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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.
1
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.
2
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 amily’s rejecion or accepance o an LGB young adul and haperson’s long-erm menal and physical healh.
3
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.
4
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.
5
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.
6
 
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.
7
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.
8
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.
9
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.
10
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.
11
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.
12
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.
13
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.
14
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.
15
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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