Optimal mental health care for Lesbian, Gay, Bisexual, and Transgender (LGBT) populations requires access to both competent prevention and treatment mental health services.

This paper will explore the barriers for LGBT people to accessing adequate and sensitive mental health care in Europe and the potential for the improvement of mental health services.

This paper will draw from an investigation on access to health care for lesbians in Germany, which triangulated qualitative und quantitative methods to study self-perceived barriers to culturally sensitive and appropriate care. The debate about LGBT mental health in the last few years will be illustrated by examples from several European countries and differences between countries will be highlighted.

LGBT people encounter numerous specific barriers to accessing mental health services, such as the lack of geographically and financially accessible providers who offer culturally sensitive, non-discriminatory care. Providers often lack specific knowledge, appropriate intervention strategies and general psychosocial skills to adequately serve LGBT clients. The findings show that these factors negatively shape the experiences of LGBT clients with the health care system.

Several countries have started initiatives to improve the quality of services for LGBT clients and their access to optimal mental health care.

Strategies and actions on all levels of the health care system - from public health policy making to the individual provider - are required to address access barriers and to establish equal and universal access for LGBT populations.