Issues in the treatment of lesbian women and gay men with chronic mental illness

A growing theoretical and practical body of knowledge recognizes the common clinical concerns of chronic psychiatric patients who are homosexual and promotes their affirmative inclusion in psychiatric programs for other persons with chronic mental illness. This paper provides a clinical context for understanding essential issues in the inpatient and outpatient treatment of chronic psychiatric patients who are gay men or lesbian women. Such patients are largely an ignored or invisible subgroup in long-term psychiatric programs and in the gay and lesbian community. They are dependent on therapeutic communities, residences, and families that are heterosexually acculturated and often unaware of their needs. Most have experienced antihomosexual prejudice and the stigmatizing effects of mental illness. Affirmative models of treatment can be adapted to this population but must be modified to accommodate their psychiatric deficits. Increased efforts to destigmatize both mental illness and homosexuality are needed.