Background: Youth who are lesbian, gay, bisexual, trans, queer, 2-spirit, and of other identities (LGBTQ2S+) experience mental health disparities and higher rates of substance use when compared to their cisgender and heterosexual peers and yet also experience more barriers to access to services. The purpose of this paper is to determine the types of mental health and substance use programs and services exclusive to LGBTQ2S+ youth in Ontario during the pandemic. Methods: An environmental scan was conducted to identify existing programs and services in Ontario, Canada that offered exclusive mental health and addiction services to LGBTQ2S+ individuals aged 16–29, either by offering services to all or subgroups within the population. Organizations, services and programs were classified by the geographical distribution of services, populations served, types of programming or services, methods of service delivery, and program criteria. Results: In total, 113 organizations and 240 programs and services were identified as providing mental health and substance use services exclusively to LGBTQ2S+ youth. Identified adaptations for the COVID-19 pandemic included cancelling in-person services, increasing online and telephone services, and expansion to province wide from local availability. Conclusions: The findings highlight the importance of offering services that provide culturally inclusive care for LGBTQ2S+ youth, and these results can also be used by policy makers to inform policies. In particular, there was a lack of culturally relevant clinical services for youth requiring a greater intensity of treatment.
Background Mental health (MH) and substance use (SU) care supports are often difficult to access for the lesbian, gay, bisexual, transgender, queer, questioning, and 2-spirit (LGBTQ2S+) population. There is little known on how the shift to web-based care has affected and changed the experiences of LGBTQ2S+ youths within the MH care system. Objective This study sought to examine how web-based care modalities have affected access to care and quality of care for LGBTQ2S+ youths seeking MH and SU services. Methods Researchers used a web-based co-design method to explore this population’s relationship with MH and SU care supports, focusing on the experiences of 33 LGBTQ2S+ youths and their relationship with MH and SU supports during the COVID-19 pandemic. A participatory design research method was used to gain experiential knowledge of LGBTQ2S+ youths’ lived experience with accessing MH and SU care. Thematic analysis was used to examine the resulting audio-recorded data transcripts and create themes. Results Themes related to web-based care included accessibility, web-based communication, provision of choice, and provider relationship and interactions. Barriers to care were identified in particular for disabled youths, rural youths, and other participants with marginalized intersecting identities. Unexpected benefits of web-based care were also found and emphasize the idea that this modality is beneficial for some LGBTQ2S+ youths. Conclusions During the COVID-19 pandemic, a time where MH- and SU-related problems have increased, programs need to reevaluate current measures so that the negative effects of web-based care modalities can be reduced for this population. Implications for practice encourage service providers to be more empathetic and transparent when providing services for LGBTQ2S+ youths. It is suggested that LGBTQ2S+ care should be provided by LGBTQ2S+ folks or organizations or service providers who are trained by LGBTQ2S+ community members. Additionally, hybrid models of care should be established in the future so that LGBTQ2S+ youths have the option to access in-person services, web-based ones, or both as there can be benefits to web-based care once it has been properly developed. Implications for policy also include moving away from a traditional health care team model and developing free and lower-cost services in remote areas.
BACKGROUND Mental health (MH) and substance use (SU) care supports are often difficult to access for the LGBTQ2S+ population. There is little known on how the shift to virtual care has affected and changed the experiences of LGBTQ2S+ youth within the mental health care system. OBJECTIVE This study sought to examine how virtual care modalities have affected access to care and quality of care for LGBTQ2S+ youth seeking mental health and substance use services. METHODS Researchers used a virtual co-design method to explore this population’s relationship with mental health and substance use care supports, focusing on the experiences of 33 LGBTQ2S+ youth and their relationship with MH and SU supports during the COVID-19 pandemic. A participatory design research method was used to gain experiential knowledge of LGBTQ2S+ youth’s lived experience with accessing MH & SU care. Thematic analysis was used to highlight themes that emerged from the resulting audio recorded data transcripts. RESULTS Themes related to virtual care included accessibility, technology, virtual communication, provision of choice, and provider relationship and interactions. Barriers to care were identified in particular for disabled youth, rural youth, and other participants with marginalized intersecting identities. Unexpected benefits of virtual care were also found, and emphasize the idea that this modality is beneficial for some LGBTQ2S+ youth. CONCLUSIONS During COVID-19, a time where mental health and substance use-related problems have increased, programs need to re-evaluate current measures so that the negative effects of virtual care modalities can be reduced for this population. Implications for practice encourage service providers to be more empathetic and transparent when providing services for LGBTQ2S+ youth. It is suggested that LGBTQ2S+ care should be provided by LGBTQ2S+ folks/organizations or service providers who are trained by LGBTQ2S+ community members. Additionally, hybrid models of care should be established in the future so that LGBTQ2S+ youth have the option to access in-person services, virtual ones or both as there can be benefits to virtual care once it has been properly developed. Implications for policy also include moving away from a traditional healthcare team model and developing free and lower-cost services in remote areas.
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