Effectiveness of peer counseling in addressing psychological distress and exposure to violence among LGBTI population in Nepal
Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) persons in most countries in the world have more mental health problems than the general population due to discrimination, exclusion, abuse and marginalization. Unfortunately, in many low and middle income countries LGBTI persons do not have access to psychological support, and violence towards them is often ignored just because they are perceived to violate acceptable gender norms.
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The low number of trained mental health specialists in a country like Nepal imply that short-term solutions to improve the mental health among LGBTI must rely on others.
Previous studies indicate that counseling delivered by lay members of communities may be effective at improving psychological wellbeing. Considering that discrimination of LGBTI is common also within the health services, this study among LGBTI in Nepal will test whether peers can deliver effective psychological counselling. We will adapt and strengthen the ‘Problem Management Plus’ (PM+) treatment developed by the World Health Organisation with a component that aims to reduce some of the causes of mental distress, namely violence, marginalisation and lack of social support.
LGBTI persons will be invited to give inputs to the study and be involved as peer counsellors to deliver the treatment. After a prestudy on exactly how to provide the treatment, a randomized controlled trial design will be implemented to study the impact of the treatment on mental health and violence among Lesbian, Gay, Bisexual, Transgender and Intersex persons. The study findings may be used to improve the mental health of LGBTI in Nepal and other low and middle income countries where they commonly experience discrimination, marginalization and violence. The research project will be conducted as a collaboration between the Public Health and Environment Research Centre in Nepal and the University of Bergen.
