How to improve LGBTQ mental health care post-pandemic

The pandemic — with its requisite physical distancing, economic strain, and continued racial trauma — only exacerbated the many mental health challenges already facing LGBTQ community, and particularly LGBTQ youth.

Though the situation has been dire, there's plenty of hope for a better future. To discuss solutions, Mashable Senior Features Writer Rebecca Ruiz hosted a livestream panel with a lineup of experts to discuss the most effective ways to improve LGBTQ mental health care — both during the pandemic and throughout our slow return to normalcy.

The panel was part of the latest edition of Mashable's Social Good Series, which for this month's installment focused on health equity. Ruiz was joined by Michele Giordano, the vice president of digital crisis services at the Trevor Project; Yolo Akili Robinson, the founder and executive director of BEAM, a collective that advocates for Black healing; Juan Acosta, a mental health advocate who has pushed for LGBTQ protections in his hometown; Elliott Hinkle, a foster care, rural, and youth mental health specialist; and Peter Karys, the Center's director of youth counseling and support.

Their conversation covered a wide range of solutions, from individual actions that can create welcoming mental health environments to the kind of systemic changes panelists want to see in healthcare systems at large.

When it comes to formal, clinical mental health environments, panelists discussed the importance of cultural competence. Karys introduced the idea of "cultural humility," in which mental health providers demonstrate an openness to learn and respect what they don't know. "Providers in the field need to do that work themselves," he said.

Similarly, Hinkle noted that while some doctors might specialize in caring for trans folks, it should be every doctor's responsibility to equip themselves with tailored mental health information. "Any doctor should be able to care for the patient in front of them," they said.

On the topic of cultural competence more broadly, Robinson also stressed the importance of breaking down systemic barriers that might turn Black folks and other people of color away from formal mental health care after having a therapist who doesn't affirm their experience.

He provided the useful example of a barbershop as an analogy for therapy: "If you went to a barbershop and got a bad haircut, you wouldn't stop getting your haircut." Instead, Robinson says mental health advocates need to focus on getting people the resources to find affirming mental health care, and there should be an overall focus on structural blockages to care.

Ruiz also asked panelists for their thoughts on the common (and misguided) refrain in mental health conversations that it's your own responsibility to pull yourself up by the bootstraps and help yourself through self care. As Ruiz herself recently reported, more often than not, the barriers to our mental and emotional flourishing are actually informed by systemic issues — and panelists felt similarly. "There's a focus on queer people as being resilient, that expectation of 'you're so brave; you're so courageous,'" Hinkle said. "But I'd like to not have to be."

Panelists also discussed the stigma that can keep people from getting care, particularly stigma that's informed by those same kinds of systemic barriers. Giordano pointed out that in order to think about intersectional mental health solutions to things like stigma and shame, it's necessary to also look at things like unemployment and homelessness, in order to get a full portrait.

Robinson also talked about the harm that comes when police are called in during escalated mental health episodes for Black and brown people, instead of relying on community solutions. "We have to recognize there's ongoing, deep-seated trauma [to mental health support] because of the prison industrial complex," Robinson said. "Until that is done, a lot of Black and brown folks are going to be hyper-resistant to these institutions."

Asked for their "radical vision" for an improved mental health care system for the LGBTQ community in the U.S., panelists all outlined broad, systemic changes. Hinkle stressed "not having people [have to] prove their suffering to receive support and services," which they see as a direct contrast to the way things are right now. "The model in America is 'how bad is it?' before we help you, versus 'let's help you before it gets bad.'"

Similarly, Acosta said he wants institutions to focus on preventative care options, while Karys wanted to see a broadened definition of mental health care in general. "It's not just seeing a therapist or counselor, but it's finding a support group or showing up at a protest." Giordano added that "we need a long term strategy, from a policy point of view, on how we can improve more access to providers, how we can eliminate structural barriers, and really elevate that intersectional approach to mental health."

Finally, Robinson wrapped up by driving home his view that supporting LGBTQ mental health needs a systemic approach. "I think we need to start defunding the police and fully funding community health, and think about moving towards a universal living wage, and universal healthcare," he said.