Coming Out Issues of Gay and Lesbian Mental Health Professionals in Voluntary and Involuntary Settings

Abstract

Mental health professionals are increasingly called upon to provide consultation and treatment in settings different from the traditional outpatient and hospital inpatient settings. This paper provides an overview of the unique problems posed when considering self-disclosure by gay or lesbian mental health professionals working with institutionalized populations. A review of literature concerning self-disclosure to patients in outpatient settings is provided and applied to institutionalized settings. Benefits of, as well as cautionary notes regarding, self-disclosure of homosexuality by mental health staff are reviewed.     

Who is willing to come back? College students' willingness to seek help after using campus mental health services

Objective: To examine characteristics of college students who have previously received mental health (MH) services on campus and are willing to seek help again in the future. Participants: Spring 2015 ACHA-NCHA II (N = 12,501) undergraduate respondents who had previously used MH services on their current campus. Methods: Binary logistic regression with willingness to seek MH services in the future as the dependent variable. Results: Among students who had already utilized campus MH services, significant predictors for future help-seeking were: female, white, gay/lesbian, those not working for pay, having the college/university health insurance plan, and not currently/previously serving in the military (p < .05). Conclusions: The predictors for willingness to use services in the future were consistent with the existing literature related to initial use. Colleges and universities need to consider factors that influence openness to MH services after a previous experience in addition to initiating care. Implications for college MH professionals are provided.     

Being a Gay or Lesbian Professional in a Psychiatric Hospital for Adolescents

Abstract

Differing styles and ranges of self-disclosure are highlighted through interviews with lesbian and gay clinical staff at an in-patient setting in the Midwest. Each staff, three men and one woman aged 44 to 62, is presented through a psychosocial history concerning religious, marital, and coming out issues. Participants are interviewed about their style and degree of disclosure of homosexuality to staff, clients, and family. The author concludes that degree of “coming out” correlates with positive adjustment to sexual orientation for the interviewees more than with fears about job loss or personal reprisal.     

Physical health characteristics of student service members and veterans by sexual orientation

Abstract

Objective: Little is known about the health status of the diverse population of student service members and veterans (SSM/V) enrolling in higher education in great numbers. The objective of this study was to explore the differences in physical health characteristics by sexual orientation among a national sample of SSM/V. Methods: Using secondary data, a series of maximum likelihood (ML) logistic regression models were estimated to explore physical health characteristics by sexual orientation in a sample of SSM/V. Results: SSM/V that identify as lesbian or gay reported higher rates of treatment and diagnosis for some physical health matters (respiratory illness and HIV) when compared with their heterosexual counterparts. Conclusions: Our findings support the need for campus health officials and policymakers to develop services to address the physical health needs of this population that differ from their peers.     

Mental Health Among College Students: Do Those Who Need Services Know About and Use Them?

Objective: The objective of this study was to examine connections between university students' mental health and their knowledge and use of campus mental health services. Participants and Methods: In March 2001, a sample of undergraduate students (N = 266) completed a Web-based questionnaire, providing information related to their mental health, knowledge of mental health services, and use of those services. Results: Students who were mentally distressed were more likely to know about and use services; however, some students who reported to be mentally distressed either did not know about services or knew about services but did not use them. Living off campus, identifying as male, and having fewer years in college were related to less knowledge of campus mental health services. In addition, female sex and number of years in college were predictive of higher service use. Conclusions: With the high prevalence rates and severity of mental health problems, university mental health providers must continue to make strategic efforts to disseminate knowledge about mental health services to all students.     

Creating LGBTQI+ programing in urban higher education: Considering the creation process of a campus resource room

Abstract

While many community college campuses provide resources of some kind for students who identify as lesbian, gay, bisexual, transgender, queer, intersex, or other sexual or gender-non-binary minorities (LGBTQI+), surprisingly few institutions have dedicated physical spaces designated for that purpose. This article explores, by way of a case study on the establishment of an LGBTQI+?resource room on a community college campus, the processes that must be considered and undertaken when establishing such spaces. Needs assessments, identification of stakeholders, and strategies for making an LGBTQI+?resource room a reality on campuses that have never had such spaces or initiatives are discussed for the purposes of carefully considering the components of a proposed template for campus administrators, staff, faculty, and students to follow. While outcomes described in this article are specific to one particular case, the procedures by which they were achieved were undertaken with the hopes that they might be replicable by other similar institutions, in light of the very few LGBTQI+?spaces in community college contexts.     

Growing Up with a “Spoiled Identity”

Abstract

Being a lesbian, gay or bisexual youth means having the stigma of homosexuality or bisexuality. A stigma is anything that discredits an individual and leads to one being assigned a “spoiled identity.” With reference to lesbian, gay and bisexual youth, the stigma is considered a blemish on one's character that often leads to stereotyping and stigmatisation. This homophobia puts many lesbian, gay and bisexual youth at risk for suicide, chemical abuse, dropping out of school, verbal and physical abuse, homelessness, prostitution, HIV infection, and psychosocial developmental delays. Approaches and strategies for working with lesbian, gay and bisexual youth are suggested and trends and issues about homosexuality in the United States, with a potential impact on lesbian, gay and bisexual youth, are discussed.     

