their
findings emphasize the importance of addressing mental illness stigma among healthcare
providers, as it can impact patient outcomes and influence healthcare decisions. They also
recommends targeted interventions, such as anti-stigma programs, to improve the quality
of primary healthcare for individuals with serious mental illness. The limitations of this
study, including the correlational nature of the model and the need for further research, are
acknowledged. This article contributes to understanding the complex dynamics between
mental illness stigma, provider attitudes, and healthcare decisions, providing insights for
potential interventions in healthcare settings.

6. Grasse, A. J (2022). Mental Health in the Military (Doctoral Dissertation). Walden

University. Grasse (2022) investigates the challenges faced by senior enlisted leaders when
employing military personnel seeking mental health treatment. Her study focuses on the
stigma surrounding mental health in military environments, exploring barriers and
facilitators encountered by leaders in their working relationships with service members
undergoing mental health treatment. Individuals in organizations that devalue mental
health disorders are more likely to perceive stigma when seeking treatment. Stigma is the
shame or disgrace people feel that results in discrimination or rejection from societal
groups (Britt et al., 2020; Shann et al., 2019; Yamawaki et al., 2016). Researchers have
shown that military members often perceive psychological disorders as more stigmatizing
than physical issues and, as a result, are less likely to admit they need treatment (Schreiber
& McEnany, 2015). The author use attribution-emotion model and the modified labeling
theory as theoretical frameworks to understand individuals' hesitance in disclosing mental
health issues and the consequences of being labeled "mentally ill." Through purposeful

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 sampling and semi-structured interviews, the research aims to bridge the gap in existing
literature by examining the experiences of enlisted leadership, providing insights into
stigma, avoidance behaviors, and barriers to care. The study's significance lies in its
potential to improve communication, reduce negative behaviors, enhance the work
environment, and provide better support to military personnel seeking mental health
treatment, ultimately mitigating stigma-related issues within the military workplace. The
research acknowledges limitations related to participant availability and sensitivity,
utilizing social media and non-intrusive questioning techniques to address these
challenges. Grasse's (2022) dissertation contributes to the understanding of mental health
challenges in the military, particularly focusing on the role of senior enlisted leaders and
the impact of stigma on service members seeking mental health treatment. The study's
theoretical frameworks, research methodology, and consideration of limitations
collectively enhance the credibility and relevance of the research in addressing a critical
aspect of mental health within military contexts.

7. Hampson, M., Watt, B. D., & Hicks, R. E. (2020). Impacts of stigma and
discrimination in the workplace on people living with psychosis..
https://doi.org/10.21203/rs.2.23097/v2. The article discusses the persistent issue of
stigma and discrimination against individuals with mental health conditions in the
workplace. The authors argues for inclusive workplaces and cites studies on the
stigmatization of mental health patients. It focuses on Australia, presenting recent research
on discrimination and concealment in the workplace, especially in male-dominated fields.
It introduces a study on the impacts of stigma and discrimination on individuals with
psychosis, involving 137 participants from various stakeholder groups. Hampson, Watt and
Hicks (2020) reveals that stigma affects job-seeking, leads to workplace victimization, and
contributes to stress. Despite positive experiences, the study calls for cultural change in the
workplace, emphasizing the ongoing challenges of workplace stigma and discrimination.
It acknowledges efforts in Australia but calls for increased education and awareness to
combat stereotypes and support individuals with psychosis in the workforce. The author
concludes that stigma and discrimination are major barriers to employment for individuals
with psychosis, emphasizing the need for a shift in workplace culture for better inclusion
and outcomes. They presents a comprehensive examination of the persistent issue of stigma
and discrimination against individuals with mental health conditions in the workplace. The
argument for inclusive workplaces is well-supported by references to studies on the
stigmatization of mental health patients, providing a theoretical foundation for the
discussion. The focus on Australia and recent research adds a contextualized perspective,
highlighting specific challenges in male-dominated fields. the author effectively addresses
the issue of stigma and discrimination in the workplace, combining theoretical insights
with empirical evidence. The paper offers a well-rounded evaluation of the challenges

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 faced by individuals with psychosis and provides a compelling argument for the
importance of cultural change in workplaces to foster better inclusion and outcomes.

8. Kakuma, R., Kleintjes, S., Lund, C., Drew, N., Green, A., & Aj, F. (2010). Mental
health stigma: what is being done to raise awareness and reduce stigma in south
africa? African Journal of Psychiatry, 13(2).
https://doi.org/10.4314/ajpsy.v13i2.54357. The author of this article highlights the
increasing recognition of mental health as a significant public health concern in South
Africa, ranking third in disease burden after HIV/AIDS and other infectious diseases.
According to the authors, stigma plays a substantial role in the suffering, disability, and
economic loss associated with mental illnesses, affecting areas like housing and
employment. Their study focuses on existing anti-stigma programs in South Africa,
employing quantitative and qualitative methods to assess mental health resources and
policy development processes. Their findings reveal numerous initiatives coordinated by
organizations such as the Department of Health, NGOs like SAFMH, SADAG, and MHIC.
Public awareness campaigns target diverse audiences, and collaboration with various
entities varies across provinces. Consumer involvement is evident, especially in NGOs and
community activities. Early education efforts emphasize starting mental health education
in schools. Correctional services show limited awareness activities, and media
collaborations play a significant role. Recommendations include diverse strategies for
education, collaboration, and legislative support. This article is relevant for policymakers,
healthcare professionals, and organizations involved in mental health initiatives in South
Africa. It not only provides a snapshot of the existing landscape but also emphasizes the
necessity for ongoing evaluation to ensure the continuous improvement of anti-stigma
efforts.

9. Mahardika, H. F. K., Kustin, K., & Yuhbaba, Z. N. (2021). The relationship between
mental health literacy and stigma mental disorders in the soko village community,
bagelen district, purworejo regency. International Journal of Islamic and
Complementary Medicine, 2(2), 65-70. https://doi.org/10.55116/ijim.v1i1.19. This
study underscores the significant challenge of mental health issues in Indonesia, globally
affecting about 10.7% of the population. It emphasizes the detrimental stigma attached to
mental disorders, resulting in unfavorable treatment and societal isolation. Mental
disorders are elucidated as psychological patterns causing distress and a diminished quality
of life. The importance of Mental Health Literacy, encompassing knowledge and beliefs
about mental disorders, is introduced for the purposes of recognition, management, and
prevention. The imperative role of socialization and counseling to dispel misconceptions
about mental disorders is underscored. The study, carried out in Soko Village, Bagelen
District, Purworejo Regency, engages 52 respondents to investigate the correlation between
mental health literacy and the stigma associated with mental disorders. The results indicate
a high level of mental health literacy and a moderate level of stigma within the community.

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 The correlation analysis, however, reveals no significant relationship between mental
health literacy and the stigma of mental disorders. In conclusion, the residents demonstrate
positive mental health literacy and a moderate level of stigma, with no substantial
correlation observed in the studied population. The authors provides a comprehensive
exploration of mental health challenges in Indonesia, amalgamating statistics, societal
perspectives, and research outcomes from Soko Village, Bagelen District, Purworejo
Regency. The employed methodology, utilizing a quantitative correlation approach and
specific questionnaires, lends credibility to the study's findings. The detailed presentation
of demographic characteristics, mental health literacy, and stigma scores enhances the
reader's comprehension of the community's mental health landscape. While the study could
benefit from additional contextual information on the cultural and social factors influencing
mental health perceptions in Indonesia, explicit acknowledgment of study limitations and
smoother transitions between sections would enhance overall coherence. Although the
discussion section offers insights into the absence of a correlation between mental health
literacy and stigma, further depth and recommendations for interventions or policies would
bolster its impact. Despite these potential areas for improvement, this study remains
relevant, shedding light on a critical global issue and emphasizing the necessity to address
mental health stigma in specific communities like Soko Village. It contributes to broader
discussions on mental health interventions and policies.

10. Sharac, J., McCrone, P., Clément, S., & Thornicroft, G. (2010). The economic impact
of mental health stigma and discrimination: a systematic review. Epidemiologia E
Psichiatria Sociale, 19(3), 223-232. https://doi.org/10.1017/s1121189x00001159. Sharac
(2010) et al. examine the pervasive impact of mental health stigma on various aspects of
individuals' lives, including housing, employment, and healthcare. Their study highlights
how stigma restricts access to services, limits activities, exacerbates health problems, and
leads to economic consequences such as reduced employment opportunities. The authors
methodically analyzed 30 papers, addressing diverse mental disorders and geographical
locations. The study revealed widespread discrimination in employment, mental health
services, physical health services, and financial institutions. Towards the end, the authors
acknowledge limitations, including a focus primarily on employment impact, a lack of
research on direct financial losses, and challenges in distilling specific conclusions due to
broad coverage. Recommendations for combating stigma include campaigns, public
attitude surveys, strengthening legislation, and conducting research to estimate economic
costs, enhancing understanding of mental health stigma's multifaceted impact. Despite
limitations, the findings remained consistent across various settings and time periods.
Sharac et al.'s (2010) article contributes valuable insights into the economic impact of
mental health stigma and discrimination. The comprehensive review of literature, along
with the acknowledgment of limitations and the proposed recommendations, makes the

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 study a significant resource for understanding the multifaceted consequences of stigma and
developing strategies to address them.

