Effectiveness of Strategies to Increase Mental Health Services Utilization among Young Adult Gender & Sexual Minorities: A Scoping Review

Sexual and gender minority (SGM) young adults in the United States experience disproportionately high levels of psychological distress, suicidality, and unmet mental health needs, yet engagement with formal mental health services remains uneven. This scoping review synthesizes U.S.-based evidence published between 2015 and 2025 on interventions and strategies designed to increase mental health service utilization among SGM young adults aged 18–25 years. Six databases (PubMed, PsycINFO, CINAHL, MEDLINE, Scopus, and Google Scholar) were systematically searched, yielding 7,951 records. After automated deduplication, 4,825 unique studies were screened using Covidence, following PRISMA-ScR guidelines. A total of 354 full-text articles were assessed for eligibility, and six studies met inclusion criteria for synthesis. Across the six included studies, several consistent patterns emerged. SGM individuals remained underrepresented in intervention research, despite reporting the highest levels of suicidal ideation and service barriers. Moreover, institutional context mattered where students perceiving positive campus mental health climates were significantly more willing to seek care (OR = 1.51, 99% CI: 1.38–1.64). Additionally, prior engagement strongly predicted future help-seeking willingness (OR = 7.40, 99% CI: 6.78–8.09). Most importantly, digital and mobile health interventions demonstrated high feasibility and engagement, with transgender participants averaging four app logins per week, though evidence of long-term effectiveness remains limited. Overall, findings indicate that while SGM young adults frequently engage with mental health services, utilization is shaped by structural stigma, provider trust, institutional climate, and intersectional marginalization. The limited number of evaluative interventions and absence of longitudinal outcomes underscore an urgent need for equity-centered, culturally affirming, and scalable strategies to improve sustained mental health service engagement among diverse SGM young adults.