Health service use by same-sex attracted Australian women for alcohol and mental health issues: a cross-sectional study

Background: Same-sex attracted women (SSAW) have higher rates of alcohol and mental health problems than heterosexual women, but utilisation of and satisfaction with treatment is limited. Aim: This study investigated the influences on health service use for alcohol and mental health problems among SSAW. Design & setting: The Gelberg-Andersen behavioural model of health service utilisation was used to generate outcome variables. Method: A convenience sample of 521 community-connected Australian SSAW completed an online survey. Health service use according to sexual identity was compared using x2 analysis. Binary logistic regression examined associations between the independent variables with treatment utilisation. Results: Reports of alcohol treatment were very low. Only 41.1% of participants with service need had utilised mental health and alcohol treatment. Bisexual women (adjusted odds ratio [AOR] = 2.76) and those with 'other' identities (AOR = 2.38) were more likely to use services than lesbian women. Enablers to service use were having a regular GP (AOR = 3.02); disclosure of sexuality to the GP (AOR = 2.42); lesbian, gay, bisexual and transgender (LGBT) community-connectedness (AOR = 1.11); and intimate partner violence ([IPV] AOR = 2.51). Social support was associated with a reduction in treatment use (AOR = 0.97). Significant access barriers included not feeling ready for help, and previous negative experiences related to sexual identity. Conclusion: Disclosing sexual identity to a regular, trusted GP correlated with improved utilisation of alcohol and mental health treatment for SSAW. The benefits of seeking help for alcohol use, and of accessing LGBT-inclusive GPs to do so, should be promoted to SSAW.