A Study of Attitudes Towards Gays and Lesbians in the State of Utah,U.S.A.

Abstract

The purpose of this study was to examine Utahans' attitudes towards gay and lesbian people and their civil rights. Utah politics are dominated by the Church of Jesus Christ of Latter Day Saints (the Mormons) and the Republican Party, with membership typically shared by the two. However, Mormon sociocultural values are also distinctively pro-family and companionate. We wondered to what extent caring, warmth, and inclusiveness toward family members mitigated against the doctrinaire injunction to reject homosexuality and, if necessary, to reject family members who were homosexual.

We found that proponents of gay and lesbian civil rights were likely to be personally familiar with gays and lesbians, to have empathetic attitudes about gay and lesbian youth and being out, and to possess a commitment to legal rights for gay and lesbian individuals and families. Opponents of gay and lesbian civil rights were driven by moralistic imperatives about sexuality and the roots of sexual behavior, made a sharp distinction between what they perceived as social privileges and legally mandated rights and were not likely to have had much direct contact with gay and lesbian people. Our results suggest that Utahans indeed appear to be torn, or at best ambivalent, about the religious mandate to condemn homosexuality while at the same time prizing family ties and relationships above other values. For the same reasons, political actions directed at obtaining specific legal rights for gays and lesbians appear to have more support than expected, especially in the realms of partner benefits, employment discrimination, health benefits, and private freedoms. Legal marriage, however, is soundly rejected as a possibility, especially in view of the belief that marriage is sacred and exclusively for heterosexuals.     

Increasingly Gay Self-Representations of Male-Male Sexual Experiences in Thailand

Abstract

With Thailand's economic development, urbanization (especially the rapid growth of Bangkok), growing contact between Thais and non-Thais, an increased availability of representations of ho-mogender homosexuality (i.e., masculine men being sexually penetrated), and international AIDS discourse, male homosexuality not structured by differences in age, gender or class has become more apparent. Three sets of stories and letters sent by Thai men to Thai gay magazines show a decline in a gender-stratified conception and enactment of homosexuality in Thailand, paralleling the heterogender-to-gay transformation of homosexuality elsewhere in the world. The highly developed commercial venues for males who have sex with males in Bangkok are little mentioned in these texts and suggest the need for the development of other kinds of community infrastructure such as telephone advice lines (providing information about the basic mechanics of safe sex and other aspects of male-male relationships). Males who have sex with males in Bangkok, in particular, need a community center in which to discuss issues of power, gender, and sexuality.     

A Missing Voice

Abstract

Contemporary gay and lesbian social service literature still heavily focuses on White middle/upper-class issues and uses an isolated and fixed concept of homosexuality. As a result, the discourse has only a limited applicability to people with “dual” or “multiple” identities, accentuating the power of those who control the discourse and the oppression of those with “dual” or “multiple” identities. Using Asians as a case example, I argue that the lack of published articles about Asians in contemporary gay and lesbian social service literature is the result of the different worldviews of Asian and White queers. However, this deficiency is sustained by social structures that are saturated with White middle/upper-class values. Implications of this situation and some directions for social change are discussed.     

A Family Matter

Abstract

The 2004 debate over civil marriage for same-gender couples highlights issues faced by mixed-orientation couples after one of the spouses comes out as gay, lesbian, or bisexual. The disclosure becomes a family matter as their spouses and children cope with the new information and antigay attitudes. The majority of couples divorce. A minority stays married for three years or more by developing strategies that enhance the relationship, offset outside pressures, and sustain the family circle. Peers provide the most support, while therapists are often unfamiliar with sexual orientation, mixed orientation couples, or societal attitudes that impact families with a gay, lesbian, or bisexual parent. This article provides that information so that professionals can help these couples improve the quality of their lives and develop skills to create a future in which homosexuality, same-gender relationships, and gay parenting are more widely accepted and legalized. This development would decrease the number of mixed-orientation marriages with closeted spouses and increase the potential for both types of families to form lasting marriages and strong family units.     

Reparative Therapy for Gays and Lesbians

Abstract

In recent years there has been much public controversy about “conversion or reparative therapies” designed to change homosexuals into heterosexuals. Various national mental health associations have taken a stand against these therapies. Social service professionals who work with gay and lesbian clients need to develop beliefs about the mutability of sexual orientation that reflect sound research findings.     

