LGBTQ+/People of the global majority (Pogm) navigate complex intersecting aspects of identity. These identities both separately and in combination are subject to longstanding historic and current oppression operating from a systemic level which have wide ranging impacts on the lives of these communities. One such impact is experiencing poorer mental health and health inequalities in terms of outcomes. This thesis aimed to add to the growing body important research into how best to support the mental health of LGBTQ+/Pogm communities. Part A utilises narrative analysis in an attempt to capture the stories and voices of this under-researched group’s experiences of therapeutic mental health support. Results demonstrated some alarmingly inadequate treatment that prevented participants from utilising therapy effectively. Part B used an anonymous online survey to explore expectations of treatment for this group. Thematic analysis of findings demonstrated the pervasive impact of the hostile context navigated by LGBTQ+/Pogm and its impact in the therapy room. Both studies demonstrated the negative ‘trickle down’ effect systemic oppression has on the efficacy of therapeutic services for LGBTQ+/Pogm. Discussion of findings highlighted the interaction of multiple jeopardies; systemic oppression creates additional stressors for LGBTQ+/Pogm that mean they are more likely to need support; the current findings demonstrated it also impacts how effectively they can engage in mental health support and that the therapeutic support is likely to be inadequate in meeting their needs. This may subsequently be perpetuating the cycle of inequality experienced by LGBTQ/Pogm. The thesis concludes that responsibility at a systemic level must be challenged. The findings are used to suggest changes on a structural level for systems as well as an individual therapeutic level for clinicians to improve therapeutic outcomes and tackle mental health inequalities for LGBTQ+/Pogm. Part C contains a summary of clinical practice and assessments.