LGBTQ+ Health Equity

LGBTQ+ individuals continue to face health disparities linked to societal stigma, prejudice, discrimination, which can all lead to feelings of isolation, low self-esteem, and a sense of not belonging. We all know this can have a profound impact on overall well-being and can contribute to higher rates of mental health disorders.

LGBTQ+ individuals face significant behavioral health challenges because of their sexual orientation and gender identity. It is well known that LGBTQ+ individuals are at higher risk of experiencing mental health issues such as depression, anxiety, and substance use compared to their heterosexual and cisgender counterparts. LGBTQ+ youth are particularly vulnerable to behavioral health issues; too many face bullying, harassment, and rejection from their peers, family, and community. The COVID-19 pandemic, the social unrest and recent political actions have further exacerbated the lack of supportive environments, including schools and family structures, and compound the stress and adversity they experience.

In a recent survey, more than half of all LGBTQ+ respondents reported that they had faced situations where providers denied them care, used harsh language, or blamed their sexual orientation or gender identity as the cause for their illness. LGBTQ+ individuals all too often encounter barriers to accessing adequate healthcare services, including behavioral health support. This can be due to a lack of culturally competent providers, discriminatory practices, or a fear of discrimination and judgment from healthcare professionals. The limited availability of LGBTQ-affirming care can result in delayed or inadequate treatment, exacerbating mental health and substance use challenges.

There are several known and effective interventions for LGBTQ+ mental health services that have been shown to be beneficial for addressing the unique needs and challenges faced by LGBTQ+ individuals. These range from LGBTQ-Affirmative Therapy, Cognitive-Behavioral Therapy (CBT), Support Groups, Family Therapy, LGBTQ+ Community Centers, Mental Health Education and Awareness programs. All these are critically important, if and when available, and if they are truly anchored in a firm commitment to offer these interventions in a respectful, welcoming and inclusive setting with health professionals who have specific training and experience in working with LGBTQ individuals.

I want to specifically call out a recent initiative that I think can be transformative in NYS and hopefully far wider: NYS OASAS Part 830 LGBTQ-Affirming Program Endorsement Standards and Guidance. [https://lnkd.in/e8wdVuCj] This set of standards and guidance have the unique opportunity to truly transform how LGBTQ+ affirming services must be structured, delivered and fostered in an ambulatory setting as well as addressing the workforce training and competence issues needed. I encourage everyone to check out the standards set forth and make an effort to apply for this program endorsement (for those programs that this applies to) or review and adopt these to whatever setting you are in, because it is critical that we address the serious health inequities that LGBTQ+ individuals face.

We must start to address the behavioral health impacts on LGBTQ+ individuals. This will require a multifaceted approach and involves:

1. creating inclusive and accepting settings and communities that foster a sense of welcoming and belonging,

2. educating healthcare providers on LGBTQ+ cultural competency, and

3. increasing access to LGBTQ-affirming mental health services.

   
   

In June 2023, Centers for Medicare and Medicaid Services’ (CMS) Office of Minority Health (OMH) released a statement with information and resources focused on improving health care for LGBTQ+ individuals in recognition of LGBTQ+ Pride Month. The website lists available resources including access to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Excellence in LGBTQ+ Behavioral Health, toolkits for equitable care, Telehealth for LGBTQ+ Patients Resource, and much more. [https://lnkd.in/eciEvwR6] 

We must make concerted efforts to increase visibility and promote acceptance [being seen and heard is critical!], reduce discrimination, and provide supportive networks that can greatly improve the mental wellbeing of LGBTQ+ individuals. 

[1] Choi KR, Wisk LE, Zima BT. Availability of LGBTQ Mental Health Services for US Youth, 2014 to 2020. JAMA Pediatr. Published online June 05, 2023. doi:10.1001/jamapediatrics.2023.1473