11. Sickel, A., Seacat, J. D., & Nabors, N. A. (2014). Mental health stigma update: a review
of consequences. Advances in Mental Health, 12(3), 202-215.
https://doi.org/10.1080/18374905.2014.11081898. The authors discusses the prevalence
and consequences of mental illness, particularly focusing on mental health stigma (MHS)
as a significant barrier to seeking mental health treatment. It highlights that 46.6% of adults
in the US are likely to experience mental disorders, with anxiety disorders being the most
common. Mental illness results in significant financial costs and higher mortality rates for
affected individuals. Despite the impact, many people delay or avoid seeking mental health
treatment due to Mental Health Stigma, which affects various aspects of their lives
including self-perception, employment, housing, relationships, and physical and mental
health. Sickel, A., Seacat, J. D., & Nabors, N. A. (2014) reviewed existing research on
MHS, emphasizing its complex relationship with treatment-seeking behavior. It discusses
the factors influencing this relationship, including illness severity, race, ethnicity, and
gender. This study underscores the need for a comprehensive theoretical framework to
understand the impact of MHS on treatment seeking. The authors suggests future research
directions, including studying the impact of MHS on different social groups, standardizing
definitions of treatment seeking, assessing the efficacy of informal treatments, and
exploring variables that intervene, mediate, or moderate the relationship between MHS and
treatment seeking. Developing such a model can help minimize the effects of MHS and
promote early and consistent mental health treatment. This study provides valuable insights
into the prevalence and consequences of mental illness, shedding light on the critical role
of MHS as a barrier to seeking mental health treatment. The call for a comprehensive
theoretical framework and future research directions emphasizes the importance of
addressing MHS to enhance mental health outcomes in diverse populations.

12. Pinto, M. D., Logsdon, M. C., & Myers, J. (2011). Feasibility, acceptability, and initial
efficacy of a knowledge-contact program to reduce mental illness stigma and improve
mental health literacy in adolescents. Social Science &Amp; Medicine, 72(12), 2011-
2019. https://doi.org/10.1016/j.socscimed.2011.04.006. This study underscores the
importance of addressing mental illness stigma and improving mental health literacy in
adolescents to enhance their well-being. Existing research indicates that adolescents face
moderate levels of mental illness stigma and possess limited mental health literacy,
contributing to obstacles in seeking appropriate mental health care. The authors seek to
evaluate the feasibility, acceptability, and initial effectiveness of the "In Our Own Voice"
intervention in tackling these issues specifically among adolescent girls. Employing a non-
blinded cluster-randomized trial design in two public high schools, with a focus on
adolescent girls, the intervention group received "In Our Own Voice," while the control
group did not. The study concentrated on assessing the feasibility of enrollment, retention,

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 and intervention administration, gauging acceptability through the narrative paradigm
theory, and examining mental illness stigma and mental health literacy as efficacy
indicators. Despite enrollment challenges, the study demonstrated feasibility in terms of
retention and intervention administration. Participants found the intervention content
highly acceptable, and although immediate effects on mental illness stigma were not
evident, there was a significant improvement in mental health literacy in the intervention
group over the intermediate period. These findings offer valuable insights into the
feasibility, acceptability, and initial efficacy of the "In Our Own Voice" intervention for
adolescent girls, laying the groundwork for future adaptations and enhancements in mental
health knowledge-contact interventions tailored to this demographic. In the realm of
adolescent mental health, this study constitutes a meaningful stride toward comprehending
and addressing pertinent challenges, presenting a robust basis for the ongoing refinement
and customization of mental health interventions for adolescent girls.

13. Williston, S. K., Bramande, E., Vogt, D., Iverson, K. M., & Fox, A. B. (2020). An
examination of the roles of mental health literacy, treatment-seeking stigma, and
perceived need for care in female veterans’ service use. Psychiatric Services, 71(2),
144-150. https://doi.org/10.1176/appi.ps.201800405. Williston et. al (2020) investigated
the dynamics among treatment-seeking stigma, perceived need for care, and mental health
literacy in a longitudinal sample of female military veterans. Hypotheses were formulated,
anticipating that higher mental health literacy would be linked to reduced treatment-
seeking stigma, increased perceived need for care, and a higher likelihood of mental health
service use. Conversely, higher treatment-seeking stigma was expected to correlate with
lower perceived need for care and a diminished likelihood of service use. This article also
posited that perceived need for care would mediate the effects of mental health literacy and
treatment-seeking stigma on service use. Results indicated partial support for these
hypotheses, with mental health literacy influencing reduced treatment-seeking stigma and
an indirect impact on service use through stigma reduction. The findings underscore the
significance of targeted interventions tailored to the unique pathways influencing
treatment-seeking behaviors among female veterans, with an emphasis on the potential
effectiveness of mental health literacy interventions in mitigating treatment-seeking
stigma. Limitations and the need for further research to explore gender differences,
diagnostic variations, and the effectiveness of interventions are acknowledged, marking a
substantial contribution to understanding and addressing healthcare utilization challenges
among female veterans. This article is relevant and significant in the field of mental health
research, particularly in understanding the factors that influence healthcare utilization
among female military veterans. By investigating the interplay between treatment-seeking
stigma, perceived need for care, and mental health literacy, the study contributes valuable
insights into the complex dynamics that impact female veterans' decisions to seek mental
health services. The author’s emphasis on the role of mental health literacy in reducing

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 treatment-seeking stigma and indirectly influencing service use is noteworthy, suggesting
practical strategies for intervention. Acknowledging the limitations and advocating for
further research on gender differences, diagnostic variations, and intervention effectiveness
demonstrates a commitment to refining our understanding of these issues.

14. Xin, H. (2020). Addressing mental health stigmas among refugees: a narrative review
from a socio-ecological perspective. Universal Journal of Public Health, 8(2), 57-64.
https://doi.org/10.13189/ujph.2020.080202. This study conducts a narrative systematic
review focusing on mental health stigma among refugee populations. According to Xin
(2020), mental health stigma is a significant barrier to accessing services for refugees
globally. A U.S. survey and studies from various regions, including Sweden, Australia, and
Syria, underscore the prevalence of stigma, particularly among Somali populations. This
study aims to identify and analyze strategies addressing mental health stigma among
refugees, excluding information related to immigrants and asylum. The study,
encompassing English publications up to 2019, employs key phrases to narrow down 711
publications to 26 peer-reviewed articles and one report for analysis. The review
categorizes interventions into five levels: intrapersonal, interpersonal,
organizational/institutional, community, and policy. Strategies include increasing mental
health literacy, tailored educational programs, culturally competent workforce training,
community engagement, and advocacy for social norm change. Results, based on
publications from 1991 to 2018, highlight the effectiveness of interventions such as
contact-based education in reducing stigmatizing beliefs. The discussion emphasizes the
need for tailored interventions for refugee populations due to cross-cultural differences in
stigma. Collaborations between researchers and refugee communities are deemed essential
for identifying, replicating, and expanding effective anti-stigma programs. In conclusion,
the study advocates for culturally competent, refugee-specific anti-stigma interventions,
recognizing the urgency of addressing mental health stigma among refugees. The
effectiveness, feasibility, and replicability of strategies may vary across populations,
emphasizing the importance of evidence-based practices in this critical area. This study
holds significant relevance in the context of global mental health, particularly regarding
refugee populations. By conducting a comprehensive narrative systematic review, the
research addresses a crucial issue—mental health stigma—and its impact on the
accessibility of services for refugees, as noted by Xin (2020). It provides a valuable
contribution by advocating for evidence-based, culturally competent strategies to address
mental health stigma among refugees, thereby addressing an urgent and overlooked aspect
of global mental health.

