This project utilized a Community-Based Participatory Research (CBPR) approach to conduct qualitative interviews with 30 transgender adults living in a rural state. Participants’ identities spanned from trans women and men to non-binary and Two-Spirit. The aim of this study was to better understand the experiences, needs, and priorities of the participants as well as to examine possible determinants of mental health, well-being, and suicidality for transgender individuals in Montana. These factors were investigated at individual, interpersonal, community, and societal levels using an ecological framework. Qualitative results indicate that participants experienced discrimination at all levels. Participants noted that discrimination contributed to mental health challenges and limited access to adequate general and transgender-specific healthcare services, both of which impacted overall well-being. This is reflected most notably in the elevated rate of past suicidal ideation attempts among the sample. Participants reported that the ability to transition, as well as other protective factors, played a role in reducing suicidality and improving mental and physical health. Our findings highlight the need to address transgender mental health through implementing changes at multiple ecological levels.

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Background Sexual minority-based victimization, which includes threats or enacted interpersonal violence, predicts elevated suicide risk among sexual minority individuals. However, research on personality factors that contribute to resilience among sexual minority populations is lacking. Using the Five-Factor Model, we hypothesized that individuals classified as adaptive (versus at-risk) would be at decreased risk for a suicide attempt in the context of reported lifetime victimization. Method Sexual minority-identified young adults between the ages of 18 and 25 (N=412) were recruited nationally and asked to complete an online survey containing measures of personality, sexual minority stress, and lifetime suicide attempts. Results A two-stage cluster analytic method was used to empirically derive latent personality profiles and to classify respondents as adaptive (lower neuroticism and higher extroversion, agreeableness, conscientiousness, and openness) or at-risk (higher neuroticism, lower extroversion, agreeableness, conscientiousness, and openness) on the basis of their Five Factor Personality trait scores. Adaptive individuals were slightly older and less likely to conceal their sexual orientation, but reported similar rates of victimization, discrimination, and internalized heterosexism as their at-risk counterparts. Logistic regression results indicate that despite reporting similar rates of victimization, which was a significant predictor of lifetime suicide attempt, adaptive individuals evidenced decreased risk for attempted suicide in the context of victimization, relative to at-risk individuals. Discussion These findings suggest that an adaptive personality profile may confer resilience in the face of sexual minority-based victimization. This study adds to our knowledge of sexual minority mental health and highlights new directions for future research.

Introduction: Individuals with chronic mental illness and addiction have poorer health outcomes than the general population, largely because of preventable medical conditions. Early onset and heightened incidence of chronic disease—such as type two diabetes, chronic obstructive pulmonary disease, and hypertension—might limit behavioral health consumers’ quality life years and ultimately lead to early mortality. These health risks are exacerbated by coinciding poor health correlates such as low socioeconomic status, disrupted cycles of care, and substance use. Primary and Behavioral Health Care Integration (PBHCI) initiatives address these compounding health disparities by improving access to quality primary care and wellness services inside of behavioral health centers. As opposed to traditional integrated care models in which behavioral health services are co-located in medical settings, reverse integration targets consumers with serious and persistent mental illness who are more likely to frequent behavioral health care settings. Recently, this model of reverse integrated care delivery has been on the rise because of its unique capacity to meet the complex needs of behavioral health consumers... The current study employs semi-structured individual interviews to assess behavioral health consumers’ perceived barriers to and engagement in PBHCI services at an urban community mental health center

Persons with severe mental illness and addiction are at higher risk for early morbidity and mortality than the general population, and are less likely to receive primary care and preventive health services. Primary and behavioral integrated care programs aim to reduce these health disparities by providing comprehensive health and wellness services. Gender in particular may play a significant role in individuals' engagement and outcomes in such programs. Hence, this study examines the salient characteristics of behavioral health consumers accessing an integrated care program at a large community mental health center. Baseline gender differences in consumer demographics, substance use, psychological distress and functioning, physical health indicators, and risk factors for serious medical conditions are examined. Our results demonstrate that key gender differences exist and may warrant distinct treatment needs for men and women receiving integrated care.