Mental Health Services for LGBTQ Community

The essay argues about the mental disorders faced by the LGBTQ community and the discrimination they face in mental health services. It proposes an ecological model to prevent discrimination and improve mental health treatment.

Running Head: MENTAL HEALTH SERVICES
MENTAL HEALTH SERVICES
Name of the Student
Name of the University
Author Note

1MENTAL HEALTH SERVICES
Abstract
The essay tends to argue about the mental disorders of the sexually marginalized
community that is the LGBTQ community. The people who belong to this category are being
discriminated at every phase of their life and thus, face a lot of mental disturbance. This is
also hampered by the rate of discrimination being faced by them at the hospitals and clinics
as the doctors often deny to provide them proper mental check-up. This study also focuses on
the fact that the sexual orientation of this community is also connected to mental state that
even worsens the scenario. Lastly, the paper proposes certain ecological model in order to
prevent the cases of discrimination among the LGBTQ community.

2MENTAL HEALTH SERVICES
Table of Contents
Introduction....................................................................................................................3
Discussion......................................................................................................................3
Ecological Model.......................................................................................................5
Conclusion....................................................................................................................10
References....................................................................................................................11

3MENTAL HEALTH SERVICES
Introduction
The mental illness is a growing disorder that is affecting a lot of young people. It is
related to the anxiety issues and depression problems that are being noticed within an
individual. The treatment of any mental disorder is related to certain stigmas and myths
(Assari & Lankarani, 2017). These problems are faced much more by the people who belong
to the marginalized community as the society holds differential views regarding the
community and does not want to either interact with them or give them their rights that
includes addressing their ethical needs which is the non-maleficence which means no harm
can be done by the doctors or the nurses to their patient irrespective of their caste, gender, sex
and race (Sutter & Perin, 2016; Assari & Lankarani, 2017). This essay focuses on the LGBTQ
marginalized community and problems they face while treatment of the disorder and the
ecological approach that should be adopted by the society, doctors and the individuals so that
a change can be brought in the healthcare system (Kuper, Coleman & Mustanki, 2014).
Discussion
The LGBTQ community includes the people who classify them as Lesbian, Gay,
Bisexual, Transgender and Queer. This is the most scrutinized and analyzed community in
the world. As the terms of sexuality and gender identification are changing there are certain
myths and facts still associated with that of the community (Veltman & Chaimowitz). There
are certain stigma that is associated with the treatment of the LGBTQ community with that of
mental disorders. It is very common for the association of the LGBTQ community with that
of psychiatric disorders that ultimately results in the discrimination faced by the individuals
belonging to these community. Thus, there is a need for the psychiatrists to understand the
position of these people and their actual mental needs (Veltman & Chaimowitz, 2014; Kano
et al., 2016). There are certain perceptions and experiences in the healthcare services

4MENTAL HEALTH SERVICES
especially the mental health care services regarding the people of the community that needs
to changed. Research has shown that there are many areas within the healthcare setting like
attitudes of the clinicians or health knowledge that needs to be identified and analyzed in
order to change the perceptions (Quinn et al., 2015).
There has been a lot of instances where the people who belong to LGBTQ community
have faced discrimination that includes prohibition in jobs, promotion, education as well as
mental harassment wither in school, colleges or at the workplace. The impact of
discrimination on the people is such that it leads to increase in the emotional distress, anxiety
and depression (Whitehead, Shaver & Stephenson, 2016). There is a lot of pressure on the
people to fit in the community with the conventional idea of the society because any misfit
with the societal mould, they can be subjected to physical abuse and intimidation
(Beyondblue.org.au, 2019). This is a special problem in the rural areas and thus, there need,
stress, anxiety and depression should be addressed. This can only be achieved by the increase
in the amount of cultural competency among the healthcare workers (Quinn et al., 2015 ;
Whitehead, Shaver & Stephenson, 2016). The mental disorder within the LGBTQ community
can be resolved by the coaching of people who are associated with the treatment of the people
with mental disorders. This will include the following themes that need to be addressed for
the mental health disorders of the LGBTQ people (Willging et al., 2016). The health
behaviour can be emphasized by the ecological models. It emphasizes the environmental
policies of behaviour that incorporate the social and psychological context. The major goals
of the ecological model includes four core components that are multiple level of influence on
health behaviour, interaction of behaviour across these levels, behaviour specific model and
interventions that are multi-level (Cook et al., 2014).
There are certain different contexts of the mental health practice that involves the
socio-ecological theories. In order to understand the influencing and multi-layered social and

