​​ISSUE BRIEF:  LESBIAN, GAY, BISEXUAL, TRANSGENDER, QUEER or QUESTIONING (LGBTQ+)

    Trauma from discrimination, oppression, bullying and family rejection can lead to high levels of mental illness, and substance use for individuals, young and old, who identify as LGBTQ+.
    It is important for members of advisory boards and commissions to understand the need, and the key components for successful programs and services. 

THE STATISTICS

Adults

• 59% of LGBTQ adults & 60% of transgender adults experience mental illness (compared with 20.6% of adults) 1
  
• LGBTQ adults are 2X as likely to use federally prohibited drugs  4
  
• 61% of transgender adults of color experience mental illness. 5
  
• 50% of transgender adults reported having made a suicide attempt. 92% of these individuals reported having attempted suicide before the age of 25. 4
   
  

Children & Youth 

• 41.6% LGB report 4 or more Adverse Childhood Experiences (ACEs), compared to 25.3% for heterosexual individuals 2
  
• Over 50% of LGBTQ+ youth report feelings of chronic sadness 2
  
• 35% of LGBTQ youth, 45% of transgender youth and 40% of questioning youth have seriously considered attempting suicide, compared to 13% of non-LGBTQ youth. 3
  
• Over 50% of transgender youth report contemplating suicide compared to about 15% of non-transgender youth 2
  
• LGBT youth are 2X as likely to experiment with drugs & alcohol. 4
  
• BIPOC (Black, Indigenous, People of Color) LGBTQ youth report feeling: Depressed (79%); Hopeless or worthless (73%); Nervous or anxious (82%) 3
  
• Family support and acceptance is associated with less depression, less substance abuse and less suicidal behavior in LGBT youth. 10
  

 

KEY COMPONENTS

​All Ages:
Data Collection, Reporting & Analysis

• Forms that provide options for multiple gender identities and sexual orientation
• Performance outcome data to include LGBTQ+ alongside race and ethnicity

 
Policies & Procedures

• To prevent the use of stigmatizing or invalidating language
• To prevent bullying/harassment
• Inclusivity/Anti-Discrimination Statements visible on materials, in offices and facilities

 
Providers that represent and relate to age, ethnicity, race, religion, and culture, including LGBTQ+
 
Training for Providers, Families, Schools

• Sexual orientation, gender identity and expression
• Intersectionality: How race, gender, sexuality, age, ethnicity, health and many other characteristics are inseparable and experienced simultaneously 7

Suicide Prevention

• Programs that provide accessible resources to LGBTQ+ identified individuals

 
 Children & Youth:

• Alliances: Support networks that include both LGBTQ+ and non-LGBTQ+ allies.
• Youth & Families: Advocacy and therapeutic-style support for families and youth
   

PROGRAMS  9

Outreach
Breaking Down Barriers (San Diego)  is an outreach campaign that engages five distinct, underserved communities, including Latino, African-American, Native American, African immigrants/refugees, and Lesbian, Gay, Bisexual, Transgender and Questioning (LGBTQ) individuals, to increase access to mental health services.
 
Prevention & Early Intervention
Community Partnership - LGBTQ Counseling  (Monterey) provides outreach, engagement and mental health counseling (individual, family and group) for LGBTQ individuals and their significant others. This program also provides specialized trainings to staff, community providers and therapists.
 
Engagement (Amador)  A monthly, activity-based group was created to engage isolated members of the LGBTQ community in a unique way. Each month the group is held in a different location within Amador County. A case manager (or Personal Services Coordinator) organizes the activity and arranges transportation, if necessary, for behavioral health participants.
 
Older & Out Therapy Groups (Alameda)
Free, drop-in therapy groups for LGBTQIA+ adults over 60, now all online. Groups are facilitated by a licensed therapist, clinician, and trained peer specialist. Topics include: coping with loss, wisdom that comes with aging, going back in the closet to survive, ageism, dating, invisibility in the LGBTQIA+ community, family acceptance challenges, loneliness, resilience, and more.
 
Community Counseling & Supportive Services (CCSS) (Orange) is a short-term counseling program for Orange County residents of all age groups, who have or are at risk of developing a mild to moderate behavioral health condition. The program specializes in providing services to diverse communities including Lesbian, Gay, Bisexual, Transgender, Intersex, and/or Questioning (LGBTIQ+), deaf and hard of hearing and underserved ethnic communities.  CCSS provides:

• Screening & Assessment
• Individual Counseling
• Groups (Support & Educational)
• Case Management
• Referral and Linkage
• Community Outreach

 
Respite
Danelle’s Place Respite Program (Sacramento)
Danelle’s Place Respite Program, administered by Gender Health Center (GHC), provides mental health respite care, via a drop in center, to unserved and underserved adults ages 18 and over, who identify as lesbian, gay, bisexual, transgender, queer, questioning and/or allied. There is an emphasis on serving transgender individuals who are experiencing overwhelming stress. 
 
