Improving alcohol and mental health treatment for lesbian, bisexual and queer women: identity matters

Abstract Objective: Lesbian, bisexual and queer (LBQ) women experience substantial unmet alcohol and mental health treatment needs. This paper explores the way in which sexual identity shapes experience, and needs, in relation to alcohol and mental health treatment, and presents key messages for improving treatment. Methods: Twenty‐five in‐depth interviews were undertaken with same‐sex attracted Australian women, aged 19–71. Interview transcripts were analysed thematically. Results: Key messages offered by participants focused on language, disclosure and practitioner training. Variation in sexual identity did not alter treatment expectations or needs; however, we noted an important difference with respect to identity salience, with high LBQ identity salience linked with preference for disclosure and acknowledgement of sexual identity in treatment interactions, and low identity salience linked with a preference not to disclose and for sexual identity not to require acknowledgement in treatment. Conclusions: Treatment providers may find it useful to gather information about the centrality of sexual identity to LBQ women as a means of overcoming treatment barriers related to heteronormative conventions and discrimination, language and disclosure. Implications for public health: Treatment providers should adopt more inclusive language, seek information about identity salience and the importance of sexual identity to the current treatment, and regularly pursue LBQ‐related professional development upskilling

Mental and Physical Health Needs of Lesbian, Gay, and Bisexual Clients in Substance Abuse Treatment

OBJECTIVE: Lesbian, gay, and bisexual (LGB) orientation predicts greater substance use, treatment utilization, and poorer mental and physical health, but health needs of LGB individuals in substance abuse treatment remain largely unknown. The purpose of this study was to identify differences in mental and physical health needs of LGB individuals in substance abuse treatment. METHODS: Substance abuse treatment admissions data from the County of San Francisco were used in this investigation of differences in mental and physical health problems and service utilization between LGB (n=1,441) and heterosexual individuals (n=11,770). RESULTS: LGB individuals were more likely to have mental health diagnoses ((adj)ORs ranging from 1.86–4.00) and current mental health prescription medications ((adj)ORs from 1.79–4.99) than heterosexual counterparts. Gay and bisexual men and bisexual women but not lesbian women, were more likely to be receiving mental health treatment. Gay men and bisexual women were more likely than heterosexual counterparts to report physical health problems. Gay and bisexual men and bisexual women but not lesbian women were more likely to be receiving health care. There were no differences between LGB individuals and heterosexual counterparts in the number of emergency room visits or hospital overnight stays. DISCUSSION: This study found that LGB individuals entering substance abuse treatment have greater mental and physical health needs than heterosexual counterparts. Implications for healthcare integration, research, and practice are discussed

Wounded Healers: A Multistate Study of Licensed Social Workers’ Behavioral Health Problems

Studies indicate that helping professionals are disproportionately affected by behavioral health problems. Among social workers, the nature and scope of these problems are understudied. This article reports the findings of a 2015 survey of 6,112 licensed social workers in 13 states regarding their problems with mental health; alcohol, tobacco, and other drugs; and gambling. To ascertain whether these problems preceded or developed during their social work careers, the periods of time when these issues were experienced were identified. Results indicate that 40.2 percent of respondents reported mental health problems before becoming social workers, increasing to 51.8 percent during their social work career, with 28 percent currently experiencing such problems. Nearly 10 percent of the sample experienced substance use problems before becoming social workers, decreasing to 7.7 percent during their career. Analyses by race or ethnicity, sex, and age identified between-group differences in the prevalence of these problems. The article concludes with a discussion of the implications for the social work profession