5MENTAL HEALTH SERVICES
biological processes that determine the mental health of the there is a need to understand the
theory working behind it (Eriksson, Ghazinour & Hammarstrom, 2018). The socio-ecological
framework challenges of the individual concept instead it focuses on the concept of social
interactions and roles as a medium for personal transformation. The socio-ecological models
play a role in order to understand the dynamic and the environmental factors that describes
the relation between the individual and his or her surrounding environment (Willging et al.,
2016).The ecological model can be applied in the treatment of mental health disorder as the
basis of ecological model is to provide the individuals of the marginalised community with
skills and motivation. This will facilitate the clinicians to change the behaviour of the
clinicians towards the LGBTQ community people (Cook et al., 2014).
The other factors are interpersonal process of development that comprises of formal
and informal networks of the individual that are related to the family and friendship support.
The institutional factors that are related to the socio-ecological model are characteristics and
the rules and regulations that are being supported by certain organization (Eriksson,
Ghazinour & Hammarstrom, 2018). The community factors are very integral and important to
the development of the relationships among the individuals within the organization. The
public policies include the local and state policies that should make certain amendments in
order to support the LGBTQ community. Thus, the individual is influenced by a number of
factors that include the school or local community as it can directly affect the thoughts and
behaviour of the individual (Willging et al., 2016).
Ecological Model
The ecological model cannot be effective if the policies and environment make it
difficult to choose the healthy behaviour rather the environments and policies should be
created in such a way that the is convenient and attractive and thus encourages people to treat
the people of LGBTQ community with mental disorders (Cook et al., 2014). The application

6MENTAL HEALTH SERVICES
of the ecological model can be done at the primary level that is starting from the school. The
school based services for mental health support the developmental process and also bridge
the neighbourhood and home. The focus of the ecological models of mental health is to
prevent, intervene, analyse and support the growth and mental need of the individuals who
belong to the community right from the tender age so that they can feel free to accept their
sexual orientation without any social pressure and thus, it will help to reduce the distress that
the individuals of LGBTQ community face (Cappella et al., 2013).
The next ecological model that can be approached to treat the mental disorder of the
LGBTQ adults or youth is to include them within the community services that will help to
reduce their level of stress and pressure (Hoy et al., 2016). The extent of discrimination on
the LGBTQ people also affects their treatment extent. Even in the absence of discrimination,
LGBTQ community people still experience certain barriers to equitable services for mental
health (Hoe et al., 2016). As the current healthcare framework fails to address many aspects
of the LGBTQ people thus, there is a need to develop a more holistic approach for the better
understanding of the mental health needs of the people (Gahagan & Colpitts, 2017). As now
the times have changed there should be better treatment with the LGBTQ youths. However,
depression still remains the challenge within the LGBTQ community. Thus, there is a need to
accept the changes with the mental health condition so that there is recognition of the mental
challenges faced by the community and also increases the chances of getting better treatment
results (Leon, 2019).
Today the LGBTQ movement is at its highest space as the youth come out at a very
young age and it has also gained a lot of public support. Thus, there is no need for these
individuals to suffer with compromised mental health check-up. The ecological model
concept has pointed towards the directions, preventions and interventions that are needed for
the treatment of the mental illness of the LGBTQ (Fredrikson & Kim, 2017). There are

7MENTAL HEALTH SERVICES
certain legal policies that have been set for the advancement of the programs and practices
that foster the treatment of mental health of the LGBTQ people. There is an emergence of
research from multiple and diverse field in order to provide sound knowledge regarding the
mental health of the LGBTQ youth (Russel & Fish, 2016).
The application of the ecological model within the society has to be incorporated from
the different fields that have multi-level interaction of the individual. The microsystem of the
interaction includes the individual with the family, school and neighbourhood. Then the
meso-system and exo-system that involves the work setting and the family friends who are
involved with the individual. At last the social, cultural, historical influences comes under the
macro-system of the society. Thus, in order to generate a proper approach for the LGBTQ
community it is very important to focus on these aspects of multi-level interaction (Eriksson,
Ghazinour & Hammarstrom, 2018). The other factors that need attention in order to develop
an approach for the treatment of mental disorders in the marginalised community of LGBTQ
it is important to know about the relations. The intrapersonal factors are knowledge, attitude,
behaviour, self-concept and skill that are possessed by the individual.
The most important approach for the development of ecological model needs the
change in the thoughts and personal beliefs of the clinicians and the doctors associated with
the treatment of the mental illness. They should be much more culturally competent so that
they can treat the patients who belong to the marginalised group. The external factors of the
doctors should also be examined so that there is less chance of them getting motivated with
wrong ideas regarding the LGBTQ community (Fredrikson et al., 2014).
The two ecological model that can approach the better treatment of the mental illness
in the LGBTQ community people is the school-based evaluation model and the community
services. These services are included within the ecological model as these model not only

