How mental health impacts the LGBTQ+ community

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Why are mental health struggles so common in this community? Dr. Brett Johnson, child and adolescent psychiatrist at Rogers Behavioral Health's San Diego clinic, points to prejudice and marginalization as a major driving force behind the statistics. "Being subjected to any form of discrimination causes stress, and we know that chronic stress leads to both mental and physical health consequences," he explains.

Factors contributing to mental health struggles in LGBTQ+ individuals

The question as to why mental health issues are so common in people identifying as LGBTQ+ does not have just one answer. Likely factors playing a role include:

1. Trauma. Members of the LGBTQ+ community are more likely to be verbally or physically bullied both online and in person, and as a result may feel constantly on guard and that they need to monitor the environment around them. A recent survey from the Trevor Project found that two out of three LGBTQ+ youths have been confronted by someone who attempted to convince them to change their gender identity or sexual orientation. Those who have experienced "conversion therapy" are at increased risk of deep trauma.

2. Social factors. A variety of social factors also contribute to mental health disorders in LGBTQ+ people. In addition to a greater likelihood of being victimized by others, they face increased risks of housing insecurity and homelessness, which disproportionately affect LGBTQ+ youth due to discrimination, stigma, and rejection by family members.

3. Uncertainty of a clinician's acceptance. "Unfortunately, the mental health community has historically not been accepting and affirming to LGBTQ+ persons," says Dr. Johnson, pointing to the American Psychiatric Association's classification of homosexuality as a disorder until the 1970s. In addition to the historical context, many are apprehensive of seeking help because they do not know if they will be met with acceptance and understanding of their identity. "The therapist's or psychiatrist's office should not be a place where LGBTQ+ people have to hide things, put up walls, or use coded language," explains Dr. Johnson. Instead, patients should feel comfortable enough to share all their concerns with their doctor, and clinicians should approach each patient with openness and compassion.

4. Discriminatory messages in society. Compounding the issues above, society continues to perpetuate harmful stereotypes and set unrealistic expectations of the LGBTQ+ community. These messages may include pressure surrounding one's appearance, an over-emphasis on youth, and the normalization of substance use in some communities.

How Rogers sets the tone for affirmation and acceptance

As the mental health community continues to improve access to care for all people, Rogers creates an environment of acceptance for potential patients from the very beginning. When patients begin their telephone screening, they are asked their gender identity, preferred name, and preferred pronouns so staff may address them correctly. "This lets callers know that Rogers places great importance in honoring and respecting our patients," explains Dr. Johnson. Throughout treatment, staff seek to understand their patients' life experiences to ensure that they feel heard and validated.

While the field has made strides to reach all who are affected by mental health concerns, Dr. Johnson says there is still a need to raise awareness and reduce stigma around receiving mental healthcare in all populations. "We need to advocate that mental health and substance use disorders deserve the same level of treatment as physical health concerns do," says Dr. Johnson, adding "Help is out there. The right help can help people rise above their mental health challenges."