American Indian Lesbians and Gays

Abstract

This article is a study of American Indian lesbians and gays. Using interview content, this study helps practitioners understand these virtually unstudied individuals. Interview data are compared to reports in the literature in an effort to understand how American Indian lesbians and gays are similar to and different from other lesbians and gays. Implications about future research and social work practice with American Indian lesbians and gays are discussed.     

Rural HIV/AIDS Social Services for Gays and Lesbians

Abstract

The HIV pandemic persists into its second decade, with an untoward toll on rural gays which continues to generate suffering and loss. Rural HIV infections are increasing, and the unique problems of health and social services represent new challenges. Professional social services that would overcome barriers to care for rural gays and lesbians have been historically inadequate or non-existent. The HIV pandemic shows that services for HIV diseases must become part of efforts to strengthen the care delivery services for all in rural America, especially by fostering the power and resiliency of gays and lesbians. The empowerment of rural gays, bisexuals, lesbians and transgendered persons assumes that basic differences occur between those in rural and urban areas, and health and social services must build upon the unique strengths of these diverse groups.     

Older Gays and Lesbians

Summary

This article discusses the impact that coming of age in the Pre-Stonewall era has had on older gays and lesbians. Anti-gay hate and violence, within a historical context of homophobia and heterosex-ism, are examined. Risk factors, as well as coping capacities, for older lesbians and gays are explored. Research on the psychological adjustment and well-being of older gays and lesbians is reviewed, and suggestions for intervention with this population are proposed.     

Mentoring for Gay and Lesbian Youth

Abstract

Coming to terms with one's sexual identity always has presented a challenge to gay and lesbian adolescents. Older gays and lesbians have useful knowledge to contribute to the younger generation, whose members usually lack role models of successful gay and lesbian adults. Mentoring programs that involve gay and lesbian youth and adults are an important, but overlooked resource for sexual minority youth.     

Preparing College Health Professionals to Deliver Gay-Affirmative Services

Abstract

On every campus, there may be many gay students, faculty, and staff who might benefit from medical and mental health services sensitively developed as an integral part of the range of health services provided to the total campus. It is crucial to develop a cadre of providers from different disciplines who have a knowledge of gay lifestyles, developmental issues, and societal pressures. Staff must develop or heighten sometimes painful self-awareness engendered by empathic identification with a stigmatized minority. They must also conceptualize homosexuality as a relationship preference or lifestyle choice and appreciate the importance of same-sex attachments in normal development.

This paper reviews common presenting themes of gay patients and clients who rarely come for help to change their preference. The effects of homophobia on staff practices and attitudes are reviewed in the context of learned negative stereotyping in the larger culture. Heterophobic expectations of potential gay consumers are explored, including those of being diagnosed as deviant, mentally ill, or arrested libidinally. Suggestions are offered for the design and marketing of collaborative gay-nongay services and for service to older hidden populations. Individuals are encouraged to examine their own relationships to homosexuality and to experience new learning through enriched encounters with gays.     

Co-Occurring Disorders Among Jail Inmates: Bridging the Treatment Gap

ABSTRACT

This paper presents findings based on a retrospective review of health and mental health records of 359 mentally ill jail inmates. Regardless of demographic group, substance-related disorders are the most prevalent disorder. Sixty-seven percent of the sample had a substance-related disorder, 37% an adjustment disorder, 23% a mood disorder, and 12% had schizophrenia or another psychotic disorder. Comorbidity was extensive with close to 45% of the sample having both a substance-related disorder and an additional major mental illness. Study findings indicate that there is a great need to strengthen services and create jail-community linkages for inmates with comorbid mental health and substance abuse disorders. Innovative program and resource information are provided.     

The Privatization of Social Services from Public to Sectarian

ABSTRACT

This article explores the privatization of social services from public to sectarian points of view while examining the implications of the Charitable Choice movement on the gay and lesbian community. The history of this movement is explored from a developmental perspective outlining the socioeconomic makeup of gays and lesbians, the societal perceptions and mythology of the economic status of homosexuals, and actual figures related to the number of gays and lesbians who rely on publicly supported social service providers. The article explores the history as well as the positive and negative aspects this type of privatization movement involves. Finally, a comprehensive assessment of the effects of this movement on the gay and lesbian community is presented and future recommendations will be made.     

