Toggle Main Menu Toggle Search

Open Access padlockePrints

Reducing LGBTQ+ adolescent mental health inequalities: a realist review of school-based interventions

Lookup NU author(s): Professor Eileen KanerORCiD, Dr Ruth McGovernORCiD, Dr Emma Geijer Simpson, Liam SpencerORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Background: LGBTQ+ young people have elevated rates of poor mental health in comparison to their cisgender heterosexual peers. School environment is a key risk factor and consistently associated with negative mental health outcomes for LGBTQ+ adolescents. Aims: To examine how, why, for whom and in what context school-based interventions prevent or reduce mental health problems in LGBTQ+ adolescents. Methods: A realist review methodology was utilised and focused on all types of school-based interventions and study designs. A Youth Advisory Group were part of the research team. Multiple search strategies were used to locate relevant evidence. Studies were subject to inclusion criteria and quality appraisal, and included studies were synthesised to produce a programme theory. Seventeen studies were included in the review. Results: Eight intervention components were necessary to address LGBTQ+ pupils mental health: affirmative visual displays; external signposting to LGBTQ+ support; stand-alone input; school-based LGBTQ support groups; curriculum-based delivery; staff training; inclusion policies; trusted adult. Few school-based interventions for this population group were identified. Conclusions: The programme theory indicates that “to work” school-based interventions must have a “whole-school” approach that addresses specifically the dominant cis-heteronormative school environment and hence the marginalisation, silence, and victimisation that LGBTQ+ pupils can experience.

Publication metadata

Author(s): McDermott E, Kaley A, Kaner E, Limmer M, McGovern R, McNulty F, Nelson R, Geijer-Simpson E, Spencer L

Publication type: Review

Publication status: Published

Journal: Journal of Mental Health

Year: 2023

Pages: Epub ahead of print

Online publication date: 17/08/2023

Acceptance date: 27/06/2023

ISSN (print): 0963-8237

ISSN (electronic): 1360-0567

Publisher: Taylor and Francis Ltd


DOI: 10.1080/09638237.2023.2245894