Date of Conferral



Doctor of Healthcare Administration, DHA


Health Services


Lee Bewley


The rates of mental health issues in the lesbian, gay, bisexual, and transgender (LGBT) communities are twice that of individuals who identify as heterosexual. Research in urban communities show lower mental health services utilization rates for LGBT individuals compared to their heterosexual counterparts. The purpose of the study was to examine how rural environmental factors affect the use of mental health services by LGBT individuals and provide information to improve mental health outcomes. Andersen's healthcare utilization model and the minority stress theory were the foundations of this study. This study examined the association of mental health providers' availability/characteristics and utilization of mental health services and the association of perceived sexual discrimination and mental health services utilization in rural LGBT communities. Questionnaires were used to collect data from a random sample of 121 LGBT participants in Virginia, and linear and multiple regression was used to analyze the data. The findings for the associations between environmental factors and mental health service use were p < .84 for perceived discrimination, p < .04 for fear of provider insensitivity, p < .02 for provider availability, p < .000 for provider insensitivity and hostility, and p < .003 for provider insensitivity and ridicule. The results showed a need for specialized and sensitivity training in the health community and the need for improved access for LGBT health consumers in rural communities. The results of this study might lead to social change by encouraging improvement in mental health services and mental health outcomes for the LGBT community.