- If it’s not their parents stopping them getting help, it’s the insurance company.
LGBT+ youth face major barriers getting mental health care – despite being at higher risk of depression, self-harm and even suicide.
Overall, more than half (54%) of LGBT+ youths who wanted mental health care in the past year couldn’t get it.
A new report looked at 13 to 24-year-olds who are LGBT+ in the US. It found LGBT+ youths from all backgrounds faced barriers. However, race, gender, where they live and poverty could all make the situation even worse.
Meanwhile young people used words like ‘embarrassed’, ‘ashamed’ and ‘weakness’ to explain why they aren’t getting mental health care when they need it.
The Trevor Project, the world’s largest suicide prevention and crisis intervention organization LGBT+ young people, conducted the research.
Dr Amy E Green, The Trevor Project’s research director, said:
‘Given the disproportionately higher rates of mental health challenges and suicide attempts reported by LGBTQ youth, any barriers to mental health care can have enormous consequences.
‘We must act now to break down these barriers to save lives.
‘Establishing a mental health care system that is equitable, effective, and available for all will not be easy.
‘It will require major investment in public-funded programs and a wide variety of policy changes aimed at expanding access, improving the cultural competency of providers, and eliminating structural barriers.
‘And from the top down, we must all work together to actively confront mental health stigma and reduce fears around asking for help.’
Barriers to mental health care
The new report – Breaking Barriers to Quality Mental Health Care for LGBTQ Youth – analyzes the problems in detail.
The most common barrier for LGBT+ youths is they can’t afford mental health care. Over half (53%) reported this problem.
While some said they didn’t have health insurance coverage, others said the coverage didn’t offer appropriate care.
Meanwhile 22% feared they would be ‘outed’ if they accessed help. 11% wanted to find an LGBT+ provider but couldn’t.
And 20% thought providers would not understand their LGBT+ identity. By contrast, 16% feared providers would focus too much on the fact they are LGBT+.
Likewise, around one in five (22%) had a previous negative experience, which put them off.
At the same time, the fact they are young is also a barrier. In particular 36% didn’t want to get parental permission to access help. Moreover, 16% had parents who refused them to seek care.
Meanwhile for 10% the place they could get help was too far away. Likewise, 20% had no way of getting to the service they wanted.
Furthermore, Latinx, Asian American and Pacific Islander youth are around 40% more likely and black youth nearly 30% more likely to have unmet mental health care needs compared to their white LGBT+ peers LGBTQ youth.
Some young people of color said white mental health care providers may not understand how racism damages their mental health.
Unmet mental health care needs were also greater among cisgender youths (57%) compared to transgender and non-binary youth (50%). That partly because mental health treatment is typically on offer to people who are transitioning.
Despite that, trans and non-binary youths often feared providers wouldn’t understand their identities. They were more likely to face cost barriers, say they’ve had negative experiences in the past or be worried about being outed.
Better mental health by phone or video
The Trevor Project’s ‘2020 National Survey on LGBTQ Youth Mental Health’ looked at 40,000 LGBT+ young people in the US.
And Dr Green said: ‘COVID-19 has highlighted vast disparities that exist within the US mental health care system’.
However she added it had also shown one possible solution. During the pandemic, ‘telephone or video conferencing’ have proven effective. Green now thinks telehealth services should expand to help LGBT+ youths in the long term.
LGBT+ mental health help
If you are struggling with your mental health, help is available. You will find a list of LGBT+ resources and helplines all around the world here. Please note, some of the helplines may have different operating hours during the pandemic.