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How to Improve Mental Health Care for LGBT Youth

How to Improve Mental Health Care for LGBT Youth

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Carlos Maza and Jeff Krehely's recommendations to Health and Human Services to improve the ability of the primary care system to adequately meet the mental health needs of LGBT youth.
Carlos Maza and Jeff Krehely's recommendations to Health and Human Services to improve the ability of the primary care system to adequately meet the mental health needs of LGBT youth.

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Published by: Center for American Progress on Dec 09, 2010
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1Center or American Progress | How to Improve Mental Health Care or LGBT Youth
How to Improve Mental HealthCare for LGBT Youth
Recommendations for the Department of Healthand Human Services
Carlos Maza and Jeff Krehely December 2010
Te recen repored suicides o gay eens including Asher Brown (13), Seh Walsh(13), Billy Lucas (15), and yler Clemeni (18) have sparked a naional debaeover he problem o bullying and harassmen direced a lesbian, gay, bisexual, andransgender youh. A 2009 survey o middle and high school sudens ound ha85 percen o LGB eens experienced being verbally harassed a school becauseo heir sexual orienaion. Nearly wo-hirds experienced being harassed becauseo heir gender expression.
Bullying is one o several acors ha pu immense srain on LGB eens’ menalhealh. Fear o rejecion rom amily members, ani-LGB messages heard inplaces o worship and in he media, and he chronic sress associaed wih havinga sigmaized and oen hidden ideniy all serve o exacerbae he menal healhproblems aecing LGB youh in America.
Research has demonsraed he connecion beween ani-LGB messages andacions, and a young person’s menal healh. Sudies have esablished a clear link  beween a amilys rejecion or accepance o an LGB young adul and haperson’s long-erm menal and physical healh.
LGB youh as a whole are sig-nicanly more likely han heir non-LGB counerpars o experience depression,anxiey, suicidal houghs, and subsance abuse.
Research has demonsraed hagay and lesbian youh are signicanly more likely han heerosexuals o atempo commi suicide—up o 40 percen more likely, according o some repors.
Anda recen survey ound ha 41 percen o ransgender and gender-nonconormingrespondens in he Unied Saes repor having atemped suicide a some poin inheir lives, compared o 2 percen o he general populaion.
2Center or American Progress | How to Improve Mental Health Care or LGBT Youth
 A discussion o he diculies experienced by America’s youh in accessing eec-ive menal healh services was largely absen rom he recen naional debae overhealh care reorm. Passage o he Paien Proecion and Aordable Care Ac o 2010 was an imporan vicory or progressives, bu ew have ully recognized helaw’s poenial o help he housands o young aduls wih menal healh con-cerns—LGB or no—ha are sruggling o nd appropriae reamen. When LGB youh do receive reamen, i is usually hrough primary care pro- viders. Age resricions, an inabiliy o pay or reamen, and ransporaion prob-lems preven many eenagers rom being able o reach ou o secondary menalhealh service providers.
Young aduls sruggling wih heir sexual orienaion orgender ideniy in paricular may be hesian o conac a menal healh provider,earing ha heir search or help may reveal heir LGB saus o unsupporiveparens or oher amily members.
Primary care providers canno always rely on paiens o reveal he naure orseveriy o heir menal healh concerns. Young aduls experiencing mood disor-ders wai seven and a hal years beore seeking reamen, on average.
Generalpraciioners rained in noicing and responding o he rs signs o menal healhissues in LGB youh are hereore an invaluable asse in he eor o miigaehe damaging eecs o severe depression and oher menal healh problems haLGB youh oen experience.Tere are several large srucural problems ha preven he primary care sysemrom being able o adequaely mee he menal healh needs o LGB youh.Tese include lack o LGB-specic raining or healh care providers, he limiedaccessibiliy o services, lack o nancial incenives o rea LGB youh, a ailureo deal wih he inersecion beween menal healh and subsance abuse issues,and a general lack o inormaion abou LGB healh needs.Tis brie describes hese problems and oers poenial soluions ha he UniedSaes Deparmen o Healh and Human Services can implemen, especially inrelaion o he recenly passed healh care reorm law.
Many o he recommen-daions, i implemened, could bene he enire LGB populaion. Tis brie suppors he ndings o a previous Cener or American Progress brie,“MenalHealh Services in Primary Care,”which advocaed or bringing menal healh andprimary care services ogeher or he general public.
3Center or American Progress | How to Improve Mental Health Care or LGBT Youth
Health care providers are unprepared to treat LGBT youth
Many healh care proessionals areno rained or equippedo eecively rea vulnerable LGB youh. A majoriy o medical school curricula include no inor-maion abou LGB issues, and mos public healh school programs only menionpopulaion diversiy in sexual orienaion and gender ideniy when discussing HIV/ AIDS.
Tis lack o raining and awareness may cause care providers o misdiagnoseor underesimae he exen o emerging disorders in he LGB populaion.Poorly rained medical praciioners may even make he misake o viewinghomosexualiy and gender nonconormiy as illnesses ha can be overcome wih appropriae “reparaive” herapy, urher magniying he psychologicaldamage and personal rauma already experienced by LGB youh and youngpeople who experience discriminaion because o heir perceived gender iden-iy or sexual orienaion.
LGB people are unlikely o ully disclose he severiy o heir menal healhproblems o medical proessionals hey do no perceive o be LGB-riendly.
Inac, he possibiliy o being discriminaed agains or misundersood is enougho deer many LGB youh and aduls rom seeking reamen or heir menalhealh concerns in he rs place.
Esablishing rigorous, LGB-supporiveculural compeency raining programs or primary care providers is essenial oimproving provider-paien relaionships so ha LGB youh can eel comor-able seeking ou he help hey need.
Recommendations for the U.S. Department of Health and Human Services
Develop and disseminae a culural-compeency curricula o medical rainingprograms ha explicily includes maerials concerning LGB paiens.
 Acquire congressional unds o suppor medical educaion or coninuing educa-ion programs ha each LGB culural compeency, especially or providers who paricipae in public healh programs such as Medicaid.
Develop LGB culural compeency goals, policies, raining modules, and oherools in close consulaion wih LGB communiy sakeholders, includingconsumer represenaives, policy and research organizaions, and direc serviceproviders such as communiy healh ceners serving he LGB communiy.

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