8MENTAL HEALTH SERVICES
help to approach the mental disorder in a more structured manner but also in a way that it
motivates the individuals who are either affected with mental disorders or the clinicians who
are involved with the treatment of the disorder (Capella et al., 2013). The schools are
identified as a place which has an inherent capacity for supporting the mental health and
development of the children. School-based intervention and intervention initiatives have the
capability to bridge these ecologies. The mental-health centres are very common methods for
the integration of mental health with education. However, there are certain difficulties that
pose a great threat for the integration of the intervention strategies within the marginalised
community (Hoy et al., 2016). Thus, there should be common framework for the organization
of the mental health in the schools irrespective of the gender orientation so that there is a
proper comprehensive and effective mental health treatment of all the individuals within that
school. The mental health of the people who belong to the LGBTQ community should be
developed in school by the alignments of the mental healthcare personnel with that of the
school goals. The school goals should also be multi-level in order to be applicable to all the
students who belong to different age groups as the difference in age structure generates
difference in thinking ability as well as the mental stress that they face (Cappella et al., 2013).
The next step in the school-based intervention model will be the active roles of the parents
and teachers who act as a catalyst in order to play the role of catalyst for the change of mental
disturbance within the people. This will help in the better interaction of the teachers and the
parents with the student and they will be able to analyse the mental state of the child. Thus,
the intervention level will be set at a very preliminary stage and that will help in the
development of the individual and it will also help in reducing the stigmas of the society that
are linked with the LGBTQ community. The development of the mental health resources
around the main aims of learning will promote positive outcomes from the mental health
patient (Parmeshwaram et al., 2017). This can be done by the implementation of indigenous

9MENTAL HEALTH SERVICES
schools and core technologies that should be implemented within the schools. As it is very
difficult to differentiate the normal children with those who have a difficulty with the
children who suffer from the gender identification crisis, the schools should be very discrete
in the analysis of the mental health of the children and should not link mental illness with
sexuality in order to maintain a very culturally competent behaviour while the assessment of
the mental disorder of the community (Cappella et al., 2013).
The next approach should be the involvement of the marginalised community with
that of community based services as the most cases of mental disturbance within these people
generate with the problem of social acceptance. As it is very important for the youth to be
able to intersect with the society it becomes a major stress factor among the LGBTQ youth.
The sexual minorities often experience stress due to a number of factors that are related with
the societal norms like victimization, discrimination and prejudice. These stress factors can
well be addressed by the external and internal factors that are related to that of the
individual’s community (Rossman, Salamanca & Macapagal, 2017). Thus, in order to
improve the problems faced by the community it is very important for the people to have a
multi-level approach including the policies, clinical practice and community practice. This
can be explained by the Brofenbrenner model of socio-ecology that describes the micro,
meso, exo and macro-system of the society (Eriksson, Ghazinour & Hammarstrom, 2018).
These systems are well integrated with the environmental factors of the society and thus,
influence the individuals’ mental health. According to the Brofenbrenner theory the child try
to integrate and inherent the qualities of the society that will influence the child’s overall
growth and development. Thus, the community of the child will play an important role
(Russell & Fish, 2016). Hence, the interventions at the community level can help the people
within the marginalised community to openly discuss their psychological problems and also
to get the correct treatment that is required for them (Kattari et al., 2015).

10MENTAL HEALTH SERVICES
Conclusion
Therefore, it can be concluded from the essay that the sexually minority people of the
LGBTQ community faces certain problems that can be linked with the stigmas and myths
associated with mental disorder. This can pose a problem in the treatment of the disorder
within the marginalised community and also these people also face the problem while voicing
their problems. These problems can be well addressed by the application of the certain
ecological models that influences the social as well as educational background of every
individual. The social factors include the community services that are related with certain
factors that control or influence the thoughts, behaviours, beliefs and personal values of the
individuals. The educational background of the individual also plays an important role in the
development of the individual as it forms the framework of the early childhood development.
Thus, in order to treat the mental disorder of the patient in the LGBTQ community it is
important to analyse these two aspects so that these individuals have proper access to the
mental illness treatment and also that their condition is not linked with any type of mental
problem.

