This week I had the privilege of speaking with experts, activists, and advocates about the various mental health needs we have in the LGBTQ communities, at an event hosted by Crisis Text Line. We all agreed that a supportive and continuous, therapeutic relationship is key, for everyone really. But for those of us who face constant discrimination it can be a matter of life and death. The trouble is that psychotherapy is stigmatized; not enough clinicians are competent, curious, or empathetic enough to make a connection with LGBTQ clients; and too many people simply can’t afford therapy, or their insurance won’t cover it (if they even have insurance). The experts I spoke to all fight tirelessly against these obstacles, in order to connect people to the safe, loving, and supportive relationships they need and deserve.
For this segment of my Pride in Mental Health Series, I talk with Becca Mui, Education Manager at GLSEN (which aims to create safe and affirming schools for all, regardless of sexual orientation, gender identity, or gender expression), and Thomas Krever, CEO of The Hetrick-Martin Institute, (which creates a safe and supportive environment for LGBTQ youth between the ages of 13 and 24 and their families, and offers a comprehensive package of direct services and referrals), about the role of education in LGBTQ mental health. Ross Schwartz, Director of Communications and Public Relations at the Hetrick-Martin Institute, joins us as well.
What are some of the specific mental health needs of the youth who engage with your organizations?
Thomas Krever: Well we’ve always seen this but it’s been worsening, as you can imagine, over the last four months or so: higher levels of anxiety, stress, and trauma. A lot of young people who are seeing, or witnessing...in the media... some things in our “leadership” expressing... and young people are... well, it’s a toss up I don’t know if I would say they are feeling invisible or feeling ostracized and actually spotlighted. So really trauma. Which our organization, the work we do, is ensconced in mental and emotional wellness, so all the young people that come to our doors--2,000 plus--every single one of them receives a mental health assessment, about 1100 of them will stay for short term or long term care.
My whole career has been youth work. I was a gang intervention expert for almost fifteen years nationally, and now here fourteen years. I am personally witnessing much higher rates of violence, verbal emotional or physical. In our community. And I don’t see people talking about it yet. So, any oppressed or distressed emotionally, any community witnessing or experiencing that...the energy has to go somewhere. We’re seeing people triggered much more easily, and young people reacting to each other, whether it’s verbal or physical. So you’re seeing lots of mace incidences, lots of things going from zero to sixty, and I think it’s prescriptive. Because any oppressed community energy has to go somewhere. So they’re acting out on each other if not other communities.
Becca Mui: GLSEN is the leading national non-profit organization supporting LGBT young people in schools. I’m the education manager so in my role, I really focus on our educator engagement and educator support. I was a classroom teacher before I came to GLSEN, so I know firsthand that there’s a tremendous amount that educators need to do, [to address the needs of LGBTQ+ youth] and my job is basically to make their job of integrating LGBT identities and visibility into their school as easy as possible.
What are some of the services you provide that address LGBTQ youth mental health needs?
Thomas Krever: So one of the things for us, at the Mayor’s office, I think we’re their only LGBT focused organization to provide Mental Health First Aide, through our First Lady’s campaign. And so all of our staff, I think any staff, would be better served to recognize how to provide Mental Health First Aide. So how do you recognize signs of trauma, distress, anxiety? Whether you’re running a swim and gym program, or an arts program, or a job readiness. Because it masks itself and far too many service providers don’t recognize what it is or what it looks like.
We really applaud the Mayor [on this initiative], because this is the first time that NYC as a city wide initiative started to look at mental health and trauma, and its effects on young people.
What we see for so long are either misdiagnosis, specifically around LGBT youth of color, so young people lacking services or being misdiagnosed. That’s usually about the service provider’s inabilities.
For instance, young people who are not receiving an Independent Education Plan (IEP)...It masks itself, [the need for mental and emotional health care]. It’s under the surface. We still live in a world where LGBT youth are three times as likely to be suspended from school. Or arrested or detained. Or on probation status. So it means that something’s going on. Things we as a society--I’m talking en masse--we tend to think we make a law and it all goes away. And counter that with No: that's when the work really begins. It doesn’t go away, it goes underground. So as a service provider, as a storyteller, we have to be really more skilled in recognizing what those symptoms look like. And how they mask or evolve. That we as a community of providers, whether we’re LGBT or not does not matter. We need to know and recognize when they’re occurring.
