Presentation on theme: "An Introduction to Reducing Disparities for LGBTQ Communities"— Presentation transcript:
1 An Introduction to Reducing Disparities for LGBTQ Communities First, Do No Harm:An Introduction to Reducing Disparities for LGBTQ CommunitiesPoshi Mikalson, MSWProject DirectorLGBTQ Reducing Disparities ProjectIntroduction to WorkshopIs everyone in the right place? Pass around sign-in.
2 How it all started Passed in 2004 Increased funding for mental health servicesIs anyone not familiar with Prop. 63?This is funded thru PEIProvided funding for prevention and early intervention programs
3 CA Reducing Disparities Project In response to the call to reduce mental health disparities and seek solutions for historically underserved communities in California, the Department of Mental Health (DMH), has called for a key statewide policy initiative as a means to improve access, quality of care, and increase positive outcomes for racial, ethnic and cultural communities.In 2009, DMH launched this two-year statewide Prevention and Early Intervention project focusing on 5 population groups that have been underserved, and underrepresented by the public mental health system. (READ LIST ON SCREEN)Each of the five groups was awarded a contract to develop population specific reports which will be combined into a statewide comprehensive plan to identify new approaches towards reducing disparities.
4 Strategic Planning Workgroup This was the first statewide project to include LGBTQ communities and has been an exciting opportunity for us to make our voices heard about the specific needs of our communities.Explain collaboration with EQCAI
12 First, Do No HarmFirst and foremost…prevention should be the operative term when discussing LGBTQ disparities…&Explain why it is titled first do no harmRead p 18 & 19 to audiencePOSHI – these are fly-insFirst, do no harm should be the credo
13 First, Do No HarmLGBTQ individuals are being harmed…daily, weekly, monthly, yearly, & sometimes lifetime basis due to stigma, discrimination, prejudice, rejection & legal inequality.The need for culturally competent mental health services is great, but greater still is the need to eliminate the multiple harms that contribute to negative mental health throughout LGBTQ communities.Poshi these are Fly insLook at p 18 & 19 “they represent invisible… also work with “The need for culturally competent…”Explain why it is titled first do no harmRead p 18 & 19 to audience
14 FindingsExplain what they will see in the following slides
16 QueerQueer? Who fell under that identity? Talk about the decision of why we (the community) changed to queer; when someone says they are queer this is where they really fall.Questioning – very few responded with questioning
18 Experienced Emotional Difficulties Due to sexual orientation
19 Social Supports I am not out about my sexual orientation to: Extended familyChildhood ReligionCoworkersFamily of originRacial/ethnic communityOther students at my schoolPoshi – these are all fly-ins so you will have to click to make each one appear
20 Social Supports: Rejection Childhood religionRacial/ethnic communityFamily of originExtended familyCurrent religionOther students at my schoolTop 6 rejecting social supportsPoshi – these are all fly-ins so you will have to click to make each one appearReligion was listed as the top most rejecting for almost all subgroupsBlack and AANHPI listed their communities as most rejecting
21 Providers I am not out to about my sexual orientation ? GynecologistSpecialistMental Health ProviderNurse/Nurse PractitionerPrimary Care DoctorDentistPediatricianSchool CounselorPoshi – this is for your interactive portion. This is the list they can choose from. Answers are on the next slide.
22 Providers I am not out to about sexual orientation DentistPrimary CareNurse/Nurse PractitionerSpecialistGynecologistPediatricianFly ins
23 Most rejecting providers of Sexual Orientation? PsychiatristNurse/Nurse PractitionerAdoptionGynecologistPrimary Care DoctorSchool CounselorSpecialistDentistPoshi – this is for your interactive portion. This is the list they can choose from. Answers are on the next slide.
