This exploratory study recruited a purposive sample of twelve clinical staff from a Program of Assertive Community Treatment (PACT) team in central Virginia to understand the perceptions and experiences related to assertive engagement. The researchers coded the transcribed data initially as twenty-three sub-themes and further refined the data into four overarching themes: characteristics of assertive engagement, PACT engagement strategies and engagement strategies for difficult to engage clients. Further analysis emphasized that PACT team members emphasized the importance of the therapeutic relationship for engagement, which proves challenging for hard-to-engage clients.

Sexual and gender minority (SGM) youth are at risk of stigma and victimization, which may lead to increased mental health symptoms, including depression, anxiety, and stress. The role of the community in exacerbating or mitigating the frequency of victimization and mental health symptoms among SGM youth has been understudied. Using a minority stress framework, this study examined the association between physical and nonphysical anti‐SGM victimization, perceived community climate, and community size and their effects on depression, anxiety, and stress among SGM youth. An online survey was completed by 296 SGM‐identified youth (aged 14–18 years). Results revealed that nonphysical forms of victimization were associated with depression, anxiety, and stress above and beyond physical victimization and community variables. Both types of victimization were more common in communities that participants perceived to be hostile and small towns. Practice implications include ways to reduce victimization and improve mental health via community climate and community interventions.

Although prior research has demonstrated that faith communities, religiosity, and/or religious affiliation can be risk factors for depression, suicide, and substance abuse among LGBTQ+ people, there is also promising evidence of the protective functions of faith communities for LGBTQ+ people. This study's purpose was to explore what draws LGBTQ+ people to stay in faith communities. The data were collected from a sampling pool recruited at a national conference formerly called the Gay Christian Network (GCN) conference. Our sample of 30 individuals were purposively selected in order to represent diverse views from a variety of demographic domains, many of which are underrepresented in the extant empirical literature on this topic. Qualitative data were analyzed using a procedure by Maietta and colleagues called Sort and Sift, Think and Shift. The analysis resulted in six themes: profound loss versus healing authenticity, fear of rejection versus joy of inclusion, what works for now versus heavenly bliss, isolation versus community, cultural versus not cultural, and mainstream versus marginalized. The results of the study have implications for clinical practice with LGBTQ+ individuals and offer a more nuanced understanding of both the risk and protective functions of faith communities in the lives of LGBTQ+ people.

This study examined trends in general hospital discharges and dispositions involving episodes of severe mental illness (SMI) with and without co-occurring substance use disorders. We analyzed data from the National Hospital Discharge Survey from 1979 through 2008. Discharges involving SMI and co-occurring substance use disorders (COD) were associated with shorter lengths of stay and had a greater likelihood of being discharged routinely or home and reduced likelihood of being transferred to a short- or long-term facility. Although COD discharges had a greater odds of leaving against medical advice than SMI discharges, this effect was not significant over time. A greater understanding of hospital discharge planning practices is needed to ensure that patients are linked to appropriate aftercare services.

Research indicates that rural transgender and gender diverse (TGD) populations have a greater need for health services when compared with their urban counterparts, face unique barriers to accessing services, and have health disparities that are less researched than urban TGD populations. Therefore, the primary aim of this mixed-methods study (n = 24) was to increase research on the health care needs of TGD people in a rural Appalachian American context. This study was guided by a community-engaged model utilizing a community advisory board of TGD people and supportive parents of TGD children. Quantitative results indicate that travel burden is high, affirming provider availability is low, and the impacts on the health and mental health of TGD people in this sample are notable. Qualitative results provide recommendations for providers and health care systems to better serve this population. Integrated mixed-methods results further illustrate ways that rural TGD people and families adapt to the services available to them, sometimes at significant economic and emotional costs. This study contributes to the small but growing body of literature on the unique needs of rural TGD populations, including both adults and minors with supportive parents, by offering insights into strategies to address known disparities.