A Review of Lesbian Depression and Anxiety

SUMMARY

The Surgeon General's first report on mental health identified depression and anxiety as significant mental health issues that disproportionately affect women. Research indicates that lesbians experience depression at rates that parallel those of the general female population, suggesting that depression is an important mental health issue for lesbians. Given the high rate of comorbidity between depression and anxiety disorders, it is likely that many depressed lesbians have struggled with problems related to anxiety as well. This paper reviews literature pertaining to lesbians and depression including incidence rates, risk factors, suicidality and treatment approaches, and stress and anxiety that may also contribute to the experience of depression among lesbians.     

What Do Social Workers Need to Know About Mental Health Courts?

Abstract

Mental health courts are an emerging strategy to engage mentally ill offenders in treatment and to avoid unnecessary incarceration. These courts began in 1997 based upon the drug court model; there are currently over 70 courts nationwide. These courts are heterogeneous in structure, work with interdisciplinary teams, and seek to engage the consumer in treatment rather than use judicial sanctions. Social workers are integral members of these teams; yet, no research has been published in social work journals on mental health courts. This article explains the background and context of the courts, describes their features, discusses what social workers need to know about mental health courts, and concludes with ideas for how social workers may work effectively with mental health courts.     

Mental health and substance use of sexual minority college athletes

ABSTRACT

Objective: Assess the mental health and substance use of sexual minority collegiate student-athletes in the United States, as compared with heterosexual college students and heterosexual student-athletes. Participants: Undergraduate students (N = 196,872) who completed the American College Health Association's National College Health Assessment (Fall 2008–Fall 2012 administrations). Methods: Written cross-sectional survey. Results: Sexual minority student-athletes had a higher risk of experiencing mental health difficulties than their heterosexual athlete peers. There were no significant differences in mental health between sexual minority male athletes and nonathletes. Sexual minority female athletes appeared to fare better than nonathlete peers. Substance use was greater among sexual minority students (athlete and nonathlete) and was mediated by mental health. Conclusions: Participation in athletics does not appear to be associated with an elevated risk of negative mental health outcomes for sexual minority participants; however, there are disparities in mental health outcomes by sexual orientation regardless of athletics participation.     

Playing BINGO with the Best of Them

Abstract

As the author explored different community programs for older gays and lesbians, he realized his own ambivalence as a middle-aged man about associating with older gay men. Gerontological differences and needs are explored in the context of these community programs.     

Mental Health Needs and Supportive Services for Elderly and Disabled Residents

Abstract

This study longitudinally assesses the impact that the provision of supportive services has on the mental well-being of the elderly and disabled population living in independent housing developments. The results indicate that the use of supportive services by the mentally ill allowed them to overcome initial lower functional status and achieve a level of mental functioning virtually similar to that of the total resident population. Thus, it is argued that independent living facilities with supportive services can certainly be a successful and cost effective model for a number of frail elderly and mentally ill residents.     

Attitudes Toward Lesbians and Gays Among American and Dutch Adolescents

Attitudes toward lesbians and gays vary across national populations, and previous research has found relatively more accepting attitudes in the Netherlands as compared to the United States. In this study, we compared beliefs about and attitudes toward lesbians and gays in samples of Dutch and American heterosexual adolescents, utilizing survey data from 1,080 American adolescents (mean age = 15.86 years) attending two schools and from 1,391 Dutch adolescents (mean age = 16.27 years) attending eight schools. Findings indicated the Dutch participants were more tolerant of lesbians and gays, after adjusting for the gender, age, and racial/ethnic minority status of the participants. However, between-country differences were attenuated by accounting for the beliefs about lesbians and gays that participants used to justify their attitudes. American participants were more likely to justify their attitudes using beliefs related to social norms and religious opposition, while the Dutch participants were more likely to justify their attitudes using beliefs related to individual rights and the biological/genetic basis of homosexuality. The results suggest that the relative importance of particular beliefs about lesbians and gays to attitudes at the group level may be context dependent but also that certain beliefs are salient to attitudes across national contexts.     