24 Most rejecting providers Primary Care PhysicianNurse/Nurse PractitionerGynecologistSpecialistAdoption AgencyDentistPoshi – these are all fly-ins so you will have to click to make each one appear
25 LGBTQ-Specific Barriers to service Don’t know how to find an LGBTQ competent providerCannot find a provider who I am comfortable with who is also LGBTQ knowledgeableConcerned my provider will be unsupportive of my LGBTQ identityNo LGBTQ specific services in my areaSO/GI confidentiality concernsLGBTQ competent providers are in the same social circlePoshi these are fly-ins
26 Problems with Mental Health Providers Did not know how to help with my sexual orientation concernsDid not know how to help with my gender identity/expression concerns(Trans Spectrum – 5X more likely)My SO/GI became the focus of my treatment, but was not why I sought services(no fly ins)
27 Problems with Mental Health Providers Made negative comments about my sexual orientationMade negative comments about my gender identity/expression(Trans Spectrum - 4x as likely)Did not know how to help same-sex couplesDid not know how to help mixed-orientation couples
29 Barriers to providing services What were the barriers to providing services? (LGBTQ provider slide is next)
30 Experiences of LGBTQ Providers BECAUSE of sexual orientation or gender identity /expression Sought after as an expert on LGBTQ issuesTreated differently by colleaguesVerbally harassedAssigned to LGBTQ clients/patientsSocially excluded by colleaguesInstructed to keep sexual orientation or gender identity hidden
32 Top 7 BarriersLack of training on the concerns and needs of Transgender peopleLack of training on the concerns and needs of LGBTQ parentsLack of training on the coming out processLack of training on the concerns and needs of LGB peopleTop 7 Barriers listed with regards to providing services
33 Top 7 BarriersNo access to supervision/consultation with providers who have expertise in LGBTQ concerns and needsNot able to provide services in client’s/patient’s native languagePersonal religious beliefsTop 7 Barriers listed with regards to providing services
34 Comfort mattersof non-LGBTQ providers reported being very comfortable working with LGBTQ clientsA providers comfort level is one indicator of cultural competence and affirmative care.As comfort level increases, positive beliefs regarding LGBTQ people significantly increases, as well.of LGBTQ providers reported being very comfortable with working with LGBTQ clients
35 Gay Affirmative Practice(GAP) Scale Explain the Gay Affirmative Practice Scale (Catherine Crisp)
36 Training matters75% reported attending at least one LGBTQ specific training in the past 5 years67% reported attending at least one LGBTQ specific training in the past yearLGBTQ providers reported completing significantly MORE LGBTQ workshops and trainings than non-LGBTQ colleagues in the past 12 monthsFly ins
37 for each training they attended their GAP score went up 3pts Why training mattersThe more trainings someone reported attending the higher their GAP scale…for each training they attended their GAP score went up 3ptsfly insTraining affects beliefs
38 RecommendationsExplain what they will see in the following slides
39 Counting LGBTQ peopleDemographic information should be collected for LGBTQ people across the lifespan, & across all demographic variations (race, ethnicity, age, geography) at the state and county levels.
40 Possible barriers to counting LGBTQ People What are the possible barriers to implementing this recommendation?What are the barriers to implementing recommendations
41 Asking the QuestionOnly 29% of Mental/Behavioral/Medical Health providers ask about sexual orientationOnly 26% ask about gender identityMore trainings = asking about sexual orientation or gender identity/expression!
42 TrainingStatewide workforce training & technical assistance should be required in order to increase culturally competent mental, behavioral, and physical health services, including outreach and engagement, for all LGBTQ populations across the lifespan, racial & ethnic diversity, & geographic locations.Fly insTraining of service providers in public mental/behavioral & physical health systems should focus on the distinctiveness of each sector—lesbians, gay men, bisexual, transgender, queer & questioning—with an overarching approach to mental health throughout the lifespan for the racial, ethnic, & cultural diversity of LGBTQ communities.
43 TrainingCultural competency training,[…] cannot only be a general training on LGBTQ as a whole but also needs to include separate subgroup-specific training sessions.
44 Possible barriers to more LGBTQ Trainings What are the possible barriers to implementing this recommendation?What are the barriers to implementing recommendations
45 Promising Practices?If you don’t know who you’re serving, how will you know what promising practices to put into place?Also, suggestion regarding partnering with community members to do the actual work.
46 LGBTQ Reducing Disparities Project Final ThoughtsContact InformationPoshi Mikalson, MSWProject Director,LGBTQ Reducing Disparities ProjectCell phone:Any final thoughts, questions, comments?