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15. Zivin, K. and Prigerson, H. G. (2006). The stigma receptivity scale and its association
with mental health service use among bereaved older adults. Journal of Nervous
&Amp; Mental Disease, 194(2), 139-141.
https://doi.org/10.1097/01.nmd.0000198200.20936.03. Zivin and Prigerson (2006)
emphasizes the consistent identification of mental health-related stigma as a significant
barrier to accessing services for refugees, citing a 2010 U.S. national survey and systematic
reviews highlighting the prevalence of somatic symptom expression. This study aims to
conduct a narrative systematic review to explore strategies addressing mental health stigma
among refugees. The authors outlines the study criteria, including English publications up
to 2019, leading to the selection of 26 peer-reviewed articles for analysis. The results
categorizes findings from these publications into five levels within the socio-ecological
model, detailing strategies at intrapersonal, interpersonal, organizational/institutional,
community, and policy levels. The discussion identifies and discusses these five-level
strategies, emphasizing the lack of extensive research on their effectiveness among refugee
populations. The study stresses the necessity for culturally competent, refugee-specific
anti-stigma interventions and highlights the importance of partnerships between
researchers and refugee communities for evidence-based practices. Towards the end, the
authors underscores the urgency of developing such interventions to address mental health
stigma given its high prevalence and impact among refugees. This study is highly relevant
in addressing the critical issue of mental health stigma among refugee populations. Its
systematic approach, thorough literature review, and emphasis on culturally competent
strategies make it a valuable contribution to the field. The study not only identifies gaps in
the existing research but also advocates for urgent action, recognizing the significant
impact of mental health stigma on refugees and stressing the importance of evidence-based
practices.

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PART II: MENTAL HEALTH INTERVENTIONS AND SUPPORT PROGRAMS

16. Barry, M. M., Clarke, A. M., Jenkins, R., & Patel, V. (2013). A systematic review of
the effectiveness of mental health promotion interventions for young people in low
and middle income countries. BMC Public Health, 13(1).
https://doi.org/10.1186/1471-2458-13-835. The authors underscores the pivotal role of
mental health in overall well-being, particularly among children and adolescents on a
global scale, where a substantial proportion grapple with mental health challenges. Despite
the success of mental health promotion initiatives in high-income countries, such efforts
are often disregarded in low and middle-income countries (LMICs), contributing to
inequalities, especially among those in impoverished conditions. They identified 10,471
articles, with 35 primary studies selected for review, encompassing interventions in both
school and community settings. According to the authors studies on school-based
programs, primarily published between 2010-2012, reported positive outcomes, including
enhanced emotional and social well-being and diminished conduct problems. The
discussion spotlighted effective interventions and urged further research on program
components and their effects in relation to age, gender, and experiences related to conflict.
Despite limitations in scope and selection criteria, this article concludes that mental health
promotion interventions for young people can prove effective in LMIC settings. However,
there is a need to fortify evidence regarding their sustainability and effectiveness when
implemented on a larger scale, especially in low-income nations. Recommendations
include extended follow-up periods and research on the intricate connections between
mental health and other outcomes. This article is highly relevant for its global perspective,
meticulous methodology, and practical implications for addressing mental health
disparities among young people in LMICs.

17. Boucher, J., Subramonian, A., Hill, S. E., Gates, M., Brundisini, F., Severn, M., … &
Helis, E. (2022). Peer support programs for youth mental health. Canadian Journal
of Health Technologies, 2(11). https://doi.org/10.51731/cjht.2022.495. The article
delves into the critical mental health issues confronting Canadian youth, exacerbated by
the COVID-19 pandemic. Boucher et al. (2022) are exploring the adoption of peer support
programs as a potential solution to enhance youth access to mental health care. Their study
evaluates the clinical effectiveness and safety of formal peer support programs for youth
mental health and investigates methods for their assessment, with a focus on ensuring
equity in various aspects. According to the authors to ensure relevance to service users and
workers, the study involves peer support youth advisors with lived experience. They
underscore the importance of recovery-based outcomes, diversity, inclusion, and
representation in the strategies employed for program evaluation. Their clinical evidence
regarding the effectiveness and safety of peer support programs, as derived from a
systematic review, indicates a potential preference for specific personal recovery outcomes.

14
 However, the evidence remains uncertain due to study limitations. An environmental scan
reveals a lack of standardization in program evaluation methods, although programs adhere
to principles like practice-based evidence and a recovery model. Despite challenges, peer
support programs demonstrate adaptability and inclusivity in meeting the needs of youth.
Their study concludes that while the clinical evidence on the effectiveness of peer support
programs is uncertain, these programs exhibit promise as informal and flexible
interventions. Formal programs, involving trained support workers with ongoing support
mechanisms, can address safety concerns. Program evaluations play a pivotal role in
understanding needs, driving quality improvement, and ensuring inclusivity. The study by
Boucher et al. is relevant as it addresses a critical public health issue, explores innovative
solutions, incorporates diverse perspectives, and provides insights that can inform the
design and implementation of mental health interventions for youth, particularly in the
challenging context of the COVID-19 pandemic.

18. Dray, J., Bowman, J., Wolfenden, L., Campbell, E., Freund, M., Hodder, R. K., … &
Wiggers, J. (2015). Systematic review of universal resilience interventions targeting
child and adolescent mental health in the school setting: review protocol. Systematic
Reviews, 4(1). https://doi.org/10.1186/s13643-015-0172-6. The authors introduces the
global concern surrounding the mental health of children and adolescents, highlighting the
prevalence of mental health issues in this demographic, especially among those facing
socio-economic challenges or living in rural areas. They emphasize the adverse outcomes
linked to adolescent mental health problems, including common disorders such as
depression, anxiety, disruptive behavior disorders, attention deficit hyperactivity disorder,
and substance use disorders. They also acknowledges the protective role of resilience
against mental health issues and introduces resilience-focused interventions as strategies
to enhance coping mechanisms and promote positive mental health. This article
concentrates on universal school-based interventions as a potential approach to address
mental health problems in adolescents on a population level. They wanted to evaluate the
impact of such universal school-based resilience-focused interventions on mental health
outcomes in children and adolescents aged 5 to 18 years, aiming to address the limitations
of previous systematic reviews in this field. According to the authors eligible studies must
involve participants within the specified age range attending school, excluding those with
diagnosed mental illness, cognitive, or developmental disabilities. Their review focuses on
randomized controlled trials (RCTs), including cluster-randomized controlled trials,
comparing school-based resilience-focused interventions with alternative interventions or
control groups. The setting must be school-based, and primary outcomes include measures
of the prevalence or extent of child or adolescent mental health problems. The interventions
considered must be universal and explicitly state a focus on resilience, or they must address
at least three internal protective factors. Their search strategy involves electronic databases
and additional sources, and the review will include studies published in the last 20 years.

15
 Detailed procedures for data extraction, risk of bias assessment, and data analysis are
provided, including considerations for heterogeneity and reporting bias. Their review aims
to offer a comprehensive synthesis of the evidence and will assess the strength of the
cumulative evidence using the GRADE approach. This article presents a well-structured
and relevant study that addresses a crucial gap in the understanding of the effectiveness of
universal school-based resilience-focused interventions on the mental health of children
and adolescents. The comprehensive methodology enhances the credibility of the study,
and the dissemination plans suggest a commitment to contributing meaningful insights to
both research and practice in the field of adolescent mental health.

19. Kempf, M. C., Huang, C., Savage, R. M., & Safren, S. A. (2015). Technology-delivered
mental health interventions for people living with hiv/aids (plwha): a review of recent
advances. Current HIV/AIDS Reports, 12(4), 472-480. https://doi.org/10.1007/s11904-
015-0292-6. Kempf et al (2015) explores the historical evolution of behavioral intervention
technologies and telemedicine in the context of mental health disorders, tracing back to the
pioneering use of two-way television by Dr. Cecil Wittson in 1959. Various technologies,
including telephones, instant messaging, videoconferencing, web-based interventions, and
mobile technologies, have been integrated into mental health interventions. Despite these
advancements, there is limited knowledge about the application of behavioral intervention
technologies for mental health outcomes in people living with HIV/AIDS (PLWHA). The
authors underscores the potential of telephone-based interventions, particularly
teletherapy, and the growing significance of text messaging interventions, especially
among minority populations. They employed a two-phase search strategy to identify recent
articles on technology-based interventions addressing mental health conditions in PLWHA.
From 1,056 abstracts, 45 potential articles were identified, meeting inclusion criteria for
peer-reviewed studies using behavioral intervention technologies in PLWHA and
employing a randomized controlled trial (RCT) design. The authors highlights a gap in
evidence for computer-delivered health behavior interventions in HIV-infected
populations, advocating for larger-scale efficacy trials. According to the authors, the
potential of emerging technologies, including wireless monitoring systems and social
media, is considered for real-time clinical assessment and building virtual communities of
social support. Their study concludes by emphasizing the need for flexibility and
adaptability in interventions, considering the rapid evolution of technology. Despite the
growing effectiveness of technology-based interventions, the text notes challenges in state
licensing laws and practice regulations, hindering the broad adoption of new treatment
approaches due to ethical and privacy concerns. This study is relevant and timely, shedding
light on the current state, challenges, and potential avenues for leveraging behavioral
intervention technologies in mental health care for PLWHA. The identified gaps and
recommendations for future research contribute to the ongoing discourse on the

16
 intersection of technology and mental health, urging the field to evolve in tandem with
technological advancements.