Lambda Lounge Respite Program (Sacramento)
Lambda Lounge Adult Mental Health Respite Program provides drop-in mental health respite care designed to prevent an acute mental health crisis from occurring, as well as suicide prevention support services to unserved and underserved adults ages twenty-four (24) and older who identify as LGBTQ. 
  
Workforce Education & Training (WET)
FACES introduces high school students to career paths in healthcare, public health, mental and behavioral health while supporting them with academic and behavioral health services that address their needs. 
 
Youth & Transitional Age Youth (TAY) Programs
Our Safe Place (San Diego) provides a full range of mental health treatment services for LGBTQ youth. Multiple drop-in centers across San Diego County will provide supportive services to any youth who identifies as Lesbian, Gay, Bisexual, Transgender, and Questioning. The drop-in centers will have support groups for youth, family members and/or caregivers, youth partners, and alumni mentorship programs.
 
Reducing Time Spent in Foster Care: The Youth Acceptance Project (YAP)8  (Alameda) is designed to keep LGBTQ youth safe in their family homes (family reunification/family preservation) and to advocate for safe and equitable permanency of LGBTQ youth when family reunification is not possible. This involves working with parents and caregivers of children either in care or at risk of entering in order to increase acceptance of LGBTQ children among their support systems. The YAP intervention reduces the time that children spend in foster care and reunites children with their families.
 
Yellow Submarine TAY Drop-In Centers (Los Angeles) Assist youth who are LGBTQ identified or questioning, foster youth, and/or experiencing homelessness between the ages of 16-25.  TAY centers are an LA County Department of Mental Health (DMH) funded contract in partnership with CA’s Department of Rehab (DOR) in order to provide services for mental health as well as career preparation.
 
LGBT Support (Calaveras)
With a contract from BHS, a local therapist provides bi-weekly community support group facilitation, in order to improve wellbeing, increase confidence/self-esteem, increase support network, and gain coping skills. The support group meets in local High Schools twice a month.

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ON-LINE PROGRAMS

​On-Line Programs & Resources
Gender Spectrum hosts free online groups for pre-teens, teens, parents, caregivers, and other family members and adults. These groups provide the opportunity to connect with others, share experiences, and feel the comfort of a supportive community. Various groups Include: Pre-Teens and Teens (13-19); Black Trans, Non-Binary & Gender Expansive Teen Group (13-19); People of Color Trans, Non-Binary & Gender Expansive Teen Group (13-18); Pre-Teens (10-12); Parent Support Group; Topic-based Discussion Groups for Parents and Other Adult Family Members and Facilitators Support Group (for anyone who runs a group serving youth and/or families)
 
Family Acceptance Project is a research, intervention, education and policy initiative to prevent health and mental health risks for LGBTQ children and Youth.
 
The Trevor Project provides crisis intervention and suicide prevention services to lesbian, gay, bisexual, transgender, queer & questioning (LGBTQ) young people under 25.

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Detrimental Impact of "Conversion Therapy"

“Change” Efforts Double and Triple Rates of Depression, Suicide Attempts, Decrease Self-Esteem,
Social Support, Education & Income in Young Adulthood
 November 2018, Family Acceptance Project
 
The American Medical Association, American Psychiatric Association & American Psychological Association all strongly oppose “Conversion Therapy”

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End Notes

1. James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016). The Report of the 2015 U.S. Transgender Survey. Washington, DC: National Center for Transgender Equality.
2. A Child is a Child—Snapshot:  California Children’s Health: LGBTQ+ Youth Health & Wellbeing, The Children’s Partnership, June 2020
3. The State of Mental Health in the LGBTQ Community, Human Rights Campaign Foundation, 2021
4. Sexual Orientation and Estimates of Adult Substance Use and Mental Health,  Substance Use and Mental Health Services Administration (SAMHSA), 2015
5. The State of Mental Health in LGBTQ Communities of Color, Human Rights Campaign Foundation, 2021
6. First, Do No Harm:  Reducing Disparities for Lesbian, Gay, Bisexual, Transgender, Queer and Questioning Populations in California,  The California LGBTQ Reducing Mental Health Disparities Population Report
7. SOGIE Handbook, Sexual Orientation, Gender Identity, and Expression, Affirming Approach and Expansive Practices, Kiku Johnson, Once Circle Foundation, 2019, Page 18
8. Family Builders: Best Practice for Serving LGBTQ Youth in Foster Care, Council on Accreditation
9. Mental Health Services Oversight & Accountability Commission (MHSOAC) Program Search Tool​

​More information is at:  www.calbhbc.org/lgbtq