11MENTAL HEALTH SERVICES
References
Assari, S., & Lankarani, M. M. (2017). Discrimination and psychological distress: gender
differences among Arab Americans. Frontiers in psychiatry, 8, 23.
Beyondblue.org.au. (2019). Beyond Blue. Beyondblue.org.au.
Cappella, E., Frazier, S. L., Atkins, M. S., Schoenwald, S. K., &Glisson, C. (2013). Enhancing
schools' capacity to support children in poverty: an ecological model of school-based
mental health services. Administration and policy in mental health, 35(5), 395–409. Doi:
10.1007/s10488-008-0182-y
Cook, J. E., Purdie-Vaughns, V., Meyer, I. H., & Busch, J. T. (2014). Intervening within and
across levels: A multilevel approach to stigma and public health. Social Science &
Medicine, 103, 101-109.
Eriksson, M., Ghazinour, M., &Hammarström, A. (2018). Different uses of Bronfenbrenner’s
ecological theory in public mental health research: what is their value for guiding public
mental health policy and practice? Social Theory & Health, 16(4), 414-433.
Fredriksen-Goldsen, K. I., & Kim, H. J. (2017). The science of conducting research with LGBT
older adults-an introduction to aging with pride: National health, aging, and
sexuality/gender study (NHAS).
Fredriksen-Goldsen, K. I., Kim, H. J., Shiu, C., Goldsen, J., & Emlet, C. A. (2014). Successful
aging among LGBT older adults: Physical and mental health-related quality of life by age
group. The Gerontologist, 55(1), 154-168.
Gahagan, J., &Colpitts, E. (2017). Understanding and measuring LGBTQ pathways to health: A
scoping review of strengths-based health promotion approaches in LGBTQ health
research. Journal of homosexuality, 64(1), 95-121.

12MENTAL HEALTH SERVICES
Hoy-Ellis, C. P., Ator, M., Kerr, C., & Milford, J. (2016). Innovative Approaches Address Aging
and Mental Health Needs in LGBTQ Communities. Generations (San Francisco,
Calif.), 40(2), 56–62.)
Kano, M., Silva-Bañuelos, A. R., Sturm, R., & Willging, C. E. (2016). Stakeholders'
recommendations to improve patient-centered “LGBTQ” primary care in rural and
multicultural practices. J Am Board Fam Med, 29(1), 156-160.Kattari, S. K., Walls, N. E.,
Whitfield, D. L., & Langenderfer-Magruder, L. (2015). Racial and ethnic differences in
experiences of discrimination in accessing health services among transgender people in
the United States. International Journal of Transgenderism, 16(2), 68-79.
Kuper, L. E., Coleman, B. R., & Mustanski, B. S. (2014). Coping with LGBT and racial–ethnic‐
related stressors: A mixed‐methods study of LGBT youth of color. Journal of Research
on Adolescence, 24(4), 703-719.
Leon, A. (2019). LGBT people are prone to mental illness. It’s a truth we shouldn’t shy away
from | Alexander Leon. the Guardian.
Parameshwaran, V., Cockbain, B. C., Hillyard, M., & Price, J. R. (2017). Is the lack of specific
lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) health care education
in medical school a cause for concern? Evidence from a survey of knowledge and practice
among UK medical students. Journal of homosexuality, 64(3), 367-381.
Quinn, G. P., Sutton, S. K., Winfield, B., Breen, S., Canales, J., Shetty, G., ...&Schabath, M. B.
(2015). Lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ) perceptions and
health care experiences. Journal of Gay & Lesbian Social Services, 27(2), 246-261.

13MENTAL HEALTH SERVICES
Rossman, K., Salamanca, P., & Macapagal, K. (2017). A qualitative study examining young
adults’ experiences of disclosure and nondisclosure of LGBTQ identity to health care
providers. Journal of homosexuality, 64(10), 1390-1410.
Russell, S. T., & Fish, J. N. (2016). Mental Health in Lesbian, Gay, Bisexual, and Transgender
(LGBT) Youth. Annual review of clinical psychology, 12, 465–487. doi:10.1146/annurev-
clinpsy-021815-093153
Sutter, M., & Perrin, P. B. (2016). Discrimination, mental health, and suicidal ideation among
LGBTQ people of color. Journal of counseling psychology, 63(1), 98.
Veltman, A., &Chaimowitz, G. (2014). Mental health care for people who identify as lesbian,
gay, bisexual, transgender, and (or) queer. Canadian journal of psychiatry. Revue
canadienne de psychiatrie, 59(11), 1.
Whitehead, J., Shaver, J., & Stephenson, R. (2016). Outness, stigma, and primary health care
utilization among rural LGBT populations. PloS one, 11(1), e0146139.
Willging, C. E., Israel, T., Ley, D., Trott, E. M., DeMaria, C., Joplin, A., & Smiley, V. (2016).
Coaching mental health peer advocates for rural LGBTQ people. Journal of gay &
lesbian mental health, 20(3), 214-236.