20. Kuhn, E. S. and Laird, R. D. (2014). Family support programs and adolescent mental
health: review of evidence. Adolescent Health, Medicine and Therapeutics, 127.
https://doi.org/10.2147/ahmt.s48057. Kuhn and Laird (2014) discusses family-centered
approaches to promoting adolescent mental and behavioral health, with a focus on family
support programs. These programs aim to enhance parent well-being, parenting skills, and
the mental health of at-risk adolescents. The authors reviews the effectiveness of family
support programs, categorizing them based on delivery methods and components. They
assesses clinician-led, peer-led, and team-led programs, emphasizing the need for tailored
approaches. Family support programs typically include instructional, informational,
advocacy, emotional, and instrumental support components. Selective programs focus on
high-risk individuals, with varied outcomes. Indicated programs target youth with minimal
symptoms, showing generally positive results. According to the authors family support
programs are deemed effective in improving caregiver and child outcomes. Clinician-led
programs with diverse support components are most effective in treatment, while peer-led
programs have a weaker research base. Among prevention programs, multilevel and
indicated approaches are more effective than universal and selective ones. According to the
authors, the overall effectiveness of programs is influenced by factors such as intensity,
target population, and the inclusion of diverse forms of support. Kuhn and Laird's (2014)
study is highly relevant in the context of promoting adolescent mental and behavioral
health through family-centered approaches. By focusing on family support programs, the
authors contribute valuable insights into the enhancement of parent well-being, parenting
skills, and the mental health of at-risk adolescents. The authors' recognition that the overall
effectiveness of programs is influenced by factors like intensity, target population, and
diverse forms of support adds practical considerations for the implementation of these
interventions. Kuhn and Laird's study provides a comprehensive and relevant exploration
of family-centered approaches in promoting adolescent mental and behavioral health,
offering valuable guidance for both researchers and practitioners in the field.

21. Monnapula-Mazabane, P., Babatunde, G. B., & Petersen, I. (2021). Current strategies
in the reduction of stigma among caregivers of patients with mental illness: a scoping
review. South African Journal of Psychology, 52(1), 73-86.
https://doi.org/10.1177/00812463211001530. This article examines the growing global
burden of mental health conditions, emphasizing the situation in Africa, where the
population is projected to double in the next three decades. It identifies depressive disorders
as a major cause of disability, highlighting the challenges arising from social and economic
frustrations. The authors underscores the 'silent crisis' of mental health in Africa, noting its
limited attention compared to other health issues. They points out the low density of mental

17
 health workers and limited utilization of mental health services in Africa. Their study
delves into mental health stigma and advocates for a shift toward a social and human rights
approach in mental health services. Challenges faced by family caregivers, including
stigma by association, are highlighted, and the study emphasizes the need for increased
focus and scale-up of mental health services, especially in low- and middle-income
countries. The scoping review on anti-stigma interventions for caregivers reveals a dearth
of literature, with only nine studies identified. According to the authors majority of
interventions were conducted in high-income countries, emphasizing the need for more
research in low- and middle-income countries. The interventions varied in content, delivery
methods, and target populations, with positive outcomes observed for those encompassing
multiple components. Face-to-face and telephone interventions showed significant impacts
on stigma reduction. The authors acknowledges the limitations, calling for robust
randomized control trials to assess intervention efficacy, particularly in regions with limited
mental health resources. It concludes by recognizing the challenges in adapting
interventions across diverse cultural contexts and underscores the importance of
developing cost-effective and culturally appropriate approaches to tackle the global burden
of mental health stigma. This study is relevant and timely, addressing critical issues in
global mental health, particularly in the context of Africa. The authors' call for increased
research, attention to cultural nuances, and the development of cost-effective and culturally
appropriate interventions reflects a comprehensive and forward-looking approach to
tackling the complex challenges associated with mental health stigma.

22. Mukhiya, S. K., Wake, J. D., İnal, Y., Pun, K. I., & Lamo, Y. (2020). Adaptive elements
in internet-delivered psychological treatment systems: systematic review. Journal of
Medical Internet Research, 22(11), e21066. https://doi.org/10.2196/21066. This study
explores Internet-delivered psychological treatments (IDPTs), which are based on
evidence-backed psychological treatment models like cognitive behavioral therapy,
adapted for online use. Despite evidence supporting the effectiveness of internet
interventions in treating mental health disorders, user adherence remains suboptimal
Mukhiya, S. K., Wake, J. D., İnal, Y., Pun, K. I., & Lamo, Y. (2020). They sought to address
this issue by (1) scrutinizing and identifying the adaptive elements of IDPT for mental
health disorders, (2) investigating how system adaptation influences the efficacy of IDPT
in mental health treatments, (3) pinpointing the information architecture, adaptive
dimensions, and strategies for implementing these interventions for mental illness, and (4)
leveraging the findings to develop a conceptual framework that enhances user adherence
and adaptiveness in IDPT for mental health issues. Their studies primarily focused on
tailoring interventions for mental health disorders. Common adaptive elements, such as
feedback messages from therapists and intervention content, were identified, but their
specific contributions to the efficacy of IDPT in mental health were not consistently
reported. The conclusions drawn from several studies suggest that adaptive IDPT holds the
potential to enhance intervention outcomes and improve user adherence. However, there is

18
 a notable gap in the literature regarding the reporting of design elements, adaptive
components, and strategies in IDPT systems. Consequently, the study underscores the need
for focused research on adaptive IDPT systems, including clinical trials to rigorously assess
their effectiveness. The call for focused research and clinical trials aligns with the growing
demand for evidence-based digital mental health solutions. This study contributes to the
field by emphasizing the need for a deeper understanding of adaptive elements in IDPT
systems, providing valuable insights for future developments in online mental health
interventions.

23. Murphy, J., Noble, J. M., Chakraborty, P. A., Michlig, G. J., Greenshaw, A. J.,
Michalak, E. E., … & Lam, R. W. (2023). Values and preferences related to workplace
mental health programs and interventions: an international survey..
https://doi.org/10.1101/2023.03.02.23286684. This study delves into the viewpoints of
employees and managers concerning initiatives in the workplace designed to promote
mental well-being and address mental health issues. The results play a crucial role in
substantiating the creation of the first-ever global guidelines by the World Health
Organization (WHO) for mental health and work, offering evidence-backed
recommendations to facilitate the incorporation of mental health programs in workplaces.
The author’s goal is to improve the reception, suitability, and implementation of these
programs. Their survey focuses on educated, urban women from Europe and the Americas,
employed full-time in large companies, often in roles supporting mental health. The
sampling method may introduce bias, favoring those with pre-existing interest. Available
in three languages, the survey might limit participation. Despite aiming for a global
overview of mental health program preferences, more research is needed for diverse
perspectives. According to the authors, almost 70% of respondents have experienced
mental health conditions, underscoring the importance of improved workplace mental
health support. The study is significant as it explores the perspectives of employees and
managers regarding workplace mental health initiatives, contributing crucial evidence for
the development of global guidelines by the World Health Organization (WHO). The
finding that almost 70% of respondents have experienced mental health conditions
emphasizes the urgency of improving mental health support in the workplace.