Adoption of Black children by White parents in heterosexual and homosexual relationships: Exploring mental health trainees' explicit and implicit attitudes

ABSTRACT

We investigated 163 (82.2% female; 73% White; and 91.4% heterosexual) mental health trainees' explicit and implicit attitudes toward heterosexual, lesbian, and gay White couples adopting and raising Black children. Explicit attitudes were assessed with a vignette depicting a Black child in need of a home. Implicit attitudes were assessed with the multifactor implicit association test (IAT) protocol. Explicit data showed that most participants indicated no strong family preference. However, IAT data showed that most trainees had implicit preference, with a moderate preference for lesbian couples over heterosexual couples and a moderate-to-strong preference for lesbian couples over gay couples. The trainees only demonstrated a very weak preference for heterosexual couples over gay couples. Overall, congruence between explicit and implicit is very low. Implications for training are discussed.     

Gay Men and HIV

SUMMARY

This paper reports on the results of qualitative studies examining the personal experiences of sex and sexual negotiation for British gay men who are diagnosed HIV positive and those who know or presume themselves to be uninfected. These are contrasted with the results of a study of representations of HIV and AIDS within an international review of community health promotion literature aimed at gay men. The paper highlights the disparity between specific community responses to the epidemic as engendered in the cultural production of health promotion materials and the individual experience of HIV, suggesting a! paradigm for a community response to the epidemic which reflects the personal experience of gay men both infected and uninfected.     

HMOs and the Future of Student Mental Health Services

Abstract

The health maintenance organization (HMO) is likely to have a prominent position under national health insurance, which will have a strong systematizing effect on the nation's health services. Over the past two years the University of Massachusetts mental health services have provided benefits at both the university and a private medical group practice. Experience has shown that a university which already provides broad services to a large student population can extend itself to the university community including its faculty and staff. Several advantages of this development, as well as some significant problems, are discussed. As the HMO grew and quality services were established, it became feasible for the private medical group to develop its own mental health component. Based on this and other experiences in mental health delivery systems, certain conclusions are drawn about the ways universities can develop HMOs and some recommendations are made for national mental health planning.     

Older Lesbians and Gays Accessing Health and Aged-Care Services

Abstract

The present paper examines older lesbian and gay people's experiences of and expectations for the delivery of health and aged-care services. In-depth narrative interviews were conducted with older gays and lesbians in the Blue Mountains, west of Sydney (NSW, Australia). Data were analysed by identifying evaluative statements within specific narratives and grouping these statements into themes. Participants reflected on the meaning of their sexual identity and how they would like it to be acknowledged when in contact with health and aged-care service providers. In addition to direct discrimination, participants reported a more indirect form of discrimination in providers’ assumption of heterosexuality among clients and their failure to provide lesbian- or gay friendly services. The findings highlight the need for health and aged-care services to better understand and acknowledge older gay and lesbian people's sexual identities to enable improved access to services in the future.     

Chapter 14. Older Lesbian and Gay Caregivers

SUMMARY

This chapter will explore the experiences of older lesbian and gay men caregivers by examining the socio-historical times in which they have lived, the impact of a lifetime of adverse societal messages about homosexuality, family rejection, and internalized homophobia, as well as their development of resiliency and psychological well-being. Once the contextual issues have been identified, the research on older lesbian and gay caregivers for families of origin and families of choice will be explored.     

Mens Sana: The Growth of Mental Health in the American College Health Association

Abstract

In 1910, the first college mental health service sought to help college students with personality development and building a healthy mind. In 1920, the meeting that founded the American College Health Association (ACHA) identified “mental hygiene” as important, although a separate Mental Health Section was not established in ACHA until 1957. Between 1920 and 1960, a series of national meetings helped define the role and functioning of college mental health and counseling services. Most colleges employed a multidisciplinary staff of psychologists, psychiatric social workers, and psychiatrists to provide clinical services for students and consultation and education for faculty and staff. Mental health services on college campuses grew rapidly in the 1960s and 1970s, leading to discussions in the late 20th century of the use of brief psychotherapies, prevention and treatment of drug and alcohol abuse, prevention of suicide and homicide, the use of psychotropic medications, and effective campus interventions.     

Diagnosis of Pregnancy

Abstract

Contraceptive failure is a growing problem, especially on the college campus. Because of this, college health care providers are treating more and more college women not only for pregnancy-related problems, but women that present to the health center with other health complaints and are pregnant as well.

For these reasons, the diagnosis of pregnancy must always be entertained by all health care providers treating young women. Pregnancy must always be excluded before any tests or procedures are done that may be teratogenic. This is not only important for optimal health care, but also for medical-legal reasons.

This paper presents four unusual presentations of pregnancy and reviews the guidelines for diagnosis of pregnancy.     

Lesbian,Gay Male,Bisexual and Transgendered Elders: Elder Abuse and Neglect Issues

ABSTRACT

Unfortunately, due In large measure to our society's still-pervasive social prejudice against and ignorance about sexual orientation and gender minorities, there have been few studies of this population of elders, and virtually no one has examined how this population's culture affects its experience with elder abuse. Based on the author's knowledge of this community and discussions with social workers and domestic violence specialists who serve it, these clients are likely to be more resistant than other clients to accepting services. Greater awareness of the existence and circumstances of lesbian, gay male, and transgendered elders should help protective services staff in building rapport with these clients and in getting them the services and assistance that they need.