Being a part of the LGBTQ community can come with a sense of pride, support and camaraderie. It can highlight the strength that is felt when experiences are shared openly and supported deeply.
However, being a part of this community can also bring forth a unique set of challenges, one of them being mental health. Members of the LGBTQ community face a higher risk of mental health conditions, especially depression and anxiety.
"If you or someone you care about identifies as a part of this community, it doesn't mean you or their mental health is automatically at risk," says Sarah Aked, MSW, a social worker at Main Line Health. "However, it does mean there are certain cultural and socioeconomic factors — such as discrimination, limited rights and social hurdles — that may be more challenging."
The risk factors for the LGBTQ community are clear. What's even clearer is the importance of getting help if you or a loved one needs it. Here are five risk factors that the LGBTQ community faces and how to find the help you or a loved one needs.
1. Rejection from family and friends
Either during the coming out process or after, many LGBTQ people have faced rejection from others about this significant part of their identities. This includes from family, friends, coworkers and faith communities.
For instance, roughly 86% of LGBTQ youth say they've been harassed at school. Their homes aren't always a safe space, either, as just 37% of LGBTQ youth say they consider their homes to be LGBTQ-affirming. This lack of support from loved ones can have a major impact on mental health, including low self-confidence and depression.
However, acceptance from others — particularly family members — can have a protective effect. It can enhance self-esteem and overall health as well as reduce feelings of depression.
Rejection is traumatic, but LGBTQ people may also face other trauma. This includes stereotyping, lack of access to opportunities and abuse (verbal, physical and mental). In fact, LGBTQ folks are some of the most frequent victims of hate crimes in the US.
This trauma can lead to an increased risk of post-traumatic stress disorder (PTSD) compared to people who are heterosexual or cisgender (those who identify with the gender they were assigned at birth).
While no one should have to experience trauma, there are ways that healthcare providers can support those who have. This can include providing trauma-informed care (which considers the impact of identity-based trauma), cultivating inclusive healthcare environments and screening for trauma (by primary care providers, behavioral health settings and emergency rooms).
3. Substance use
Possibly as a way to cope with these challenges or self-medicate, members of the LGBTQ community more commonly misuse or overuse substances. In fact, compared to the heterosexual population, they are more than twice as likely to use drugs and alcohol and also more likely to smoke cigarettes.
Regular substance use is more common in those who have tried to change their sexual orientations or gender identities as a part of "conversion therapy" as well as those who have been the victims of physical harm as a result of their LGBTQ identity.
Unfortunately, due to a lack of inclusive services, many don't seek the care they need. This can cause problems to not go away and become worse over time.
Like most health conditions, early intervention is crucial for addressing substance abuse. In order to help people get the support they need, family members and healthcare providers play an important role in identifying a problem and helping that person get the right support.
4. Suicidal thoughts and suicide
Many LGBTQ individuals face an increased risk of suicidal thoughts, plans and attempts.
Lesbian, gay and bisexual adults have a suicide risk that is three to six times higher compared to heterosexual adults. As for transgender adults, roughly half say they've considered suicide in the past year.
There are a number of factors that can lower this risk. They include support from loved ones, attending LGBTQ-affirming schools and living in communities that are accepting of LGBTQ people.
5. Lack of quality care for mental health
Care for mental health is crucial to anyone's well-being, and it should take into account an individual's experiences, needs and goals.
"However, mental health care often groups together the entire LGBTQ community, when each sub-community has unique challenges. What's worse, the needs of the LGBTQ community are sometimes not considered at all," says Ms. Aked.
Add in other factors — like race and socioeconomic status — and mental health professionals must be well-equipped in supporting the needs of a wide variety of patients. Unfortunately, not only do some mental health professionals lack cultural competency, but it can also be difficult for patients to disclose their gender identities or sexual orientations to their providers.
Needless to say, LGBTQ people are not getting the mental health care they need and deserve. If approached with an LGBTQ-inclusive philosophy, this can improve outcomes.
Addressing mental health challenges in the LGBTQ community
Mental health is a part of overall health. In the LGBTQ community, mental health challenges are common — but also preventable.
At Main Line Health, we're committed to:
- Using LGBTQ language, which is a key component to improving relationships.
- Improving culture, such as establishing the LGBTQ and Allies Employee Resource Group to establish priorities and a vision for engaging with LGBTQ communities.
- Setting policies, including making sure they are written with inclusive language.
- Nurturing strong relationships between providers and LGBTQ patients to build trust and improve health.
- It continues with supporting one another — family, friends, coworkers, neighbors and classmates.
Mirmont Outpatient Center Broomall, part of Main Line Health, offers a mental health intensive outpatient group (IOP) called SAGE (Sexuality and Gender Expansive). This group is open to any adult who identifies as LGBTQ+ and lives with a primary mental health diagnosis. It will include mental health psychoeducation, DBT-informed therapy, mindfulness and a culturally responsive and strengths-based approach.
If you know someone who is struggling with their mental health, encourage them to get the help they need from a healthcare provider who will respect and consider their identity as a part of their care.
Like any community, the LGBTQ community is stronger together. With the right resources, support and love, everyone can get the mental health care they need.
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