24. Peng, Y., Jiang, F., Huang, W., & Shu, Q. (2019). Efficacy of cognitive behavioral
therapy for heart failure. International Heart Journal, 60(3), 665-670.
https://doi.org/10.1536/ihj.18-408. This study addresses the prevalence of depressive
symptoms among heart failure patients, ranging from 20%-40%, and explores the potential
of cognitive behavioral therapy (CBT) as a treatment. According to the authors, heart
failure, often caused by various cardiovascular conditions, can lead to depression due to
negative thoughts about health loss and an uncertain future. Depression in heart failure
patients contributes to increased morbidity and mortality, reduced self-care, and diminished

19
 quality of life. While traditional face-to-face CBT has shown positive effects in reducing
depression, there is a growing interest in Internet-based CBT as a time-efficient alternative.
Peng, Y., Jiang, F., Huang, W., & Shu, Q. (2019) conducts a systematic review and meta-
analysis of randomized controlled trials (RCTs) to evaluate the efficacy of CBT in
alleviating depression for heart failure patients. They employ the Preferred Reporting Items
for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching databases for
relevant studies up to June 2018. Their selected studies, published between 2010 and 2017,
involve face-to-face or Internet-based CBT for heart failure patients. The primary outcome
is the depression scale, with secondary outcomes including quality of life, self-care scores,
and 6-minute walk test distance. The meta-analysis of eight RCTs, with a total of 480
patients, reveals that CBT is associated with a significant reduction in depression scale
scores compared to control groups, indicating its effectiveness in alleviating depression in
heart failure patients. However, there is no substantial impact on other outcomes such as
quality of life, self-care scores, and 6-minute walk test distance. Their study acknowledges
some limitations, including the small sample size in some trials and the inability to analyze
certain outcomes like hospitalization rates and mortality based on the available RCTs. In
conclusion, the study suggests that cognitive behavioral therapy is effective in reducing
depression among heart failure patients. This study makes a meaningful contribution to the
understanding of depressive symptoms in heart failure patients and the potential of CBT as
an effective intervention. The findings support the relevance of incorporating CBT into the
holistic care of heart failure patients, emphasizing the importance of addressing mental
health alongside traditional medical treatments.

25. Prom, M. C., Denduluri, A., Philpotts, L., Rondón, M. B., Borba, C. P., Gelaye, B., …
& Byatt, N. (2022). A systematic review of interventions that integrate perinatal
mental health care into routine maternal care in low- and middle-income countries.
Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.859341. This systematic
review addresses the challenges faced by women in low- and middle-income countries
(LMICs) concerning perinatal depression and anxiety, exacerbated by limited access to
mental health care. The authors focus on assessing the effectiveness of interventions that
integrate perinatal mental health care into routine maternal care in LMICs to enhance both
maternal and infant health outcomes. Following PRISMA guidelines, the review involved
an extensive electronic database search, resulting in the inclusion of twenty studies out of
2,382 unique citations. The findings reveal substantial heterogeneity in study samples,
intervention designs, and outcome assessments. While less than half of the studies
concentrated on women with active depression or anxiety, the majority adopted single
intervention designs, primarily involving psychological, psychosocial, psychoeducational,
or adjuvant emotion/stress management. Notably, few interventions employed
multicomponent approaches, pharmacotherapy, or referrals to mental health specialists.
Despite variations in outcome measures and assessment timing, a significant majority of
the studies (18 out of 20) demonstrated marked improvement in depression and/or anxiety

20
 measures in the intervention groups compared to controls, emphasizing the potential
effectiveness of integrated perinatal mental health care in LMICs. This article offers
valuable insights into the effectiveness of integrated perinatal mental health care in LMICs
and contributes essential information for ongoing intervention development and
implementation.

26. Raevuori, A., Hofman-Roddman, V., Goldin, P. R., Gillung, E., Connolly, S., Dillon,
E. C., … & Huang, F. (2019). Smartphone-delivered, therapist-supported digital
health intervention for physicians with burnout..
https://doi.org/10.31234/osf.io/y3u49. This research aims to investigate the impact of an
innovative 8-week eHealth intervention, the Meru Health Program (MHP), delivered via
smartphones, on burnout and depression symptoms among physicians in a large California
medical group. According to the authors the MHP integrates practices from various
therapeutic approaches and involves therapist support through chat-messaging. Their study
aims to assess changes in burnout and depression symptoms and examine the relationship
between program engagement and symptom changes. Their study involved 36 physicians
(24 females, 12 males), aged 31 to 56, examining the impact of the Meru Health Program
(MHP), an 8-week smartphone-delivered intervention, on burnout and depression
symptoms. According the authors the three participants dropped out during the
intervention. The remaining 33 participants showed significant reductions in depression
symptoms (PHQ-9) and burnout scores post-intervention. The correlation between
depressive symptoms and burnout was maintained. However, there were no significant
linear correlations between program engagement (mindfulness practices, chat activity) and
outcomes. Their study suggests the MHP is feasible and efficacious, with high completion
rates and significant symptom improvements. Their findings highlight the need for larger
controlled studies to confirm results and explore non-linear associations. The MHP
addresses a gap in interventions targeting burnout and depressive symptoms in physicians,
showcasing promise in enhancing physician well-being. The authors study acknowledges
limitations such as a small sample size, lack of a control group, and the need for further
research to confirm results.

27. Rauschenberg, C., Schick, A., Goetzl, C., Röhr, S., Riedel‐Heller, S. G., Koppe, G., …
& Reininghaus, U. (2021). Social isolation, mental health, and use of digital
interventions in youth during the covid-19 pandemic: a nationally representative
survey. European Psychiatry, 64(1). https://doi.org/10.1192/j.eurpsy.2021.17. In this
cross-sectional panel study conducted amid the COVID-19 pandemic, the researchers
delve into the psychosocial repercussions of public health measures on individuals aged
16–25. The investigation specifically looks at how factors like social isolation, COVID-
19-related cognitive preoccupation, worries, and anxiety, as well as objective social risk
indicators, are associated with psychological distress in youth. The authors also explores
the youth's utilization of and attitudes toward mobile health (mHealth) interventions,

21
 finding connections between psychological distress, worries, and anxiety with both the
positive attitude toward and actual use of mHealth interventions. Although migrant/ethnic
minority group status correlates with distress, other social risk indicators show inconsistent
links. Positive attitudes toward mobile health (mHealth) apps are widespread, especially
among those with severe distress and increased worrying. They emphasizes the necessity
for evidence-based interventions, particularly digital solutions like mHealth apps, to
address the mental health struggles faced by youth during the pandemic. This study holds
significant relevance in understanding the psychosocial impacts of COVID-19 public
health measures on the mental well-being of youth aged 16–25. By investigating the
associations between various factors, including social isolation, COVID-19-related
concerns, and objective social risk indicators, the study sheds light on the complexities of
psychological distress during the pandemic. Notably, the research identifies connections
between distress, worries, and anxiety with both the positive attitude toward and actual use
of mobile health (mHealth) interventions, emphasizing the potential role of digital
solutions in mitigating mental health challenges.

28. Rominov, H., Pilkington, P. D., Giallo, R., & Whelan, T. A. (2016). A systematic review
of interventions targeting paternal mental health in the perinatal period. Infant
Mental Health Journal, 37(3), 289-301. https://doi.org/10.1002/imhj.21560. The shift
to fatherhood is a pivotal and transformative experience involving the acquisition of new
parenting skills, adjustments to personal identity, and financial responsibilities, along with
managing pressures on the couple relationship Rominov, H., Pilkington, P. D., Giallo, R.,
& Whelan, T. A. (2016). Their study underscores the heightened vulnerability of fathers to
stress, anxiety, and depression during this period, emphasizing the public health concern
associated with paternal psychological distress. Despite reported prevalence rates of
psychological distress, interventions targeting fathers' mental health in the perinatal period
remain understudied compared to maternal interventions. The authors conducted a
systematic review, identifying 11 interventions between 1994 and 2012 categorized into
psychosocial programs, massage techniques, and couple-based sessions. Their discussion
highlights challenges such as outcome measure variability, concerns about the timing of
interventions, and the need for methodological rigor in future research. The relevance of
this study lies in its contribution to filling the gap in research on paternal mental health
interventions during the perinatal period. The findings and insights provided by the study
can inform healthcare professionals, researchers, and policymakers about the existing
interventions, their effectiveness, and areas that require further investigation. Overall, the
study adds valuable knowledge to the field and advocates for more comprehensive and
methodologically robust research on interventions targeting fathers' mental health during
this crucial life transition.

29. Thompson, C. (2013). Supported education as a mental health intervention.. Journal

of Rural Mental Health, 37(1), 25-36. https://doi.org/10.1037/rmh0000003. In 2009, a

22
 rural county in Northern California implemented a program supporting behavioral health
clients attending psychosocial rehabilitation courses, financed by the Mental Health
Services Act. Despite limited employment opportunities, the initiative achieved success by
fostering increased volunteerism and community engagement. This study aimed to discern
emotional well-being benefits and effective program components, examining the evolution
of mental health services, consumer education, and employment support. According to
Thompson (2013) emerging supported education programs focused on community college
integration, with major studies highlighting positive outcomes. However, challenges like
high dropout rates, particularly in rural areas with distinct barriers, were identified.
Employing an exploratory design, the research evaluated the emotional well-being benefits
of the program using secondary quantitative data from anonymous course evaluations
Thompson, C. (2013). His study found a nuanced outcome, indicating a more robust
correlation between engagement in supportive services and improved emotional well-being
for students from the sponsor county. The results suggested positive links between
psychosocial rehabilitation education, supportive services, and enhanced well-being,
notably for behavioral health services consumers. His study unintentionally identified a
control group, revealing superior overall emotional well-being improvement for students
from the sponsor county, with specific ties to supportive services. This study provides
valuable insights into the emotional well-being benefits of a supported education program
in a rural setting, contributing to the broader discourse on mental health services, education,
and community engagement. The unintentional identification of a control group and the
emphasis on supportive services further strengthen the study's relevance and potential
implications for similar programs in different settings.

