Mental Health and Addiction Services Exclusive to LGBTQ2S+ during COVID-19: An Environmental Scan

Where are all the Services: Mapping Community-Based Services for Canadian Autistic Youth with Co-occurring Mental Health Conditions

PURPOSE

Autistic youth are at heightened risk of mental health issues and face several barriers to accessing appropriate supports. A lack of available services is a common barrier that many autistic youth experience, with only 43% of autistic youth from the US who needed mental health services receiving them. Little is known about the availability of these mental health services in Canada, despite the high prevalence of mental health issues in autistic youth. The current study is one of very few that has reviewed the state of community-based programs and services for the support of mental health challenges in autistic people in North America, and the first such study in Canada.

METHODS

Using an environmental scan methodology, we conducted a search of resource listings on various community websites with a filter for "autism". The resulting websites were then reviewed to find what services providers offer for autistic youth (≥ 25 years) and contacted to complete a survey.

RESULTS

267 listings of mental health supports were identified in the initial search, with 94 sites that specifically mentioned serving autistic youth. 43% (n = 40) of service providers completed a survey about the services they offered, therapeutic approaches, and background training. Providers reported that neurodiversity approaches and multi-disciplinary teams were working well in their practices, yet funding access and society's views on autism were barriers they face.

CONCLUSION

Findings add to the growing body of evidence that availability of services is a systemic barrier that many autistic youth experience when accessing mental health supports.

'Snapshot in time': a cross-sectional study exploring stakeholder experiences with environmental scans in health services delivery research

OBJECTIVE

To describe stakeholder characteristics and perspectives about experiences, challenges and information needs related to the use of environmental scans (ESs).

DESIGN

Cross-sectional study.

SETTING AND PARTICIPANTS

A web-based survey platform was used to disseminate an online survey to stakeholders who had experience with conducting ESs in a health services delivery context (eg, researchers, policy makers, practitioners). Participants were recruited through purposive and snowball sampling. The survey was disseminated internationally, was available in English and French, and remained open for 6 weeks (15 October to 30 November 2022).

ANALYSIS

Descriptive statistics were used to describe the characteristics and experiences of stakeholders. Thematic analysis was used to analyse the open-text questions.

RESULTS

Of 47 participants who responded to the survey, 94% were from Canada, 4% from the USA and 2% from Australia. Respondents represented academic institutions (57%), health agency/government (32%) and non-government organisations or agencies (11%). Three themes were identified: (a) having a sense of value and utility; (b) experiencing uncertainty and confusion; and (c) seeking guidance. The data suggest stakeholders found value and utility in ESs and conducted them for varied purposes including to: (a) enhance knowledge, understanding and learning about the current landscape or state of various features of health services delivery (eg, programmes, practices, policies, services, best practices); (b) expose needs, service barriers, challenges, gaps, threats, opportunities; (c) help guide action for planning, policy and programme development; and (d) inform recommendations and decision-making. Stakeholders also experienced conceptual, methodological and practical barriers when conducting ESs, and expressed a need for methodological guidance delivered through published guidelines, checklists and other means.

CONCLUSION

ESs have value and utility for addressing health services delivery concerns, but conceptual and methodological challenges exist. Further research is needed to help advance the ES as a distinct design that provides a systematic approach to planning and conducting ESs.

Disparities in the unmet mental health needs between LGBTQ+ and non-LGBTQ+ populations during COVID-19 in the United States from 21 July 2021 to 9 May 2022

Background

Evidence highlighted the likelihood of unmet mental health needs (UMHNs) among LGBTQ+ than non-LGBTQ+ populations during COVID-19. However, there lacks evidence to accurately answer to what extent the gap was in UMHN between LGBTQ+ and non-LGBTQ+ populations. We aim to evaluate the difference in UMHN between LGBTQ+ and non-LGBTQ+ during COVID-19.

Methods

Cross-sectional data from Household Pulse Survey between 21 July 2021 and 9 May 2022 were analyzed. LGBTQ+ was defined based on self-reported sex at birth, gender, and sexual orientation identity. UMHN was assessed by a self-reported question. Multivariable logistic regressions generated adjusted odds ratios (AODs) of UMHN, both on overall and subgroups, controlling for a variety of socio-demographic and economic-affordability confounders.

Findings

81267 LGBTQ+ and 722638 non-LGBTQ+ were studied. The difference in UMHN between LGBTQ+ and non-LGBTQ+ (as reference) varied from 4.9% (95% CI 1.2-8.7%) in Hawaii to 16.0% (95% CI 12.2-19.7%) in Utah. In multivariable models, compared with non-LGBTQ+ populations, LGBTQ+ had a higher likelihood to report UMHN (AOR = 2.27, 95% CI 2.18-2.39), with the highest likelihood identified in transgender (AOR = 3.63, 95% CI 2.97-4.39); compared with LGBTQ+ aged 65+, LGBTQ+ aged 18-25 had a higher likelihood to report UMHN (AOR = 1.34, 95% CI 1.03-1.75); compared with White LGBTQ+ populations, Black and Hispanic LGBTQ+ had a lower likelihood to report UMHN (AOR = 0.72, 95% CI 0.63-0.82; AOR = 0.85, 95% CI 0.75-0.97, respectively).

Interpretation

During the COVID-19, LGBTQ+ had a substantial additional risk of UMHN than non-LGBTQ+. Disparities among age groups, subtypes of LGBTQ+, and geographic variance were also identified.