Abstract
Family relationships often play a critical role in the functional outcomes and wellbeing of persons with serious mental illness (SMI). However, research has not examined the interactions sexual minorities with SMI have with family members. This exploratory study aimed to examine whether supportive and/or problematic interactions between persons with serious mental illness and non-intimate partner relatives are associated with persons with SMI being sexual minorities. Between 2015 and 2017, 212 adults with SMI residing across the U.S. completed an online survey. Participants provided information regarding their interactions with a non-intimate partner relative in the past 6 months. Chi squared and Wilcoxon–Mann–Whitney tests were computed. The sexual orientation of participants was not significantly associated with supportive (co-residence, in-person contact, financial and other assistance, and happiness derived from the relationship) or problematic (emotional over-involvement, limit-setting, psychological abuse, and violence) interactions with non-intimate partner relatives. Practitioners are advised to attempt to include family members and address family relationships in rehabilitation services, regardless of the sexual orientation of persons with SMI.
Similar content being viewed by others
Notes
Prior research indicates that acceptance of sexual minority family members varies by relationship type, with sexual minorities perceiving parents as less accepting than other family members (see [3]). As such, it is possible that our findings may falsely conflate the interactions participants have with RR who are parents and other non-intimate partner relatives. To test this possibility, we performed identical analyses presented in Table 2, but only examining participants whose RR were their parents. Comparing these 34 sexual minority participants to 72 heterosexual participants, we found no statistically significant differences in any of the supportive or problematic interactions listed in Table 2 (results available upon request to the corresponding author). Thus, we are confident that the results presented in our main analyses (Table 2) do not mask important variation between participants with RR who are their parents versus other non-intimate partner relatives.
References
Albert M, Becker T, McCrone P, Thornicroft G. Social networks and mental health service utilisation: a literature review. Int J Soc Psychiatry. 1998;44(4):248–66.
Avery AM, Hellman RE, Sudderth LK. Satisfaction with mental health services among sexual minorities with major mental illness. Am J Public Health. 2001;91(6):990–1.
Beals KP, Peplau LA. Disclosure patterns within social networks of gay men and lesbians. J Homosex. 2006;51:101–20.
Biggs S, Manthorpe J, Tinker A, Doyle M, Erens B. Mistreatment of older people in the United Kingdom: findings from the first national prevalence study. J Elder Abuse Negl. 2009;21(1):1–14.
Bose J, Hedden SL, Lipari RN, Park-Lee E, Porter JD, Pemberton MR. Key substance use and mental health indicators in the United States: results from the 2015 National Survey on Drug Use and Health (No. HHS Publication No. SMA 16-4984). Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2015/NSDUH-FFR1-2015/NSDUH-FFR1-2015.htm (2016).
Cechnicki A, Bielańska A, Hanuszkiewicz I, Daren A. The predictive validity of Expressed Emotions (EE) in schizophrenia: a 20-year prospective study. J Psychiatr Res. 2013;47(2):208–14.
Clark RE, Drake RE. Expenditures of time and money by families of people with severe mental illness and substance use disorders. Community Ment Health J. 1994;30(2):145–63.
Cole JD, Kazarian SS. The level of expressed emotion scale: a new measure of expressed emotion. J Clin Psychol. 1988;44(3):392–7.
D’Augelli AR, Grossman AH, Starks MT. Families of gay, lesbian, and bisexual youth. J GLBT Fam Stud. 2008;4:95–115.
D’Augelli AR, Grossman AH, Starks MT. Parents’ awareness of lesbian, gay, and bisexual youths’ sexual orientation. J Marriage Fam. 2005;67(2):474–82.
Durso LE, Gates GJ. Serving our youth: findings from a national survey of services providers working with lesbian, gay, bisexual and transgender youth who are homeless or at risk of becoming homeless. The Williams Institute. Retrieved from https://escholarship.org/uc/item/80x75033 (2012).
Fowler FJ. Improving survey questions: design and evaluation. Thousand Oaks: SAGE; 1995.
Haselden M, Dixon LB, Overley A, Cohen AN, Glynn SM, Drapalski A, et al. Giving back to families: evidence and predictors of persons with serious mental illness contributing help and support to families. Community Ment Health J. 2018;54(4):383–94.
Hellman RE, Klein E. A program for lesbian, gay, bisexual, and transgender individuals with major mental illness. J Gay Lesbian Psychother. 2004;8(3–4):67–82.
Hellman RE, Klein E, Huygen C, Chew M, Uttaro T. A study of members of a support and advocacy program for LGBT persons with major mental illness. Best Pract Ment Health. 2010;6(2):13–26.