30. van Ginneken N, Tharyan P, Lewin S, Rao GN, Romeo R, Patel V. Non‐specialist
health worker interventions for mental health care in low‐ and middle‐ income
countries. Cochrane Database of Systematic Reviews 2011, Issue 5. Art. No.:
CD009149. DOI: 10.1002/14651858.CD009149. This article emphasizes the global
burden of mental illness and the significant treatment gap in low- and middle-income
countries (LMICs), where a shortage of skilled human resources compounds the issue. To
address this, the proposed intervention involves training non-specialist health workers
(NSHWs) and other health professionals (OPHRs) to deliver mental health services in
LMICs, employing a task-shifting approach to compensate for the scarcity of specialists.
This intervention seeks to equip NSHWs to provide mental health services, potentially
bridging gaps in areas with limited specialist availability and reducing costs compared to
relying solely on specialized health workers. The authors aims to assess the effectiveness
of NSHWs and OPHRs in expanding community mental health interventions, covering the
entire spectrum from detection and treatment to rehabilitation of mental health issues.
Additionally, they aims to investigate the impact of this intervention on resource use and
costs associated with mental healthcare provision in LMICs. Their review's significance

23
lies in addressing the pressing need for involving non-specialists in mental healthcare due
to shortages of specialists in LMICs. It aims to fill knowledge gaps and provide evidence
on the effectiveness of NSHWs and OPHRs in mental healthcare delivery, supporting
informed policy development and sustainable scaling up of services in LMICs. The
significance of this study is evident in its potential to bridge the treatment gap by equipping
NSHWs to provide mental health services. This strategy is particularly relevant in areas
with limited access to specialists and can contribute to cost reduction compared to relying
solely on specialized health workers. Overall, this study is highly relevant in addressing a
critical need and has the potential to make significant contributions to global mental health
policy and practice.

24
PART III: SEXUAL GENDER AND IDENTITY ISSUES, DISCRIMINATION AND
CHALLENGES, EDUCATION AND AWARENESS

31. Chettiar, A. (2015). Problems faced by hijras (male to female transgenders) in

mumbai with reference to their health and harassment by the police. International
Journal of Social Science and Humanity, 5(9), 752-759.
https://doi.org/10.7763/ijssh.2015.v5.551. This study focuses on the experiences and
challenges of Male to Female (MTF) transgenders in India, specifically the Hijras in
Mumbai. The author explores the lack of legal protection for transgender individuals in
India and the societal stratification affecting the hijra community's access to healthcare,
housing, employment, and their vulnerability to violence, particularly in sex work. Chettiar
(2015) aims to depict the socio-economic status of hijras, focusing on health issues and
police harassment. The implications for social work practice outlined in the study
underscore the evolving nature of the profession, emphasizing goals like promoting human
dignity, human rights, and democratic participation while challenging inequalities. The
study supports the concept of a "third gender," commending legislative efforts for
recognition and advocating for legal, societal, and healthcare reforms Chettiar (2015). He
highlights the need for gender sensitization in law enforcement and comprehensive
provisions ranging from documentation rights to housing policies and educational reforms.
This study also calls for medical guidelines addressing transgender-related issues and
reforms in medical curricula. Overall, it emphasizes the necessity for nuanced
understanding in legislation and the judiciary to recognize equal rights for hijras and
transgender individuals in India.

32. Clarke, V. and Demetriou, E. (2016). ‘not a big deal’? exploring the accounts of adult
children of lesbian, gay and trans parents. Psychology &Amp; Sexuality, 7(2), 131-
148. https://doi.org/10.1080/19419899.2015.1110195. Public discussions surrounding
LGBT parenting often revolve around concerns for children's welfare, yet the voices of
children with LGBT parents have been notably absent Clarke, V. and Demetriou, E. (2016).
This study, conducted in Britain by researchers who themselves have LGBT parents, seeks
to explore the experiences of these children, challenging heteronormative assumptions and
providing a platform for their unique perspectives. Their research encompasses both
childhood and adulthood experiences, involving 13 women and 1 man aged 21 to 60,
representing diverse backgrounds. Employing online methods such as email interviews and
surveys for data collection due to the dispersed nature of the population, the authors utilizes
thematic analysis to uncover patterns. Two primary themes emerge: "it's not solely about
my parent's sexuality/gender identity" and "secrecy, authenticity, and negotiating the
stigma of homosexuality." Participants underscore the de-emphasis of parental sexuality,
the normalization of family life, downplaying of bullying by attributing it to various
factors, and the promotion of a narrative asserting that love defines a family, challenging

25
 traditional norms. Their findings reveal a consistent emphasis in participants' narratives on
sameness, normality, and universality, challenging preconceptions of "deviant difference"
while adhering to compulsory heterosexuality. According to the authors, some participants
navigate the stigma associated with homosexuality/trans by framing difficulties in the
context of societal prejudice rather than attributing them solely to their parents. This study
provides nuanced insights into the experiences of children raised by LGBT parents,
shedding light on the intricate nature of their narratives and the strategies employed to
navigate societal expectations and challenges. This study is significant in contributing to
the literature on LGBT parenting, challenging heteronormative assumptions, and offering
a nuanced perspective on the experiences of children raised by LGBT parents. The research
design, inclusion of diverse participants, and the thematic analysis of narratives all
contribute to the robustness and relevance of this study in shaping discussions and
informing future research in this important area.

33. Hammack-Aviran, C. M., Eilmus, A., Diehl, C. H., Gottlieb, K. G., Gonzales, G.,
Davis, L. K., … & Clayton, E. W. (2022). Lgbtq+ perspectives on conducting genomic
research on sexual orientation and gender identity. Behavior Genetics, 52(4-5), 246-
267. https://doi.org/10.1007/s10519-022-10105-y. The authors of this article aims
investigate the viewpoints of LGBTQ+ individuals regarding genomic research on sexual
orientation and gender identity. Their methodology entails conducting in-depth interviews
with 31 participants, centering on hypothetical scenarios and addressing various aspects of
genomic research. With a majority identifying as gay or lesbian, participants engage in
discussions about potential advantages, apprehensions, and aspirations concerning the
genetic aspects of sexual orientation and gender identity. Their study illuminates the
diverse perspectives within the LGBTQ+ community, spotlighting concerns about
invalidation, apprehensions about medicalization, and fears of potential societal
drawbacks. Participants express varied opinions on the acceptability of such research,
underscoring the importance of ethical considerations and sustained involvement with
LGBTQ+ communities. Despite recognizing its limitations, the study aims to provide
nuanced insights into the intricate landscape surrounding genetic research on sexual
orientation and gender identity. This study is highly relevant as it extensively explores the
multifaceted dimensions of sexual orientation and gender identity, emphasizing the
intricate interplay of genetic factors. By shedding light on the diverse perspectives within
the LGBTQ+ community, the study brings attention to concerns such as invalidation,
apprehensions about medicalization, and fears of societal drawbacks, thereby contributing
valuable insights.

34. Hughes, M. (2003). Talking about sexual identity with older men. Australian Social
Work, 56(3), 258-266. https://doi.org/10.1046/j.0312-407x.2003.00078.x. Hughes
(2003) highlights the neglect within Australian gerontological research concerning the
challenges faced by older gay men and lesbians. According to the author, the lack of
attention in studies on sexuality and health, coupled with the unresponsiveness of aged care
commissioners and providers, has created a significant gap in addressing the distinct needs

26
 of this demographic. The focus of this study is specifically on older gay men,
acknowledging the unique intersection of gender and sexuality for men and women. The
preference for the term "sexual identity" over "sexual orientation" is due to its broader
meaning, encompassing not only attraction and behavior but also the societal and
individual meanings associated with sexuality. The author's goal is to initiate conversations
about social work assessments with older gay men, recognizing the structural
discrimination they face. This study explore stereotypes, discrimination, and challenges
experienced by older gay men, stressing the importance of integrating discussions on
sexual identity into social work practice. Finally, the essentiality for social workers to
engage in conversations about sexual identity with all older men, advocating for
opportunities for disclosure. While the paper primarily addresses challenges and the
significance of discussing sexual identity, it introduces the notion of examining the
meaning of a heterosexual identity for older heterosexual men in the realm of social work.
The central message revolves around the importance of communication and the risks
associated with neglecting discussions on sexual identity, perpetuating discrimination
faced by older gay men across various aspects of their lives. Hughes' (2003) study is
relevant and valuable, contributing to the understanding of the challenges faced by older
gay men and lesbians in Australia, and advocating for improved social work practices that
consider the broader spectrum of sexual identity.