Becca Mui: GLSEN has a research department and what we have found, we take national data on LGBT people, and also a general population of school experiences and school climate for LGBT people. And from that we provide supports that the data shows young people need. So, in terms of mental health: young LGBT people who are in inclusive school environments are more likely to report higher self esteem, higher GPA’s and, they’re less likely to say that they’ve missed school because of bullying and harassment.
So when we find those school supports for young people, we have greater success. Greater outcomes. So what we do is find those [people who can serve as] supports and then try to make implementing LGBT support systems in those schools as easy as possible. To help spread awareness to all teachers, school counselors, nurses, and whoever can provide support.
How do we educate teachers and service providers about the mental health needs of LGBTQ youth?
Becca Mui: GLSEN has been around since 1990 and we have a large media presence. But also, we have online forums and we do a lot of conferences where educators are to try to reach them. And we’re also working with teacher educators now, so we’re teaching teachers. We have a report coming out in October on where LGBTQ visibility is in those programs. And to try to increase visibility and support networks.
We are not afraid to call attention to the actual real outcomes of having an LGBT supportive school and to really raise awareness to the reality of what makes young people go to a school in which they are not harmed, or a school environment that’s allowing them to be unharmed. [And instead one that supports them so they can thrive]. We also connect them to the ACLU and connect them to legal actions they might want to take. Also we have a policy department so we are also actively working on creating more laws and better laws and policies for young people at schools.
We advocate for inclusive policies. Policies that explicitly state gender identity and LGBT identities in their policies. That’s important. And we have a model policy written up so that we can give that to young people and to schools and say, “Here’s a model policy of what a supportive school system would look like,” so that they can adopt it.
Ross Schwartz: I think it’s a matter of building the connectivity and the access to resources. Because such a big part of why a young person might lash out in school, or why they’re not doing their homework, is because they’re depressed. Or they feel victimized, or they feel in danger, so that’s why they’re not going to go to school if they feel in danger so they end up missing a lot of school. And then we need more people to be trained in how to recognize those things. So we’re very lucky to work with the city council, and the Mayor’s office, that their are programs in place, that slowly we’re building a curriculum so then more teachers will be trained in how to identify what’s really going on with a young person, and working with the DOE to build that curriculum. The governor is working on something also, that of how to implement better in schools other systems. The NYPD we’ve been working with for over a year now, so that more people understand there’s a systemic way to understand what’s going on for young people from a mental health perspective. It’s not, a young person who seems angry, they’re not really just an angry person. There’s something going on there that deserves to be addressed. And the more access to resources we can build, the resources are there. At the summits we’ve had in the last two years, we’ve had a total of over a hundred organizations partner with us, to build that connectivity. So that someone starting a GSA in Brooklyn or Queens can get help with us. Or someone who works with Trevor Project in the Bronx, or the Anti Violence Project in Staten Island, can connect and find better resources for those people in need.
Becca Mui: Also, an LGBT inclusive curriculum is a really important avenue. Making sure that young people see themselves and are learning about people who identify as LGBTQ and understanding that LGBTQ people have existed forever and have contributed positively to society and to the society we are living in now. They have been part of history. So we have a lot of supports in curriculum around that. Visibility around LGBT history month. It's important to make sure that when we talk to young people about LGBTQ history, that we don't whitewash that. That we’re centering marginalized people [in a historical context]. And that we understand that talking about how LGBT history in America was built on the backs of trans women of color. It’s important that young people really see themselves [as a crucial part of history]. And also so that all young people in that class, however they identify are learning about that culture. We know that young people who are in schools that are teaching about LGBTQ curriculums are less likely to bully because they see that’s a person. Even if they’re not LGBTQ identified, they see their teacher teaching about these people who exist. And see them in a positive way.
Becca, what specific issues related to LGBTQ youth did you observe when you were a teacher?
