Tag Archive: lgbtq+

  1. How the 988 Hotline Can Break Down Systemic Barriers to Health Care

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    This blog is the first of two posts that will take a deeper look into Virginia’s efforts to integrate the 988 hotline with the behavioral health crisis services continuum.

    **This blog contains information and statistics on suicide and mental health. If you or a loved one are experiencing a crisis or need mental health resources, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (en Español: 1-888-628-9454; deaf and hard of hearing: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741-741.

    On July 16, a new three-digit national hotline–988–will launch to connect callers with trained counselors through the National Suicide Prevention Lifeline to provide 24/7 call or text support for anyone experiencing a mental health crisis or in need of suicide prevention services. Though the hotline is administered through the national Lifeline, calls to 988 will be routed based on area code to regional crisis call centers that can connect individuals with crisis and emergency services that are available in their local communities.

    Virginia is utilizing the national 988 hotline implementation as an opportunity to link the three-digit dialing to the broader behavioral health crisis services continuum that is being developed across the state. Eventually, this will mean that more young people and their families will have access to mental health professionals responding to a crisis instead of law enforcement. This is especially important given the compounding traumatic effects of the COVID-19 pandemic, systemic racism, LGBTQIA+ discrimination, and gun violence in this country.

    The Need for a Lifesaving Hotline

    Suicide is the second-leading cause of death among young people aged 10 to 24. However, deaths from suicide are only part of the problem. Each year, approximately 157,000 youth between the ages of 10 and 24 receive medical care for self-inflicted injuries at emergency departments across the U.S.

    The Centers for Disease Control reported that during 2020, mental health–related emergency department visits among youth aged 12 to 17 increased 31% compared to 2019. Specifically, emergency department visits for suspected suicide attempts among 12 to 17-year-old girls were 50.6% higher in February to March 2021 than during the same period in 2019; among boys aged 12 to 17, such emergency department visits increased 3.7%.

    In Virginia, the percentage of students who experienced feeling sad for two weeks or more increased significantly from 2011 (25.5%) through 2019 (32.4%). And among those who reported feeling sad for two weeks or more, 39.1% reported that they considered attempting suicide, 29.5% made a suicide plan, 18.0% attempted suicide and 4.9% made an injurious suicide attempt.

    The pandemic is deteriorating children’s mental health to new lows, with more than 25% of high school students nationally having reported worsened emotional and cognitive health.

    Figure 1: Percentage of Students who felt sad or hopeless almost every day for 2 weeks or more, VYS, 2011-2019

     

    Figure 1. ED visits related to suicidal thoughts, self-harm, and suicide attempts among Virginia youth aged 9-18 years, 2016-2021

     

    Figure 2: ED visits rates for suicidal thoughts, self-harm, or suicide attempts among Virginia youth aged 9-18 years, by sex, 2016-2021

    Barriers to Accessing Mental Health Services

    Although rates of mental health problems are not statistically different by race, the rate at which children of color receive mental health care is much different than white children. A National Center for Health Statistics data brief reported that non-Hispanic white children (17.7%) were more likely than Hispanic (9.2%) or non-Hispanic Black (8.7%) children to have received any mental health treatment in the past 12 months.

    As noted in Voices’ Children’s Mental Health Discussion Paper, “systemic barriers such as eligibility criteria for health insurance and accessibility of services contribute to lower participation among Black and Latinx children. A history of racism and disinvestment in communities of color have made mental health services less accessible for children of color by geography, cultural fit, and language.”

    LGBTQIA+ youth also often lack access to affirming spaces, which include health care and mental health care services. The Trevor Project’s 2022 National Survey on LGBTQ Youth Mental Health reported that 60% of LGBTQIA+ youth who wanted mental health care in the past year were not able to get it. Some of the reasons youth cited for wanting care but not having access include fear of discussing mental health concerns (48%), concerns with obtaining parent/caregiver permission (45%), fear of not being taken seriously (43%), and lack of affordability (41%).

    LGBTQ youth who wanted mental health care but where unable to get it cited the following top ten reasons.

    Of the LGBTQIA+ youth aged 13 to 17 that were surveyed, 73% reported symptoms of anxiety and 67% reported symptoms of depressive disorder in 2020. Almost half of those youth surveyed seriously considered attempting suicide in the past year.

    These statistics demonstrate the clear need for appropriate and effective mental health services for young people. Lack of access can lead to serious and lasting impacts across all areas of a child’s life. Ensuring that emergency services are accessible, unintimidating, and culturally competent will take creating programs like the 988 hotline and implementing them with full funding and public support.

    As lawmakers work to streamline Virginia’s mental health and behavioral health system, Voices is focused on opening these services to all our communities and addressing past harms in the way of healing.

    Stay tuned for more on the 988 hotline and children’s mental health.

  2. LGBTQ+ Youth and Policy Change: Celebrating Progress and More Work to Do

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    As Pride Month is ending soon, we want to bring attention to policies that promote equality for LGBTQ+ youth.  According to the Human Rights Campaign’s State Equity Index, a scorecard ranking states on different aspects of LGBTQ+ policy, Virginia scored in the second highest category “Solidifying Equity.” This is a jump from the lowest category of “High Priority to Achieve Basic Equity,meaning that the state has done substantial work to prioritize equality in the most recent legislative sessions. Virginia is the first state to ever jump two categories in one year. We want to acknowledge the hard work of advocates and lawmakers that have pushed Virginia to make so much progress towards equality over the last few years particularly Equality Virginia and the ACLU-VA. 

