The Importance of Being LGBTQI+ Informed in Mental Healthcare

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The residents of Willow Haven give the staff ideas of topics they would like to learn about as staff prepare for person centered groups and one on one encounters. Topics asked for recently by our residents, gender and pronouns, have apt timing because the summer months are often marked with Pride celebrations throughout the United States. As a member of the LGBTQI+ community myself, I could write copious blog posts about this topic, and the myriad of connections which tie it to mental health. While I cannot address it all in one blog post, my hope is something I say will knock on the doors of your curiosity—and you might open your heart to visiting with this topic for the first time or revisiting for an umpteenth time.

Often when we think of Pride these days, we think of rainbow flags, parades, beautiful drag queens, joy, and community. However, the Stonewall Riots in 1969, the first Pride, was an outcry in opposition to the continued violence against the LGBTQI+ communities. I am personally filled with rage to know that LGBTQI+ are, today, the most hate-crime targeted population. 41 transgender and gender nonconforming people were murdered in 2020 in the US, and there have been 21 deaths in 2021 already. This is an intersectional issue, as BIPOC trans folks have always, and continue to, face increased risk of violence.

Within the mental health sphere being gay was classified as a mental health disorder in the DSM until 1973 and not removed until1987. Diagnosis targeted to transgender folks were not added until 1980, and not adjusted to address stigma, over generalizations and pathologizing of the identities of trans folks until 2013. Everyone using a DSM should continue to think critically about its use, and the diagnoses within. Back in 1973 I, and countless people I love, would have carried labels given to us by the mental health and medical fields for loving who we love and for emerging with gender variance, questioning of the binary, and fluidity. These labels had the power to impact lives in enormous ways, so we must never forget. In addition to this harrowing knowledge, LGBTQI+ youth are an especially vulnerable population, as they are more likely to experience suicidal ideation and attempt suicide. When gender identity is considered, in addition to sexuality, transgender and gender nonconforming youth are more likely to attempt suicide and have negative mental health outcomes. And with all this knowledge, queer folks are still largely underrepresented in research.

Any internet research will bring these facts to the forefront, and we must not numb out to them, rather we must continue to challenge ourselves personally and professionally to commit to nurturing values, beliefs, and actions which justly serve my community. As I write this, a friend, who is trans, texted me, “A coworker of mine repeatedly used the wrong pronouns for me at a meeting today.” This coworker apologized, after another coworker reminded them. The apology said more than, “I’m sorry.” It said, “I recognize and respect your identity.” It took bravery to correct the coworker who used the incorrect pronouns, as well as courage and vulnerability for an apology to be given. It meant the world to my friend. Now, my friend, deserves the basic respect cisgender (you identify as the gender you were assigned at birth) people have the privilege of walking through the world with. So how do we contribute to make Thrive sites truly a place for LGBTQI+ folks to literally thrive and live well?

Despite the oppression, erasure, and violence endured by the queer population, we are vibrant and resilient—qualities society at large now praises. So take note, there is something to learn from us. Do not underestimate the significance of being educated on the trauma survived, and the ways language is being evolved by communities as members boldly choose their identities. Referring to people with the names, pronouns, and symbols that they choose is paramount in creating communities where queer folks can flourish unhindered.

As part of my MSW internship at Willow Haven, I conducted a LGBTQI+ welcoming audit and made recommendations which we are working to implement within Willow Haven:

  • Gender pronouns in all email signatures

  • A space for gender neutral pronouns on our intake paperwork and in Credible

  • Gender neutral bathroom signs

  • Directories of LGBTQI+ professionals for referrals.

  • Introductions going something like this, “Hi, my name is ______ and my pronouns are ____________, what is your name and what pronouns do you use?” Always, every time! Let us make this ritual

  • Staff should have comfort with using singular they pronouns. Practice makes perfect. Remember to be kind as you rewire those neuropathways to inclusive language

  • Schedule trainings partnering with LGBTQI+ organizations locally for staff education

  • Room options with safety and comfort in mind for gender fluid and emergent folks (synonyms being non-binary, gender nonconforming)

  • A culture of accountability. A culture that cares to try, always, to address folks with respect for identify and an ethic of unconditional positive regard and lifetime learning. Words and language evolve, and one of the most exciting facets of all of this is these words have yet to be set in stone by the professionals, and this means everyone might use works differently. If you are not sure what they mean, ask the person using them what it means to them (my therapist did this for me, and I cannot describe the intense feelings of “seen” I felt)

  • Opportunities for Thrive’s LGBTQI+ staff to connect and brainstorm improvements together with LGBTQI+ residents.

To be person-centered, it is time for these changes and more! I know I am passionate about the revisions to come in the world, and throughout mental healthcare as we continue this path. And great news, it is not too late to enjoy Pride festivities in Minnesota, they are also great places to learn. Minneapolis Pride has been rescheduled to July 17th and 18th and Duluth’s Pride is September 4th. And remember the resilience you are truly a part of when you attend.

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NOTE FROM THRIVE LEADERSHIP: In 2019, Thrive developed and launched The Pride Project with the mission to provide a safe, inclusive environment within Thrive Behavioral Network that will enhance and strengthen the health and well-being of the LGBTQ+ community. By embracing and supporting cultural diversity as well as providing essential resources and training for employees, we strive to create competent, compassionate care for all. Thrive recognizes and respects the achievements of the LGBTQ+ community and will continue to work towards acceptance.

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