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By: Armando E. Colombo, President and CEO of The Menninger Clinic
A recent change in Texas could signal to other states to follow in making it more difficult for individuals in the LGBT+ community to access mental health care. This ruling has riled up mental health professionals and leaders here at The Menninger Clinic and elsewhere.
The new ruling does not just change the long-standing Texas Social Work Code of Conduct; however, it directly conflicts with the National Association of Social Workers Code of Ethics. This matter should raise eyebrows – and action we hope – nationally as an estimated 3.5% of the U.S. population of Americans identify as lesbian, gay, or bisexual and an estimated 0.3% of adults are transgender. This would equal a conservative 9 million LGBT+ Americans, a figure roughly equivalent to the population of New Jersey.
Not only does this go against the ethical standards of these licensed caregivers, it denies the rights of Americans in the LGBT+ community to treatment from specialists in social work.
While federal laws regarding disability generally categorize serious mental illness (SMI) and co-occurring substance use disorders (SUDs) as disabilities, individuals with physical, intellectual and developmental disabilities also “have a higher prevalence of SMI and SUD, as well as lower treatment rates for both conditions than do people without these disabilities.”
According to the 2015 Behavioral Risk Factor Surveillance System in Texas, “LGBT adults…were significantly more likely to have been diagnosed with a depressive disorder by a health care professional than non-LGBT adults.”
We fear the impact of the sweeping discriminatory message to the LGBTQ+ community will signify that their well-being and significance don’t matter, and they will suffer in silence, as will their families. The statistics clearly explain why:
- LGBTQ+ youth are almost five times as likely to have attempted suicide compared to heterosexual youth.
- Of all the suicide attempts made by youth, LGB youth suicide attempts were almost five times as likely to require medical treatment than those of heterosexual youth.
- LGBTQ+ adults are nearly twice as likely as heterosexual adults to experience a substance use disorder.
- Illicit drug use is significantly higher in high school-aged youth who identify as LGBTQ+ or are unsure of their identity, compared to their heterosexual peers.
Menninger Director of Social Work Janice Poplack, LCSW-S, said the action of the Governor and the Social Work Boards (TSBSWE and the BHEC), denies this population the full protection under the law, a position that is antithetical to the most basic principles of social work practice. “This notion is a blight on the profession. The Texas law needs to change, not the Social Work Code of Conduct…It maligns the very spirit of the profession, reflecting instead the cruel discrimination of vulnerable populations and overt disregard for human decency,” Poplack said.
Our colleague Candice Holloway, LPC, stated in a previous Mind Matters blog that restricting clinicians’ use of “social interventions is at odds with the accepted practice guidelines of recognized organizations such as the World Professional Association for Transgender Health (WPATH), the American Psychological Association (APA) and the American Counseling Association (ACA) … In my experience with the mental health professionals, I know that the majority would encourage state legislatures to refer to existing clinical guidelines in considering legislation that could have such a profound impact on the health and safety of such vulnerable communities.”
Safety and health. These are among The Menninger Clinic’s deepest beliefs. All individuals are worth what Menninger professionals and the vast majority of licensed mental health professionals have to give through evidence-based treatment that translates into healthier families and communities. We fear that giving social workers, or other mental health professionals, the option to deny treatment would jeopardize individuals, not just those in the LGBTQ+ community, from coming forward for necessary, even life-saving, mental health care.
Armando E. Colombo began his tenure as president and chief executive officer at The Menninger Clinic on September 16, 2019. He has spent the majority of his career in health care management. Prior to joining Menninger, he had most recently been executive vice president and chief operating officer at Sheppard Pratt Health System.
