Barriers to Mental Health Support and Recommendations for Improvement From the Perspectives of LGBTQ+ Youth.

PURPOSE

Lesbian, gay, bisexual, transgender, queer, intersex, asexual plus (LGBTQ+) youth face significant barriers to mental health care, ranging from a lack of access to therapists, months-long waitlists, and lack of insurance coverage to receiving incompetent care from non-affirming providers. The current study sought to understand the experiences of LGBTQ+ youth when accessing mental health care.

METHODS

The current study utilized a fixed, embedded mixed methods design with 808 LGBTQ+ youth in the United States. Participants reported their experiences with mental health access and use, as well as provided qualitative responses about their experiences.

RESULTS

In this sample, less than half of LGBTQ+ adolescents stated they were able to access mental health care when it was needed. Youth described experiencing unethical therapy practices by clinicians, cited their parents and practical concerns as barriers to accessing care, and concealing their identity from providers out of fear and mistrust. Youth also described feeling both validated and invalidated once they did receive care. Youth provided recommendations around LGBTQ+ competence, respect for youths' identities and autonomy, and making care as accessible as possible.

DISCUSSION

Recommendations for caregivers, providers, organizations and programs, and policymakers are provided based on youth responses and previous literature. For example, guidelines were provided for parents on how to communicate with youth about mental health concerns, for therapists on how to improve cultural competency when working with LGBTQ+ youth, and for policymakers on how to improve access to affirming care through legislation and community engagement.