Hollander M, Wolfe DA, Chicken E. Nonparametric statistical methods. Hoboken: Wiley; 2013.
Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, et al. Screening for serious mental illness in the general population. Arch Gen Psychiatr. 2003;60(2):184–9.
Kidd SA, Howison M, Pilling M, Ross LE, McKenzie K. Severe mental illness in LGBT populations: a scoping review. Psychiatr Serv. 2016;67:779–83.
Kidd SA, Veltman A, Gately C, Chan KJ, Cohen JN. Lesbian, gay, and transgender persons with severe mental illness: negotiating wellness in the context of multiple sources of stigma. Am J Psychiatr Rehabil. 2011;14(1):13–39.
Kosciw JG, Greytak EA, Zongrone AD, Clark CM, Truong NL. The 2017 National School Climate Survey: The experiences of lesbian, gay, bisexual, transgender, and queer youth in our nation’s schools. New York: GLSEN. Retrieved from https://www.glsen.org/sites/default/files/2019-12/Full_NSCS_Report_English_2017.pdf (2018).
Labrum T. Factors related to abuse of older persons by relatives with psychiatric disorders. Arch Gerontol Geriatr. 2017;68:126–34.
Labrum T. Caregiving for relatives with psychiatric disorders vs. co-occurring psychiatric and substance use disorders. Psych Q. 2018;89:631–44.
Labrum T. Characteristics associated with family money management for persons with psychiatric disorders. J Mental Health. 2018;27:504–10.
Labrum T. Persons with serious mental illness help relatives: rates and correlates of assistance. J Ment Health. 2020;29:328–35.
Labrum T, Solomon PL. Factors associated with family violence by persons with psychiatric disorders. Psychiatr Res. 2016;244:171–8.
Labrum T, Solomon P, Bressi SK. Physical, financial, and psychological abuse committed against older women by relatives with psychiatric disorders: extent of the problem. J Elder Abuse Negl. 2015;27:377–91.
Labrum T, Solomon PL, Marcus SC. Victimization and perpetration of violence involving persons with mood and other psychiatric disorders and their relatives. Psych Serv. 2020;71:498–501.
Labrum T, Walk M, Solomon PL. Measuring limit-setting practices used by family members towards relatives with psychiatric disorders. Psychiatr Q. 2016;87:465–77.
Lerner D, Chang H, Rogers WH, Benson C, Lyson MC, Dixon LB. Psychological distress among caregivers of individuals with a diagnosis of schizophrenia or schizoaffective disorder. Psychiatr Serv. 2017;69(2):169–78.
Luciano A, Meara E. Employment status of people with mental illness: national survey data from 2009 and 2010. Psychiatr Serv. 2014;65(10):1201–9.
Lucksted A. Lesbian, gay, bisexual, and transgender people receiving services in the public mental health system: raising issues. J Gay Lesbian Psychother. 2004;8:25–42.
McGeough BL, Sterzing PR. A systematic review of family victimization experiences among sexual minority youth. J Primary Prev. 2018;39:491–528.
Meade AW, Craig SB. Identifying careless responses in survey data. Psychol Methods. 2012;17(3):437–55.
Monahan J, Steadman HJ, Silver E, Appelbaum PS, Robbins PC, Mulvey EP, et al. Rethinking risk assessment: the MacArthur study of mental disorder and violence. Oxford: Oxford University Press; 2001.
National Alliance for Caregiving (NAC). On pins and needles: caregivers of adults with mental illness. Retrieved from https://www.caregiving.org/wp-content/uploads/2016/02/NAC_Mental_Illness_Study_2016_FINAL_WEB.pdf (2015).
Naughton C, Drennan J, Lyons I, Lafferty A, Treacy M, Phelan A, et al. Elder abuse and neglect in Ireland: results from a national prevalence survey. Age Ageing. 2011;41:98–103.
Newman BS, Muzzonigro PG. The effects of traditional family values on the coming out process of gay male adolescents. Adolescence. 1993;28(109):213–26.
Norman RM, Malla AK, Manchanda R, Harricharan R, Takhar J, Northcott S. Social support and three-year symptom and admission outcomes for first episode psychosis. Schizophr Res. 2005;80:227–34.
Norman RM, Windell D, Manchanda R, Harricharan R, Northcott S. Social support and functional outcomes in an early intervention program. Schizophr Res. 2012;140:37–40.
Ohlander J, Batalova J, Treas J. Explaining educational influences on attitudes toward homosexual relations. Soc Sci Res. 2005;34(4):781–99.