35. McFadden, C. (2015). Lesbian, gay, bisexual, and transgender careers and human
resource development. Human Resource Development Review, 14(2), 125-162.
https://doi.org/10.1177/1534484314549456. McFadden (2015) address two key research
questions, examining the distinctive factors influencing the professional lives and
workplace interactions of LGBT individuals while also assessing the research landscape
across various dimensions. Emphasizing the crucial human resource development
perspective, with a focus on justice and equity, the article explores the business case for
diversity and advocates for the potential advantages organizations can gain by adopting
LGBT-affirmative policies. Despite recognizing a positive trend in academic interest
between 1985 and 2013, the review identifies gaps, particularly regarding social justice
issues such as gender, race, ethnicity, sexism, racism, patriarchy, and violence. The
methodology involves a detailed, multi-step process, including a pilot study and
categorization based on quality and relevance. The results highlight a growing interest in
LGBT workplace issues, emphasizing recurring themes like discrimination, social
concerns, and identity development. The discussion explores topics such as the intersection
of career and identity, the interaction of sexual/gender identity in the workplace, and
challenges faced by the LGBT community. McFadden (2015) emphasizes the economic
rationale for workplace diversity, outlining positive outcomes for both individuals and
organizations. Despite advancements, the text underscores the ongoing need for research,
particularly in less-explored areas like transgender and bisexual populations, providing

27
 recommendations for future studies, encompassing sampling methods, longitudinal
approaches, and consideration of evolving sexual identities across diverse geographical
contexts.

36. Mehmet Enes Sağar1* and Nilüfer Özabaci2. Investigating the effectiveness of
solution-focused group counselling and group guidance programs to promote healthy
internet use of university students#. African Educational Research Journal Vol. 10(1),
pp. 14-27, January 2022. DOI: 10.30918/AERJ.101.21.156. The research study aimed
to investigate the effectiveness of a solution-focused group counseling program and a group
guidance program in increasing healthy internet use among young people. The study
included 39 university students and used various data collection tools such as personal
information forms, interview forms, and the Problematic Internet Use Scale. The data
analysis involved ANOVA for mixed measures and content analysis of interviews with
participants in the solution-focused group counseling program. The results indicated that
the solution-focused group was more effective than the guidance group and the control
group in increasing healthy internet use. The guidance group was also more effective than
the control group. These differences between the groups remained effective even after a
follow-up measurement conducted three months later. The study was conducted at Afyon
Kocatepe University in Turkey during the 2018-2019 academic year. Ethical approval and
consent from participants were obtained. The findings suggest that the solution-focused
group counseling program can effectively reduce problematic internet use among
university students measurements conducted three months after the program's completion.
The study was conducted at Afyon Kocatepe University in Turkey, and ethical
considerations were ensured throughout the research process. Overall, the findings
highlighted the positive impact of solution-focused group counseling and group guidance
on promoting healthy internet use among young individuals.

37. National Academies of Sciences, Engineering, and Medicine (2022). Measuring Sex,
Gender Identity, and Sexual Orientation. Washington, DC: The National Academies
Press. https://doi.org/10.17226/26424. The book "Measuring Sex, Gender Identity, and
Sexual Orientation" emphasizes the importance of accurately measuring sex, gender
identity, and sexual orientation as critical indicators of demographic diversity in the United
States. In light of transgender and intersex visibility, it questions the idea that sex and
gender are mutually determined and emphasizes the necessity of understanding them
separately. Because they affect opportunity, prejudice, and life outcomes, proper
measurement is vital. The book emphasizes the importance of acknowledging the diversity
of the LGBTQI+ population and improving the assessment of sex, gender identity, and
sexual orientation to identify and understand sexual and gender minority issues. It
acknowledges the many ways LGBTQI+ people are discriminated against. The book
suggests gathering gender data by default and using standardized language in survey

28
 queries to improve data quality and help organizations like the National Institutes of Health
(NIH) understand LGBTQI+ people.

38. Parrish, E. (2019). Sexual and gender minority health disparities. Perspectives in
Psychiatric Care, 55(4), 537-537. https://doi.org/10.1111/ppc.12442. Parrish (2019)
discusses the Special Issue Section in Perspectives in Psychiatric Care, focusing on health
disparities within sexual and gender minority populations (SGMHP). According to the
author, SGM individuals encounter numerous obstacles in accessing both physical and
mental healthcare. Nationally, initiatives have been launched to address these health
disparities, including the establishment of the Sexual and Gender Minority Research Office
(SGMRO) within the National Institutes of Health (NIH) in 2015. Members of the SGMHP
population face health concerns similar to other groups but at higher rates. Suicide,
substance use, HIV, STDs, mental illness, and violence occur more frequently among SGM
individuals. Many may not disclose their identity to healthcare providers, leading to a lack
of awareness regarding their specific needs. Stigma, discrimination, and unconscious bias
contribute to less frequent healthcare visits, prompting self-treatment with substances to
cope with stress. To improve care for sexual and gender minority individuals, the author
suggests creating inclusive environments, promoting open discussions about sexual
orientation and gender identity, and providing training for healthcare providers in inclusive
communication Parrish 2019. Curricular content on inclusive communication and bias
awareness could be integrated into health-related education. Additionally, healthcare
facility policies should be reviewed for nondiscriminatory language, and forms should
inquire about sexual orientation and gender identity. Information in waiting and exam
rooms should include content on sexual and gender minority health. These measures,
though seemingly simple, could contribute to reducing health disparities among sexual and
gender minority individuals. Parrish's study is relevant and timely, offering a
comprehensive overview of health disparities within SGM populations and providing
actionable recommendations for improving care and reducing these disparities. The study
contributes to the broader discourse on LGBTQ+ health and underscores the importance
of targeted research and inclusive healthcare practices.

39. Perez, L. B., & Maristela, C. M. M. (2019). Students' perspectives on a gender flexible
school uniform policy in a higher education institution. College of Home Economics,
University of the Philippines Diliman. A study focused on exploring the experiences of
students in a higher education institution regarding the school uniform policy and its impact
on their sexual orientation, gender identity, and expression (SOGIE). The study found that
some LGBTQ students feel that the uniform policy suppresses their SOGIE. Convenience
and snowball non-probability sampling methods were used to gather data from 14
respondents in focus group discussions and 51 respondents through an online survey. The
research revealed that female students experience limitations in movement due to skirts,

29
 while non-cisgender students face psychosocial discomfort due to the prescribed dress
codes. Although most respondents are satisfied with the standard uniform policy, they also
support a gender flexible approach for all students regardless of SOGIE. The study
concluded that adopting a gender flexible uniform policy could enhance the institution's
reputation and have positive psychosocial effects on students. A policy brief was developed
based on the results, analyzing the advantages and disadvantages of both standard and
gender flexible uniform policies. The brief highlights the potential of gender flexible
uniforms to promote inclusivity and serves as a foundation for future legislation related to
SOGIE. The study recommends that the institution's administration engage in consultation
with students to gain comprehensive insights into their experiences and perspectives on the
uniform policy and a gender flexible approach.

40. Quentin L. Van Meter, M.D., F.C.P. Gender Identity Issues in Children and
Adolescents. Issues in Law & Medicine, Volume 31, Number 2, 2016. This article
discusses gender identity issues in children and adolescents. It begins by explaining how
gender assignment is typically determined at birth through various methods such as genetic
testing and ultrasound assessment. The article then focuses on physical disorders of sexual
development, including male and female pseudo-hermaphrodite, mixed gonadal
dysgenesis, true hermaphroditism, XX maleness, and cloacal defects. It describes the
causes and effects of these disorders on sexual development. The author addresses gender
identity disorder (GID), which is characterized by individuals believing they were born
into the wrong sex. It mentions Dr. Kenneth Zucker, a clinical psychologist who treated
children and adolescents with gender discordance, and his approach of realigning gender
identity with biologic sex. However, GID was reclassified as gender dysphoria, shifting the
focus from gender discordance to lack of acceptance. The natural history of childhood GID
is discussed, noting that a significant percentage of cases resolve during adolescence. The
article emphasizes the importance of competent therapists evaluating the underlying
psychopathology and presenting all treatment options to the patient and their family. It also
raises concerns about certain organizations and ideologies promoting the transgender
agenda, advocating for early education about gender as a spectrum and encouraging cross-
dressing. The author of this study criticizes the guidelines for transgender medical
treatment, highlighting the lack of scientific basis for many of the recommendations. It
draws attention to the contrast with guidelines for disorders of sexual differentiation, which
are considered more scientifically valid. The author concludes by urging a comprehensive
evaluation of children with gender identity issues, considering their biologic sex and
allowing informed consent for any medical or surgical interventions.