Lesbian Health

ABSTRACT

Health care research suggests that lesbians may face unique physical and mental health risks, yet few studies make use of gender and sexuality theories to explain lesbian health. In this study, a social constructionist view of sexuality is used to examine the impact of lesbian identity on well-being. Drawing from nineteen intensive interviews with women who self-identify as lesbians, the results show that individuals' sexual identities change over time and are affected by their social environments. The data also demonstrate that sexual identity and social context have implications for well-being. Specifically, hostile environments, which are characterized by animosity toward gay men, lesbians, and others who do not conform to heteronormative gender expectations, are associated with distress over lesbian identity and with physical and mental health problems. By contrast, supportive environments, which many women report finding through feminism, facilitate the construction of a positive lesbian identity and enhance well-being.     

Strategies for improving education

1. An extensive curriculum is required to prepare mental health professionals to adequately assess, plan, and implement the necessary comprehensive treatment plan and to sufficiently develop relevant social policy. 2. A majority of professionals believe they were not adequately trained in the care of the chronically mentally ill; this may be a result of the trend of integrating the teaching of mental health nursing concepts into the baccalaureate curriculum. 3. Frequently there is a lack of mental health professional role models. Nursing faculty are in an excellent position to implement innovative practice models. 4. Learning from a multidisciplinary team may increase the likelihood that students will apply these approaches to the chronically mentally ill.     

Hidden Epidemic

Abstract

Rates of HIV infection among the seriously and persistently mentally ill contradict the widely held belief that this population is not at high risk for HIV exposure. The literature suggests that, in part, due to pervasive misconceptions around issues of sexuality and illicit drug use, HI V-positive, mentally ill individuals are not receiving appropriate care. This article focuses on the interplay of mental illness, HIV infection, and service provision through a review of the literature and the presentation of a case study. Available services are detailed and barriers to their success discussed. The importance of comprehensive community-based services specifically designed to address the multifaceted needs of this population is highlighted.     

Correlates of Homophobia and Use of Gay Affirmative Practice Among Social Workers

ABSTRACT

Research on social work practice with gay and lesbian clients has historically focused on examining social workers' attitudes towards gay and lesbian individuals, however, no studies have examined the relationship between attitudes and practice using validated measures to assess practice. The focus of this study was therefore to examine the relationship between attitudes and practice with gays and lesbians using the recently developed and validated Gay Affirmative Practice Scale (GAP). Significant relationships were found with the GAP and two measures of homophobia as well as with measures that assessed feelings about lesbians and gay men, contact with gays and lesbians, attendance at workshops that focused on gay and lesbian issues, relationship status, sexual orientation, political party, and primary area of practice. Relationships with measures of attitudes were also examined. Implications for social work practice, education, and research are discussed.     

Homelessness Among Older Adults with Severe Mental Illness

ABSTRACT

This article tackles a problem that is often overlooked in the literature-the plight of homeless elders with severe mental disabilities. Drawing on his personal experience working with sheltered homeless persons who were mentally ill, the author argues for a focus not on self-sufficiency but on closely supervised care for this vulnerable population.     

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.     

Factors in the Transition to Homelessness in the Chronically Mentally III

Although there is a great deal of literature on homelessness and mental illness, few studies have examined the factors which may lead to homelessness in the mentally ill. The objective of this research was to examine the factors in the length of time between when a client of the Los Angeles County Department of Mental Health entered the system and when he or she was first homeless on admission to a service (time before homelessness, TBH). Past psychiatric records of 142 currently homeless clients were examined through the Automated Information System of LACDMH. Results showed that total admissions to any service and total admissions to prison services were predictors of shorter TBH; being younger and being both African-American and female were predictors of longer TBH. TBH shortened dramatically from 1973 to 1993; mental health funding levels for the previous year were significantly correlated with TBH Results show that demographic, clinical, and system variables all impact on homelessness in the chronically mentally ill.