Palumbo C, Volpe U, Matanov A, Priebe S, Giacco D. Social networks of patients with psychosis: a systematic review. BMC Res Notes. 2015;8:560. https://doi.org/10.1186/s13104-015-1528-7.
Pew Research Center. Collecting survey data. Retrieved from https://www.pewresearch.org/methods/u-s-survey-research/collecting-survey-data/ (2019).
Pilling M, Howison M, Frederick T, Ross L, Bellamy CD, Davidson L, et al. Fragmented inclusion: community participation and lesbian, gay, bisexual, trans, and queer people with diagnoses of schizophrenia and bipolar disorder. Am J Orthopsychiatr. 2017;87(5):606–13.
Rahal ZA, Vadas L, Manor I, Bloch B, Avital A. Use of information and communication technologies among individuals with and without serious mental illness. Psychiatr Res. 2018;266:160–7.
Revier CJ, Reininghaus U, Dutta R, Fearon P, Murray RM, Doody GA, et al. Ten-year outcomes of first-episode psychoses in the MRC ÆSOP-10 study. J Nerv Ment Dis. 2015;203(5):379–86.
Rosario M, Schrimshaw EW. The sexual identity development and health of lesbian, gay, and bisexual adolescents: an ecological perspective. In C. J. Patterson & A. R. D'Augelli (Eds.), Handbook of psychology and sexual orientation (p. 87–101). Oxford University Press (2013).
Rosario M, Schrimshaw EW, Hunter J. Disclosure of sexual orientation and subsequent substance use and abuse among lesbian, gay, and bisexual youths: critical role of disclosure reactions. Psychol Addictive Behav. 2009;23(1):175–84.
Rosenberg S, Rosenberg J, Huygen C, Klein E. No need to hide. Best Pract Ment Health. 2005;1(1):72–85.
Roessler W. Psychiatric rehabilitation today: an overview. World Psychiatr. 2006;5:151–7.
Ryan C, Huebner D, Diaz RM, Sanchez J. Family rejection as a predictor of negative health outcomes in white and latino lesbian, gay, and bisexual young adults. Pediatrics. 2009;123:346–52.
Savin-Williams RC, Ream GL. Sex variations in the disclosure to parents of same-sex attractions. J Family Psychol. 2003;17(3):429–38.
Schofield N, Quinn J, Haddock G, Barrowclough C. Schizophrenia and substance misuse problems: a comparison between patients with and without significant carer contact. Soc Psychiatr Psychiatr Epidemiol. 2001;36(11):523–8.
Tennille J, Solomon P, Blank M. Case managers discovering what recovery means through an HIV prevention intervention. Community Ment Health J. 2010;46:486–93.
Tennille J, Solomon P, Bohrman C. Using the FIELD model to prepare social work students and field instructors on sexuality and intimacy for persons with psychiatric disabilities. Sex Disabil. 2014;32:469–83.
Tessler R, Gamache G. Family experiences interview schedule (FEIS). In: The toolkit on evaluating family experiences with severe mental illness. Retrieved from www.hsri.org (1993).
Townsend L, Zippay A, Caler K, Forenza B. Technology and opportunity: people with serious mental illness and social connection. J Soc Soc Work Res. 2016;7(2):371–93.
Wearden AJ, Tarrier N, Barrowclough C, Zastowny TR, Rahill AA. A review of expressed emotion research in health care. Clin Psychol Rev. 2000;20(5):633–66.
Williams T, Connolly J, Pepler D, Craig W. Peer victimization, social support, and psychosocial adjustment of sexual minority adolescents. J Youth Adolesc. 2005;34(5):471–82.
Wright LW, Adams HE, Bernat J. Development and validation of the homophobia scale. J Psychopathol Behav Assess. 1999;21(4):337–47.
Wright E, Wright D, Perry B, Foote-Ardah C. Stigma and the sexual isolation of people with serious mental illness. Soc Probl. 2007;54(1):78–98.
Zazzarino A, Bridges CW. A population at risk: counseling sexual minorities with a serious mental illness. J Couns Sexol Sex Wellness Res Pract Educ. 2019;1(1):36–47.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Labrum, T., Petros, R., Jacobs, L.A. et al. Supportive and Problematic Interactions Between Sexual Minorities with Serious Mental Illness and Non-intimate Partner Relatives. J. Psychosoc. Rehabil. Ment. Health 8, 19–27 (2021). https://doi.org/10.1007/s40737-020-00193-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40737-020-00193-6