    The Human Rights Campaign state scorecard divides the policies into six categories, including youth policies. Virginia has done a significant amount of work in ensuring that there are comprehensive anti-bullying laws in schools that protect LGBTQ+ youth from bullying and harassment. These policies include protections against all forms of harassment and bullying, including cyberbullying. It also requires the Virginia Department of Education to present a model policy for school boards to develop local plans to prevent bullying. The model aims to create a culture of respect through social-emotional learning practices to reduce and prevent bullying as well as provide protections for LGBTQ+ students. 

    Virginia was the first state in the South to pass a law that protects LGBTQ+ people from discrimination. In addition, Virginia was the first Southern state to ban conversion therapy in 2020, which is a huge step forward in creating affirming policy for LGBTQ+ youth. Conversion therapy, also referred to as reparative therapy, is a pseudo-scientific process that claims to be able to change an individual’s sexual orientation, gender identity, or gender expression. In reality, this practice is incredibly harmful and can lead to depression, anxiety, drug use, homelessness, and even suicide among LGBTQ+ youth that become victims of the abusive treatment.  

    VA is Leading the Way in the South but There’s More Work to Do for Youth 

    While the HRC state scorecard does celebrate Virginia’s progress, it also highlights important areas where policy is lacking to protect LGBTQ+ youth.  

    Since Virginia does not require inclusive sexual education in the sexual education curriculum, LGBTQ+ youth do not see their own relationships represented in their learning. According to the GLSEN 2019 National School Climate Survey, when the curriculum does not reflect LGBTQ+ experiences and identities, LGBTQ+ students feel less safe at school and are more likely to face harassment from their peers on the basis of their sexual orientation, gender identity, or gender expression. 

    LGBTQ+ youth are 120% more likely to experience homelessness than their peers. African American and Native American youth are disproportionately represented among LGBTQ+ homeless youth. As a result of discrimination and fear of harassment, LGBTQ+ youth are more likely to spend time on the streets rather than in a shelter.  

    LGBTQ+ youth are also disproportionately overrepresented in our juvenile justice system, making up 7-9% of all youth, but 20% of all youth in juvenile justice facilities. Of the LGBTQ+ youth in the juvenile justice system, 85% of them are youth of color. While in these facilities, these youth can suffer from inappropriate placement based on their assigned gender at birth rather than their gender identity. They may also be subject to harassment by their peers and they may lack supportive services. LGBTQ+ youth are also at increased risk for being placed in solitary confinement or segregated units. 

    It is also important to acknowledge the unique difficulties faced by LGBTQ+ youth of color and transgender youth and gender non-conforming youth. In the GLSEN 2019 National School Climate Survey, 77% of transgender students and 70% of gender non-conforming students surveyed experienced anti-LGBTQ+ discrimination at school which are much higher than the rates experienced by cisgender LGBTQ+ youth. In the same report, LGBTQ+ youth of color experience high rates of discrimination on the basis of their sexual orientation, gender expression, gender identity, and race. It is important to be cognizant of the increased hardships of LGBTQ+ youth of color and transgender or gender non-conforming youth and to prioritize creating an inclusive environment for them.  

    Though Virginia has made notable progress, there are still key policies that we believe should be passed to support the unique needs of LGBTQ+ youth. Overall, the most important way we can support LGBTQ+ youth is by creating inclusive and affirming spaces where they feel comfortable being themselves and include policies that help create those spaces.  

    1. Integrating LGBTQ+ inclusive sexual education into existing curriculum: LGBTQ+ youth deserve to feel represented in their curriculum and the existing curriculum should be updated to include information specific to LGBTQ+ relationships to ensure that they can pursue happy and healthy relationships.  
    1. Laws to address homelessness among LGBTQ+ youth: It is important that LGBTQ+ youth who are experiencing homelessness have access to inclusive and affirming spaces. This would include non-discrimination policies for service and shelter providers so that they cannot deny access to services on the basis of sexual orientation, gender identity, or gender expression. Other policies to address youth homelessness include access to transitional housing and access to emergency shelters.  
    1. LGBTQ+ inclusive juvenile justice policies: LGBTQ+ youth who are in the juvenile justice system deserve to be free from harassment or fear of violence for being who they are. To ensure inclusive and safe spaces in juvenile justice facilities, there should be a specific non-discrimination policy for these facilities that includes sexual orientation, gender identity, and gender expression. In addition to a non-discrimination policy, staff should be trained and required to maintain an inclusive and safe environment for LGBTQ+ youth. Transgender youth should also be placed appropriately based on their gender identity rather than their assigned gender at birth.  

    Virginia has continuously served as a trailblazer for other Southern states to follow and the state should continue to prioritize equality, particularly for LGBTQ+ youth. To meet their needs, the Virginia legislature should consider these policies to ensure the path toward justice for all LGBTQ+ youth. All LGBTQ+ youth deserve to be loved and supported, safe in their homes, schools, and communities, and to be treated with dignity and respect. Happy Pride Month!