The availability of LGBT-specific mental health and substance abuse treatment in the United States

Proportion of U.S. Clinics Offering LGBT-Tailored Mental Health Services Decreased Over Time: A Panel Study of the National Mental Health Services Survey

Our objective was to characterize the proportion of U.S. mental health clinics that offered LGBT-tailored mental health services between 2014 and 2018. We used data from the National Mental Health Services Survey (NMHSS) to construct a mixed logistic model of availability of LGBT-tailored mental health services over time, by region (Northeast, South, Midwest and West), and by facility type (Veterans Administration, inpatient/residential, outpatient, community mental health centers and mixed). Our results show that the overall proportion of mental health clinics that offered LGBT-tailored services decreased from 2014 to 2018. Our results also indicate that Veteran Affairs clinics and facilities in the West and Northeast were most likely to offer LGBT-tailored mental health services. Given the temporal, regional, and facility gaps in LGBT-tailored mental health services availability, more effort should be dedicated to addressing this disparity.

Depression, Anxiety, and Alcohol Use Among LGBTQ+ People During the COVID-19 Pandemic

Objectives. To describe disparities in depression, anxiety, and problem drinking by sexual orientation, sexual behavior, and gender identity during the COVID-19 pandemic. Methods. Data were collected May 21 to July 15, 2020, from 3245 adults living in 5 major US metropolitan areas (Atlanta, Georgia; Chicago, Illinois; New Orleans, Louisiana; New York, New York; and Los Angeles, California). Participants were characterized as cisgender straight or LGBTQ+ (i.e., lesbian, gay, bisexual, and transgender people, and men who have sex with men, and women who have sex with women not identifying as lesbian, gay, bisexual, or transgender). Results. Cisgender straight participants had the lowest levels of depression, anxiety, and problem drinking compared with all other sexual orientation, sexual behavior, and gender identity groups, and, in general, LGBTQ+ participants were more likely to report that these health problems were "more than usual" during the COVID-19 pandemic. Conclusions. LGBTQ+ communities experienced worse mental health and problem drinking than their cisgender straight counterparts during the COVID-19 pandemic. Future research should assess the impact of the pandemic on health inequities. Policymakers should consider resources to support LGBTQ+ mental health and substance use prevention in COVID-19 recovery efforts.

Sexual Minority Disparities in Health and Well-Being as a Consequence of the COVID-19 Pandemic Differ by Sexual Identity

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has accentuated long-standing population health disparities in the United States. We examined how the pandemic and its social consequences may differentially impact sexual minority adults, relative to heterosexual adults. Methods: Data are from a U.S. national sample of adults (n = 2996; 18.06%) collected from online panels from April to May 2020. We used eight indicators of well-being-mental health, physical health, quality of life, stress, loneliness, psychological distress, alcohol use, and fatigue-to assess the degree to which sexual identity subgroups (i.e., heterosexual, gay/lesbian, bisexual, and "other" sexual minority) varied in retrospective pre- and postpandemic onset indicators of well-being and whether groups varied in their rate of change from pre- and postpandemic onset. Results: The results showed consistent patterns of decline in well-being across sexual identity subgroups, although changes in mental health, physical health, quality of life, stress, and psychological distress were more robust among sexual minority adults in general, relative to heterosexual adults. Adjusted multivariate models testing differences in change in retrospective pre- and postpandemic onset found that well-being among bisexual men and women was most negatively impacted by the pandemic. Conclusion: The COVID-19 pandemic may have distinct health consequences for sexual minority adults in the United States. Our findings support and further legitimize calls for more comprehensive surveillance and cultural responsiveness in emergency preparedness as it relates to sexual minority people and the COVID-19 pandemic.

Changes in alcohol use since the onset of COVID-19 are associated with psychological distress among sexual and gender minority university students in the U.S

BACKGROUND

Sexual and gender minority (SGM) young persons are experiencing compounding effects of COVID-19 due to unique social inequalities and existent mental health and substance use challenges. Given that 41% of all young persons are enrolled in universities, and the increased vulnerabilities faced by SGM young persons during the pandemic, it is imperative to understand the effects of alcohol use on mental health among SGM university students amid COVID-19. This study aims to examine the associations between changes in alcohol use since the start of COVID-19 and mental distress among SGM university students in the U.S., and to explore sex-stratified differences.

METHODS

A nonprobability cross-sectional sample of 509 SGM university students (M_age = 22.04 years, SD = 3.99) were retrospectively surveyed online between May-August 2020 and asked if their alcohol use had changed since the start of COVID-19. Statistical analyses explored the association between changes in alcohol use since the start of COVID-19 and mental distress.

RESULTS

Average psychological distress (M = 27.79, SD = 7.82) was relatively high as per existing research and established clinical cutoff scores. Roughly 32% had increased alcohol use since the start of COVID-19. Subsequently, greater alcohol use (p < .05) since the start of COVID-19 was associated with higher psychological distress among SGM university students, and among females but not males assigned at birth.

CONCLUSIONS

Higher education, medical, and behavioral health professionals should consider how to adapt their practice to address alcohol use and psychological burdens among SGM university students (especially females) who are facing health inequities during and beyond COVID-19, requiring SGM-affirmative care.

The availability of LGBT-specific mental health and substance abuse treatment in the United States

OBJECTIVE

To examine the availability and facility-level predictors of LGBT-specific mental health and substance abuse treatment in the United States.

DATA SOURCES/STUDY SETTING

2016 National Survey of Substance Abuse Treatment Services, 2016 National Mental Health Service Survey, and 2015-2016 Gallup Daily tracking survey.

STUDY DESIGN

Logistic regression models and average marginal effects were used to identify characteristics of facilities that offer LGBT-specific programs. Linear regression models were used to estimate the association between the state-level proportion of LGBT people and the proportion of facilities that offer LGBT-specific programs.

DATA COLLECTION/EXTRACTION METHODS

Secondary data analysis. Cases with missing values for any predictor were excluded.

PRINCIPLE FINDINGS

12.6 percent of mental health and 17.6 percent of substance abuse facilities reported LGBT-specific programs. Several facility characteristics were statistically associated with the likelihood of mental health and substance abuse facilities providing LGBT-specific programs, including offering outpatient or residential treatment, private ownership, religious affiliation, and payment type. The proportion of LGBT adults living within each state was statistically associated with state-level density of LGBT-specific mental health programs, but not substance abuse programs.

CONCLUSIONS

Findings suggest limited availability of culturally competent mental health and substance abuse treatment, despite well-documented need.