Artistic Expression as a Source of Resilience for Transgender and Gender Diverse Young People

There is a paucity of research exploring sources of resilience among transgender and gender diverse (TGD) young people with multiple marginalized identities. Information and communication technologies (ICT) offer unique opportunities for authentic self-expression, which is not always possible offline. The primary aims of this study were to understand unique sources of resilience among TGD youth in their online and offline lives. Using photo elicitation and grounded theory methods, we conducted online in-depth interviews with TGD young people (N = 29) between the ages of 14-25 across the United States identifying with at least one of the following social statuses: (a) person of color, (b) immigrant, or (c) living in a rural area. Four themes were identified from the data, with both online and offline artistic expression being viewed as a: 1) form of authentic self-expression; 2) coping mechanism; 3) way to connect to others; and 4) pathway toward agency. Findings advance understanding about the use of artistic expression as an underexamined source of resilience among TGD youth with multiple marginalized identities. Within clinical settings, options for TGD youth to participate in various forms of expressive art may improve engagement and enhance youths’ abilities to authentically express their thoughts, feelings, and experiences to promote healing and growth

Mental health provider perspectives of the COVID-19 pandemic impact on service delivery: a focus on challenges in remote engagement, suicide risk assessment, and treatment of psychosis

Abstract Background The COVID-19 pandemic has been impacting the need, utilization, and delivery of mental health services with greater challenges being faced by clients and providers. With many clients facing reduced access to services and social isolation, a focus on suicide risk assessment and prevention is critical. Concern is particularly increased for clients with schizophrenia spectrum disorders given data show suicide rates are disproportionately high for those with psychosis in comparison to the general population. Provider perspectives of challenges in service delivery are needed to inform efforts to improve access, feasibility, and quality of mental health care throughout the evolving pandemic. This study explored mental health provider perspectives of client challenges in service utilization and provider challenges in service delivery, including remote engagement, suicide risk assessment, and treatment of psychosis. Methods Data were collected from social work mental health providers (n = 12) in United States community mental health setting. Providers consented to participate and responded to questions about service delivery experiences in late 2020 and in relation to COVID-19. Demographic and practice-related provider data were explored descriptively using SPSS and qualitative data using open coding and grounded theory methods in Dedoose. Results Among the 9 providers who engaged in remote service delivery, 7 (77.8%) experienced challenges in remote engagement with clients and 8 (88.9%) experienced challenges in treatment of psychosis. Among the 7 providers who engaged in remote suicide assessment, 4(57%) experienced challenges. Qualitative themes emerged including logistic (e.g., technology access and use), engagement (e.g., virtual rapport-building and limited remote services), and clinical (e.g., difficulty assessing suicide risk, internal stimuli, abnormal involuntary movement, and affect) challenges in service delivery. Conclusions Provider perspectives are essential to inform efforts to build resources and problem-solve challenges and barriers that both providers and clients face throughout various shifts in mental health service delivery. Findings emphasize the need to troubleshoot client access to technology, bolster support for providers to prevent burnout, and greater provider training to improve skills in remote engagement, assessment, and treatment, particularly in relation to psychosis and suicide prevention. Study implications are not only critical for the evolving COVID-19 pandemic, but also in preparation for ongoing shifts in service delivery as technology evolves.http://deepblue.lib.umich.edu/bitstream/2027.42/173788/1/12913_2022_Article_8106.pd