Date of Award

January 2019

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)



First Advisor

John Pachankis


This study examined the mental health burden of LGBTQ asylum seekers and associated psychosocial risk factors with a focus on barriers to social integration. This study also characterized LGBTQ asylum seekers’ interest in interventions aimed at alleviating mental distress and social isolation. Respondents (n = 308) completed an online survey which included the Refugee Health Screener (RHS-15), the NIH loneliness scale, and an adapted scale of sexual identity disclosure. Most respondents (80.20%) screened positive for mental distress. Loneliness (OR = 1.14, 95% CI = 1.09, 1.19) and LGBTQ identity disclosure (OR = 3.46, 95% CI = 1.01, 12.02) were associated with

screening positive for mental distress. Transgender identity (OR = 3.60, 95% CI = 1.02, 16.02) approached significance for a positive association with mental distress. Those who had been granted asylum (OR = 0.36, 95% CI = 0.169, 0.75) or had higher English

language proficiency (OR = 0.35, 95% CI = 0.12, 0.94) were less likely to screen positive. Most of those who screened positive (70.45%) were interested in receiving mental health counseling. Almost all participants wanted more LGBTQ friends (83.1%), wanted to mentor an LGBTQ newcomer (83.8%), and were interested in joining an LGBTQ community center (68.2%). LGBTQ asylum seekers are highly likely to experience mental distress and are interested in participating in mental health treatment and LGBTQ community building. Loneliness, outness, indeterminate immigration status, and low English proficiency are unique risk factors associated with mental distress.


This is an Open Access Thesis.

Open Access

This Article is Open Access