41. Ravinder Saini, Wasim Ahmad, Nazli. Awareness among parents of individuals with
intellectual disability about sexual health education. Industrial Psychiatry Journal.
Volume 30. Issue 2. July- December 2021. The article discusses a study conducted to

30
 assess the awareness of parents with children who have intellectual disabilities about sexual
health education. The study aimed to examine the knowledge, attitude, and practice of
parents in this regard based on factors such as gender, locality, and family type. A rating
scale was used to gather data from 100 parents selected through random sampling. The
results indicated significant differences in knowledge, attitude, and practice among parents
based on gender. Mothers showed higher levels of empowerment and knowledge compared
to fathers, possibly due to their role as primary caregivers and their closer relationship with
their children. No significant differences were found based on family type, although joint
families appeared to be more aware of sexual health education than nuclear families,
possibly due to greater interaction with extended family members. Regarding locality,
parents in rural areas displayed greater knowledge and practice compared to those in urban
areas, challenging the conventional assumption that urban areas have higher awareness.
However, parents in urban areas exhibited a more positive attitude. The findings suggested
that parents in both rural and urban areas should be empowered through education and
training to provide appropriate sexual health education to their children with intellectual
disabilities. The study had limitations, such as a small sample size and limited
generalizability due to its cross-sectional nature and single-institution focus. Future
research could include larger and more diverse samples, comparative or longitudinal
studies, and exploration of the perspectives of parents with different levels of education. In
conclusion, the study emphasizes the importance of raising awareness among parents of
individuals with intellectual disabilities about sexual health education. It suggests that
policymakers should provide more information and training to parents, enabling them to
empower and educate their children effectively in this regard.

42. Roddrick Colvin (2020). Special Issue on Gender Identity and Expression and Sexual
Orientation (LGBTQ+) in the Public and Nonprofit Contexts. Administrative Theory
& Praxis, 42:2, 111-114, DOI: https://doi.org/10.1080/10841806.2019.1659051. In the
early 2000s, the author reflects on their experience of being discouraged from pursuing a
dissertation on "gay rights" and instead being advised to focus on environmental policy.
However, over the past two decades, the field of sexual orientation and gender identity
research has experienced significant growth, with scholars expanding our understanding of
public administration and policy issues concerning sexual minorities. The symposium
discussed in the article features six peer-reviewed articles that delve into various aspects
of public administration and LGBTQI communities, examining topics such as women,
queer identity, nonbinary gender, and sexual orientation. An important theme that emerges
throughout is intersectionality, acknowledging that sexual identities should be considered
in conjunction with other social identities such as gender, race, and class. The articles
explore a range of subjects, including the influence of female police officers on stop-and-
frisk practices, the obstacles faced by LGBTIQ individuals in accessing police services,
the impact of academic work and embodiment within dominant discourses, the critique of

31
 marriage equality and the necessity for inclusive policies, the consequences of "bathroom
bills" on transgender and gender nonconforming individuals, and the evaluation of
nonbinary gender policies in the United States. Ultimately, the authors advocate for the
implementation of more inclusive and equitable administrative processes, policies, and
practices that ensure fairness and accessibility of public goods and services for LGBTQI
individuals and communities.

43. Rosario, M., Schrimshaw, E. W., Hunter, J., & Braun, L. (2006). Sexual identity
development among lesbian, gay, and bisexual youths: consistency and change over
time. Journal of Sex Research, 43(1), 46-58.
https://doi.org/10.1080/00224490609552298. The study explores the complexities of
developing a lesbian, gay, or bisexual (LGB) sexual identity, emphasizing the challenges
faced by individuals in unsupportive environments. According to the authors, unlike other
minority groups, LGB individuals often encounter hostility, necessitating a "coming-out
process" and the integration of their identity. Existing research mainly examines
developmental milestones, with limited longitudinal studies. The author’s findings indicate
both consistency and change in LGB sexual identity, highlighting individual variability.
This suggests that the time since reaching sexual developmental milestones influences
identity consistency. It explores correlations between changes in sexual identity and
broader aspects of sexuality. Considering gender differences, the study aims to fill research
gaps by examining how consistently identified LGB youths differ from those undergoing
changes. In conclusion, their study underscores the dynamic nature of sexual identity
development in LGB youths, revealing shifts over time. It advocates for extended
longitudinal research to comprehensively understand this process and acknowledges
limitations in sample representation. The findings contribute valuable insights into the
intricate journey of LGB sexual identity development, particularly during adolescence and
beyond. This study contributes valuable insights into the complexities and nuances of LGB
sexual identity development, making it relevant and impactful in the field of sexual identity
research.

44. Stephanie D. Smitha, Noell L. Rowanb, Tamatha E. Armsa, Kristen L. Hohnb, and
Craig S. Galbraithc. An interdisciplinary approach to enhancing health knowledge
and cultural awareness with LGBT older adults. Educational Gerontology 2021,
VOL. 47, NO. 2, 79 - 85. https://doi.org/10.1080/03601277.2021.1876584. The article
discusses a collaborative effort between social work and nursing faculty to develop a
curriculum aimed at improving cultural awareness and knowledge of the health and quality
of life issues faced by LGBT older adults. The curriculum was implemented with social
work and nursing students, who completed pre- and post-surveys to assess changes in
attitudes and knowledge. The study found positive changes in attitudes and increased
knowledge among the students. The quantitative findings indicated statistically significant

32
 changes in perceptual dimensions related to knowledge acquisition, comfort in interacting
with LGBT individuals, experience with encounters, and attitudes regarding treatment, as
well as factual knowledge. The qualitative findings identified four primary themes: bias of
healthcare providers, access to quality care, specific healthcare needs, and health risks of
LGBT older adults. The study highlights the importance of training healthcare
professionals to provide culturally sensitive care to LGBT older adults, given their unique
healthcare experiences and needs. The results suggest that interdisciplinary education and
research are necessary to address healthcare disparities in this population. Continued
education and training are essential to maintain knowledge and cultural sensitivity among
healthcare professionals. Overall, the study emphasizes the need for competent and
sensitive healthcare providers to ensure the well-being of LGBT older adults.

45. Taylor, A. B. and Neppl, T. K. (2021). Sexual identity in lesbian, gay, bisexual,
transgender, and queer or questioning emerging adults: the role of parental rejection,
and sexuality specific family support. Journal of Family Issues, 44(2), 409-428.
https://doi.org/10.1177/0192513x211050063. This article delves into the challenges faced
by LGBTQ individuals in forming positive sexual identities amid marginalization, social
stigma, and discrimination. Shifting from linear stage models to a multidimensional non-
linear model. Taylor and Neppl (2021) explores parental influences, specifically rejection
and support, on various dimensions of sexual identity. While past studies identified parental
rejection as a risk factor for psychological difficulties among LGB individuals, this
research evaluates its impact across all dimensions of sexual identity. Emphasizing the
significance of family support for the physical and mental health of sexual minorities, the
study focuses on sexuality-specific family support. Utilizing the minority stress model, the
research explains how increased stigma, prejudice, and discrimination contribute to a
hostile social environment, impacting mental health outcomes for sexual minorities. Sexual
identity development, recognizing sexual attraction and understanding one's sexual
identity, is discussed within this model. According to the authors, employing the Lesbian,
Gay, and Bisexual Identity Scale (LGBIS), a non-linear and multidimensional tool, the
study assesses various aspects of sexual identity development. By examining the influence
of family-level predictors on sexual identity, the investigation contributes to a better
understanding of complex dynamics affecting sexual minority individuals. Participants,
recruited from a Midwestern University, include a convenience sample of 338 LGBTQ-
identified individuals aged 18 to 30, with diverse sexual orientations, genders, and racial
backgrounds. Their study employs structural equation modeling to analyze the impact of
parental rejection and sexuality-specific family support on sexual identity dimensions,
considering control variables and exploring gender differences. While revealing
associations between parental rejection, sexuality-specific family support, and sexual
identity, their study suggests the need for further research addressing limitations such as
cross-sectional data and underrepresentation of certain groups.

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