Becca Mui: Well, I taught in elementary school. So really what I noticed is around gender and gender stereotypes. So I made sure to really be explicit about the harm and the limitation of gender stereotypes that there’s this idea of these traditional gender roles telling all people who they are, how to be, how to look, what to like, how to act. And so really helping young people learn at a young age, those stereotypes are where those messages are coming from and that they have a right to choose how they are, and how they want to be. And also giving them tools and language for intervening when someone is being bullied for the way that they look, the way that they dress, the things that they like, the colors that they like.
What’s interesting is that when I would teach that, then we would go to the playground. They’ll say what they need to say in a lesson. But then, what’s going to happen afterwards? And the goal is really for them to understand it, not just think, “I know I’m supposed to say bullying is wrong…” And so what I really noticed, after I taught, I would see on the playground, they would see someone wearing pink, or a boy wanting to be the mom when playing family. And I would support them to say, “Yes I can.” Of course they can. They can do that. It’s just pretend. [Play. Use of imagination, which is how we all develop.] And so just making sure they are saying something and standing up for themselves.
And really, it's important to understand how limited we are when we don't advocate for ourselves. To not be afraid of breaking outside of the box. With young people, they never say back to you, “That doesn’t seem right.” You tell young people there’s lots of ways to be, there’s lots of different genders, they’re like, “Sure.” Because they are in a place where they are learning about the world. And they are ready for that. It’s really the adults...
Right. So what do we do about them?...
Becca Mui: That’s why I switched careers. Because I realized that the work is with adults. Our own things that we have internalized that we learn that we need to unpack are the greatest obstacles for young people. Young queer teenagers know who they are. There’s a lot of knowledge and understanding that they have about their identities, of who they are, and how they want to look and be and identify. It’s really making sure that the adults around them aren’t taking our own stigmas and baggage and fears, and projecting it onto them. We so easily get in the way of the support that they need.
I encourage adults to listen to the young people around them. And provide support to them. And we provide professional development so that they can get around themselves. GLSEN, creates professional development opportunities. I make modules for us on Gender 101, and so we can hopefully provide that for parents. We have 40 local chapters, so I create modules so people across the country can go into their schools with them.
How do we connect LGBT youth to the long term mental health services they need?
Thomas Krever: Can I just add something first? I think, to not undervalue what you do. If you can humanize… So, I think part of the problem is the stigma, around mental and emotional well being. So how do you humanize that conversation, and how do you allow people to be ignorant? Right? So I’ve done more trainings than I can count, and I’ve been working in human services for twenty five years plus at this point, since I was nineteen years old. And today, the same as 1990 or so … people are embarrassed. There’s so much shame, and there’s so much fear around this conversation, whether it’s gender or sexuality or identity, and so what I find the greatest thing that you asked, *how do you get that out there?* It’s destigmatizing. You know this as a mental health professional. Repeat it. Repetition works. And you kind of know, there’s Ackerman [Institute for the Family: Gender & Family Project] and HMI, New York City Department of Education. I think it’s just telling the story, connecting in new ways. Young people are social media savvy. Speaking to their listening. Listening is one of the greatest skills. Saying it in ways that are… We don’t say “cultural competency.” To me it’s a little insulting. We say “cultural fluency.” Because organizations, just like the communities that they serve must evolve. Some of the language we use has to evolve. So the story we told twenty years ago, or two years ago, can’t look the same as it does today. Looking at each person without judgement so that they know they’re not being judged when they’re asking a question.
And then, to your question specifically, it’s up to us [adults] to [do our research and] connect them to reputable service providers.
Becca Mui: People like you [e.g., writers/therapists/teachers/social media users/people who care] help to get the word out. Saying that we exist. That there’s an organization. We’re really 25 people. We’re doing the best we can. Let people know that we exist.
Copyright Mark O'Connell, LCSW-R
More Articles in the PRIDE IN MENTAL HEALTH SERIES:
LGBTQ+ Mental Health Resources:
The Hetrick-Martin Institute
Crisis Text Line (Text 741741 for free, 24/7)
The Trevor Project
Psychology Today Therapist Finder
Refine your search based on therapists' experience with people who are LGBTQ+
New York City-Based Resources:
The Ackerman Institute for the Family: Gender & Family Project
The LGBT Center
Lighthouse LGBT (LGBTQ Affirmative Therapist Network)
Institute for Human Identity Therapy Center