Associations of LGBTQ+ Identities With Acceptability and Efficacy of Online Single-Session Youth Mental Health Interventions

Abstract

Barriers such as stigma, financial costs, and provider shortages prevent large portions of youth with depression and related difficulties from accessing treatment; lesbian, gay, bisexual, transgender, queer/questioning sexual orientation, or other non-heterosexual identity (LGBTQ+) youth are burdened with additional barriers related to minority stress. Single-session interventions (SSIs) have been found to benefit youth and help reduce depression symptoms, and since many SSIs are brief, cost-free, and accessible online, they may circumvent several access barriers. However, prior to recommending non-community-tailored SSIs as a useful resource for minoritized youths, we first assessed whether LGBTQ+ youth respond as positively to SSIs as do cisgender heterosexual youth. In a subsample of youths recruited via online advertisements from September 2019 to August 2020 (N = 258, 81.4% female-assigned sex at birth, 60.5% LGBTQ+, 47.3% youth of color), we investigated whether changes in hopelessness, agency, and self-hate from before to after completing online self-directed SSIs differed as a function of LGBTQ+ identity. We also quantitatively and qualitatively compared intervention acceptability ratings and feedback across LGBTQ+ and cisgender heterosexual youths. Analyses revealed no significant differences between cisgender LGBQ+, trans and gender diverse, and cisgender heterosexual youths for any intervention outcomes. Likewise, no group differences emerged in intervention acceptability ratings or written program feedback. Self-selection bias and underrepresentation of certain populations, such as American Indian and Alaskan Native youths, may limit generalizability of results. Results suggest that online mental health SSIs are equally acceptable and useful to LGBTQ+ and cisgender heterosexual youth alike, even prior to culturally specific tailoring.