Behavioral health in the LGBTQ+ community
Mental health, substance use disorders, suicidal ideations, and other various behavioral health issues do not discriminate and effect people of all ages, race, socioeconomic backgrounds, gender, and religions.
As the month of June comes to an end, it provides the opportunity to highlight some of the difficulties related to behavioral health for people in the LGBTQ+ community (Lesbian, Gay, Bisexual, Transgender, Queer/Questioning). The month of June is recognized as Pride month for the LGBTQ+ community across the nation and the world.
Suicide is among the leading causes of death in the United States. In fact, in 2017 the Center for Disease Control reported 47,173 suicides. People who identify as LGBTQ+, whether they do so publicly or privately, are at a higher risk for suicidal thoughts and attempts. This risk applies to both youths and adults. According to the Human Rights Campaign (HRC), LGBTQ+ youth are more than twice as likely as heterosexual youth to experience suicidal ideation. LGBTQ+ youth are also more likely to experience depression and withdrawal from social engagement as a result. LGBTQ+ adults are more likely than heterosexual adults to experience mental illness, especially serious mental illness, suicide attempts, and have a higher rate of occurrences of substance use disorders. Among LGBTQ+ population, people who identify as transgender are at the highest risk for depression and suicide.
There are many factors that contribute to overall mental health and substance use. However, one of the driving factors for the increased risk of the LGBTQ+ population is stigma. There has been recent progress toward improving the discrimination faced by the LGBTQ+ community. It has only been 5 years since the Supreme Court of the United States ruled in the cased of Obergefell v. Hodges (2015) to legalize same sex marriage nationwide. In June of 2020, just this year, the Supreme Court ruled that LGBTQ+ employees are protected from discrimination in the workplace under the Civil Rights Act of 1964. Even within the behavioral health field, conversion therapy continues to be used in some places. Conversion therapy is a debunked and harmful form of mental health therapy that aims to change a person’s sexual orientation or gender identity by a variety of methods, often including shame, guilt, and emotional pain. The use of conversion therapy as a mental health practice has been banned in 20 states, as well as the District of Columbia and Puerto Rico. A number of local municipalities in Ohio have also banned the use of the practice, including Athens, Kent, Columbus, Cincinnati, Toledo, Lakewood, and Dayton. However, there is no statewide ban on the practice of conversion therapy in Ohio.
In addition to the legal and systemic challenges faced by many LGBTQ+ people that can contribute to behavioral health problems, there are often many more personal challenges that can have an even bigger impact. These challenges can include disapproval of family, rejection and shame from religion, as well as judgement and discrimination by peers. LGBTQ+ people can sometimes lose a sense of belonging they once had in their social group, or lose personal and familial supports that are vital to them as a result of their sexual orientation. Even finding behavioral health care providers and medical care providers who do not discriminate or judge based on sexual orientation can be a challenge for some LGBTQ+ people.
The good news is that there are a number of agencies and resources committed to helping fight the stigma that exists against the LGBTQ+ community, and who exist to help support behavioral health services and suicide prevention. Progress is being made. According to a February 2020 article in Reuters news, suicide rates have fallen among LGBTQ+ youths. However, suicides in LGBTQ+ populations still outpace those of their heterosexual peers. Below is a list of some of the resources available, both local and national. If you or someone you know is struggling with LGBTQ+ identity, mental health disorders, or substance use disorders, please reach out for help.
Local resources:
¯ Local Crisis Hotline: 740-373-8240 (24/7)
¯ Suicide Prevention Hotline: 1-800-273-8255 (24/7)
¯ Ohio Crisis Text Line: text 4HOPE to 741741 (24/7)
¯ Washington County Behavioral Health Board: wcbhb.org – 740-374-6990
National Resources:
¯ NAMI (National Alliance on Mental Illness) – nami.org – 800-950-6264
¯ The Trevor Project (LGBTQ youth) – thetrevorproject.org – 1-866-488-7386 (24/7)
¯ National Center for Transgender Equality – transequality.org – 202-642-4542
¯ It Gets Better Project – itgetsbetter.org
Eric Johnston is a member of the The Washington County Behavioral Health Board.