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Background. Data exploring reasons for poor mental health among sexual minorities is lacking.
Aims. To quantify how much discrimination, lifetime and child trauma and coping predicts excess mental ill health among non-heterosexuals; and, evidence for regional variation.
Methods. Using data from the South East London Community Health study (N=1052), associations between sexual orientation and symptoms of common mental disorders (CMD), suicidal ideation, harmful alcohol use, drug use and a measure of well-being were assessed controlling for discrimination, trauma and coping style. The 2007 Adult Psychiatric Morbidity Survey (N=7403) was used to make comparisons with Greater London (GL) and national data.
Findings. Non-heterosexuals were more likely to report all risk factors. After adjustment, non-heterosexual orientation remained associated with between 2.3 and 4-fold greater odds of CMD, lifetime suicidal ideation and substance misuse. The South East London sample had poorer mental health compared to GL and national samples; the discrepancy was larger for non-heterosexuals than heterosexuals.
Conclusions. Discrimination, early childhood and adult adversity substantially influence but do not account for all sexual orientation-related disparities in mental health. National and local policy makers and clinicians should consider sexual minorities as a priority in the design and delivery of services.