A Safe Haven

Acceptance of varied sexual orientations, gender identities, and the unique mental health needs of the LGBTQIA+ population has increased dramatically over the years. In 1973, homosexuality was removed as a diagnosis from the Diagnostic and Statistical Manual as gay activism and research proved that this was a difference, not a disorder. But still, LGBTQIA+ people face discrimination, trauma, family rejection, and homelessness, among other issues that can lead to anxiety, depression, substance use disorders, and suicidal thinking. According to the advocacy group Mental Health America, more than 39% of people who identify as lesbian, gay, bisexual, or transgender reported having a mental illness in the past year. 

Fortunately, Sheppard Pratt has clinicians and programs that can address the mental health needs of this community and provide a safe place for them to seek nonjudgmental treatment. 

“We’re fostering an environment in which all of our patients, including those in the LGBTQIA+ community, can safely access care,” says Jason Addison, MD, service chief of the Adult Crisis Stabilization Unit.

“It’s so important that we as care providers reflect our values and be a welcoming, supportive environment where patients can trust us to talk about all the issues in their life, including issues relating to being part of the LGBTQIA+ community.”

That trust is built—in many ways—from recognizing that a patient may not immediately identify as a member of the LGBTQIA+ community, to using a person’s preferred pronouns and name, to respecting that the patient may not be “out” to family members or others. Keeping those boundaries safe is paramount.

For treatment, Dr. Addison describes a variety of care settings. “We have outpatient services, partial hospitalization day programs, or inpatient services depending on what level of care a person would benefit from,” he says. “We have a multidisciplinary team that assesses any underlying psychiatric conditions, such as depression, anxiety, or trauma disorders. We have a social worker who can reach out to the patient’s family or their support people. It may be immediate family, ‘chosen’ family members, or other community members, so we try to identify the positive support people in the patient’s life and build from there.” 

A Sheppard Pratt partner organization in Montgomery County, MoCo Reconnect, offers an LGBTQIA+ drop-in center—an affirming space for teens in need of anything from individual or group therapy to GED classes and job training to showers, laundry, and relaxation with peers.

Caring for LGBTQIA+ youth 

It can be especially hard for LGBTQIA+ children and adolescents when their family members disapprove of, disrespect, or fear their orientation or identity. Afifa Adiba, MD, service chief of the Adolescent Mood Disorders Unit at Sheppard Pratt, has worked with young people who are bullied at school or online and have no support at home or in their communities.

Dr. Adiba describes the type of story that she hears frequently:

“Patients say to me, ‘Doctor, I am not living my true life. I feel like I’m not being myself in front of my peers, at school, or at home. If they don’t respect me for who I am or understand me for who I am, it is hard for me to accept them in my life, and I don’t feel connected to them.’

I think that’s the conflict they deal with every single day. Imagine if you were hiding a big part of yourself. That’s a big stressor for them.” 

Building resilience

 “When we talk about resilience and pride, we need to think about expression, inspiration, and being self-advocates, and we need to think about the celebration of human life and identity,” says Dr. Adiba.

“Everyone should feel comfortable with their identity and in their own skin. It is a journey of self-acceptance. Each individual must learn how to stand tall in their truth, form a connection within their community, and embrace their uniqueness.”

But until someone reaches that place of comfort, they can rely on allies in the community, including mental health professionals. “Things don’t have to be awful to reach out for help,” says Dr. Addison. “There’s a world of options before reaching a state of crisis. I don’t just see my primary care doctor when I have pneumonia, right? As we all look to develop and become our most authentic selves, let’s find other ways to take care of our general health and mental health.”