Abstract
People who identify as LGBTQ+ and are in prison often experience many additional challenges. Once in prison, there is systemic discrimination against imprisoned LGBTQ+ people and a lack of understanding and concern regarding their care, treatment and support needs. While there is growing interest in their protection and that of other vulnerable populations in prison settings, little is known about their views and experiences regarding their distinct psychosocial needs. The aim of this systematic review is to critically evaluate and synthesize the existing research evidence relating to the unique psychological and social experiences of LGBTQ+ people in prison and identify aspects that may help or hinder access to appropriate psychosocial interventions and supports. The PRISMA procedure was utilized. A search of relevant databases from January 2010 to March 2021 was undertaken. Studies were identified that involved LGBTQ+ people, and addressed their views and experiences regarding their psychosocial needs whilst in prison. The search yielded 858 papers in total. Following the application of rigorous inclusion and exclusion criteria a total of 12 papers were considered suitable for the systematic review. Quality was assessed using the CASP instrument. Following analysis, three themes were identified: (i) interpersonal factors (ii) intrapersonal factors and (iii) institutional factors. The policy, education and practice development implications are highlighted and discussed. Future research opportunities have been identified that will add significantly to the body of evidence that may further the development of appropriate health interventions and supports specific to the LGBTQ+ population in prison.
Highlights
It is well established that LGBTQ+ people experience a higher prevalence of mental ill-health than the general population, with poorer mental health outcomes [1].For transgender people this relates to higher levels of depression, suicidality, interpersonal trauma, substance use disorders and general distress [2]
Studies were identified that involved LGBTQ+ people, and addressed their views and experiences regarding their psychosocial needs whilst in prison
Research has shown that the discrimination, alienation and victimization that LGBTQ+ people can experience in general society is often mirrored and intensified in the prison environment [4]
Summary
It is well established that LGBTQ+ people experience a higher prevalence of mental ill-health than the general population, with poorer mental health outcomes [1].For transgender people this relates to higher levels of depression, suicidality, interpersonal trauma, substance use disorders and general distress [2]. LGBTQ+ people who are in prison experience a number of additional challenges These factors are not singular, they are interlocking, giving rise to a vast inequality in the well-being of those in prisons compared to their heterosexual or cisgender counterparts [3]. Research has shown that the discrimination, alienation and victimization that LGBTQ+ people can experience in general society is often mirrored and intensified in the prison environment [4]. This stigma can inform institutional culture and behavior toward inmates and may reinforce lack of agency amongst prison staff regarding how to work and support this population.
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