Improving Mental Health for LGBTQ+ Youth

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Improving Mental Health Outcomes for LGBTQ+Youth

Steering Committee

June 23, 2022

This June we celebrate Pride Month and on the heels of Mental Health Awareness Month in May, it is an opportune time to look at how LGBTQ+ youth and their families are faring in the aftermath of the COVID-19 pandemic, in the current socio-political climate, and how we can help improve mental health outcomes for LGBTQ+ youth. In the past few months, we have discussed at length how inequity harms mental health and how economic, political, public health, and social factors can lead to inequities for marginalized communities. Our current political climate has seen an increase in the amount of anti-LGBTQ+ legislation being proposed and enacted across the US leading to continued systemic discrimination against LGBTQ+ communities. This climate sends a message to LGBTQ+ folks that they do not hold the same rights as non-LGBTQ+ people to pursue their dreams and thrive in US society.

Here are some facts that drive this message home:

  • LGBTQ+ people are twice as likely as non-LGBTQ+ people to have a mental health condition and continue to show disparities in mental health, even though they are more likely to use mental health services
  • In 2020, the Trevor Project reported that
    • 40% of LGBTQ+ youth considered suicide
    • 70% of LGBTQ+ youth considered their mental health “poor” during most or all of the pandemic
    • 50% of LGBTQ+ youth said they wanted help with their mental health but could not locate help
    • Nearly 50% of LGBTQ+ youth said that COVID-19 impacted their ability to express their sexual orientation
    • Nearly 60% of transgender and nonbinary youth said that COVID-19 impacted their ability to express their gender identity
  • 64% of LGBTQ+ households experienced employment loss compared to 45% of non-LGBTQ+ households
  • 66% of LGBTQ+ households had serious financial problems
  • 38% of LGBTQ+ households were unable to obtain medical care or delayed getting medical care for a serious problem compared to 19% of non-LGBTQ+ households
  • For People of Color (POC) who are also LGBTQ+ the COVID-19 pandemic had even worse disproportionate outcomes
    • LGBTQ+ POC are twice as likely as white non-LGBTQ+ people to test positive for COVID-19
    • 29% of LGBTQ+ POC reported problems affording basic household goods compared to 14% non-LGBTQ+ white people
    • 26% of LGBTQ+ POC reported having trouble paying their rent or mortgage compared to 9% of non-LGBTQ+ white people
    • 1/3 of LGBTQ+ POC personally knew someone who died of COVID-19 compared to 1/5 of non-LGBTQ+ white people
  • Transgender individuals are four times more likely to have a mental health condition
  • According to the US Transgender Survey, 40% of transgender adults attempted suicide during their lifetime, compared to less than 5% of the US general population

LGBTQ+ young adults who reported high levels of family rejection during adolescence were:

  • 8.4 times more likely to report having attempted suicide
  • 5.9 times more likely to report high levels of depression
  • 3.4 times more likely to use illegal drugs
  • 3.4 times more likely to report having engaged in unprotected sexual intercourse

Family acceptance helps:

  • Protect against depression, suicidal behavior, and substance abuse
  • Promote self-esteem, social support, and overall health

What this research tells us is that, perhaps more than in any other community, working with LGBTQ+ youth and their families is paramount. Therefore, it is imperative that we engage, approach, and connect with families where they are in their journey with their LGBTQ+ youth. We may find that some families can quickly learn to support their LGBTQ+ child, while others may need individual assistance to get them there, while still others may need counseling and/or family therapy. We must also not assume that all families reject their child’s identification as we may have families who come to us fully accepting of their LGBTQ+ youth and are just in need of some resources. It is important to let caregivers tell their story while we listen and try to understand where they are and what supports they need. Research has shown that few caregivers have had the opportunity to talk about their own experiences, hopes, and concerns for their LGBTQ+ child with a supportive and non-judgmental professional. We can also provide caregivers and families with respectful language about sexual orientation, gender identity, and expression (SOGIE) so that they are able to affirm and support their LGBTQ+ child even if their own experience with SOGIE is limited. This is especially important for families who may never have discussed SOGIE at all, or in ways that were not neutral or even disparaging, to help them become knowledgeable and comfortable having these discussions with their LGBTQ+ child. We also need to provide families with the information regarding how accepting behaviors and rejecting behaviors can affect the health and well-being of the LGBTQ+ youth in their care. We know that caregivers by and large love their children and do not want to intentionally hurt them, so providing them with the information and tools they need to support their LGBTQ+ child is imperative.

As practitioners and providers of services to families and youth, here are some basic steps we can take to help LGBTQ+ youth feel seen and heard:

  • Include LGBTQ+ young people and families when describing populations served in agency literature, brochures, outreach activities, and websites
  • Include families and caregivers of LGBTQ+ children and youth on advisory groups for child, youth, and family service programs and agencies
  • Actively recruit families and caregivers of LGBTQ+ children and youth to participate in recreational, social, and community activities and events
  • Include LGBTQ+ books, brochures, and posters in agency waiting rooms, offices, and care facilities - many LGBTQ+ youth and those who may be questioning their identity look for “safe zone” or rainbow stickers to indicate that a provider will be open and respectful in providing support and addressing needs related to their LGBTQ+ identity

Our goal should be to help families learn to support their LGBTQ+ children without necessarily requiring them to change their values or deeply held beliefs. We want to build an alliance to support their LGBTQ+ children, and to help them understand that family reactions that are experienced as rejection by their LGBTQ+ child, could inhibit their child’s development and well-being, and might contribute to serious health concerns.

References:

  1. Pride and Mental Health
  2. How COVID-19 is Impacting LGBTQ Youth
  3. The Disproportionate Impacts of COVID-19 on LGBTQ Households in the U.S
  4. Substance Abuse and Mental Health Services Administration, A Practitioner’s Resource Guide: Helping Families to Support Their LGBT Children

Additional References/Resources:

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