Addiction and Mental Health in the GLBT Community
by Christopher Ackerman, BA, LADC
During this Pride season, we as a GLBT community come together to commemorate the progress we have made since the Stonewall riots in combating the discrimination we face. We’ve come a long way since 1969, but a major culprit remains largely under the radar. Addiction and mental health take an unequal toll on our community, often times not just shattering but even prematurely ending the lives of many of our GLBT family, friends, and loved ones.
Addiction and mental health conditions have had a tremendous impact on the GLBT community. When we honestly stop and think about it, each of us likely knows at least one person affected or likely affected by a mental health or substance use disorder. Perhaps we’ve wondered about our own mental or emotional health or our use of alcohol or drugs. While that awareness may be initially painful, there is solace and hope in knowing that neither your acquaintance nor you are alone and that recovery is possible.
For many years, research in general on the GLBT community was sparse, especially with regard to substance use disorders and mental health. In the last several years, that story has changed. However, with the recent increase in research being conducted with the GLBT community and addiction and mental health comes some very sobering information-pun intended.
The Substance Abuse and Mental Health Services Administration (SAMHSA), within the U.S. Department of Health and Human Services, has accumulated a wealth of research on mental health and substance use disorder within the GLBT community as well as the most effective treatment methods to assist people in recovery.
Addiction/Substance Use Disorders
Research conducted by SAMHSA indicates that GLBT individuals are more likely than heterosexual, gender conforming people to use alcohol and drugs. According to SAMHSA, gay men and lesbians historically have higher rates of addiction than our heterosexual counterparts, with bisexual persons experiencing addiction more often than both gay men and lesbians (Andersen, 2009). GLBT individuals are also more likely to continue heavy drinking into later life. SAMHSA also states that we as a community are less likely to abstain from using alcohol and drugs.
Certain drugs in particular present a threat to members of the GLBT community. Reflecting recent research, SAMHSA advises that methamphetamine use is, and remains, a significant problem for gay men, lesbians, and male-to-female transgender persons.
Certain groups within the GLBT community exhibit higher use of particular methods of use. For example, thirty-four percent of male-to-female (MTF) transgender individuals and eighteen percent of female-to-male (FTM) individuals report lifetime IV drug use (Clements, Marx, Guzman, Ikeda, & Katz, 1998). This trend illustrates the significant risk our transgender community faces as a result of addiction.
Higher rates of use don’t only extend to drugs and alcohol. Studies show that GLBT individuals are more likely to smoke cigarettes than are heterosexuals (Ridner, Frost, & LaJoie, 2006; Greenwood, Paul, Pollack, Binson, Catania, Chang, et al., 2005). In society today, we are continuing to see the dramatic effects of nicotine use which then are increased in the GLBT community.
The GLBT community suffers from addiction and mental health more often than the heterosexual community, which disproportionately affects the overall quality of life for GLBT individuals compared to heterosexual, gender conforming individuals.
Mental Health Conditions
The same research coming out in the last couple of decades warns us of serious mental health and wellness concerns we face as a GLBT community. Gay men have been shown to be at a higher risk for suicide attempts and completions than other persons (Stall, Valdiserri, & Wolitski, 2008) as well as a higher prevalence of depression, often with more severe problems seen in gay men remaining “closeted” (Berg, Mimiaga, & Safren, 2008). Incidents of depression and suicide attempts among both FTM and MTF transgender persons are higher than for non-transgender persons (Clements-Nolle, Guzman, Katz, & Marx, 2001). Women who have same-sex partners are also more likely to suffer from major depression, phobias, and post-traumatic stress disorder (PTSD) (Cochran, Gilman, Hughes, et al., 2001) and generalized anxiety disorder (Cochran, Sullivan, & Mays, 2003) with gay and bisexual men being more prone to panic attacks than heterosexual men according to the same study. Bisexual men and women consistently show higher rates of depression and anxiety at rates similar to or higher than gay men and lesbians (Dobinson & Steele, 2008). We as a community require a change. Fortunately, a path to change is available.
As the Stonewall riots (which we celebrate during Pride) show, we in the GLBT community fight back. As the above research illustrates, we need to fight. However, we can only fight if a solution exits. And there is a solution. Recovery is possible and treatment works. We as a community just have to become aware of the disparate incidents of both addiction and mental health in our community and take action to make a change. If we are more in tune with the warning signs, we can address the underlying causes and overcome this discrepancy.
This is possible if the underlying causes—social, environmental, religious, etc.—are addressed as part of treatment. Research indicates that if GLBT individuals receive treatment that is geared toward our unique needs, members of our community fare better in recovery (Hicks, 2000). Standard treatment may not be enough for GLBT individuals.
When Help May Be Needed:
The question now becomes, how do we know when addiction and mental health might be a problem for us or for others?
Some signs to be aware of are persistent desires, thoughts, and cravings to drink or use drugs. Noticing that it seems to take more of what it is you’re taking/using to get to that same feeling of being high, buzzed, or drunk. Noticing blackouts and becoming ill or experiencing incapacitating hangovers are concerning. Also noticing if someone drinks or uses in situations that evoke strong or uncomfortable emotions in order to manage might suggest addiction concerns. Noticing increased irritability, long periods of feeling down, unremitting worry, trouble sleeping, and difficulty getting things done may be several signs of mental health concerns (American Psychiatric Association, 2013). If these symptoms seem to be out of the ordinary or seem to contradict or be in conflict with your personal values, seek assistance.
Where Can I Go If I Think Help May Be Needed:
A primary clinic or physician can make a referral for assessment to determine mental health or addiction conditions. Some primary physicians are even able to begin treating mental health conditions themselves. For addiction assessments, many treatment centers, hospitals, as well as the county in which you live, provide chemical health assessments (Rule 25 assessments). All you need to do is call and have one scheduled.
For 24-hour mental health crisis support call (651) 266-7900.
If you’re in need of mental health care quickly near St. Paul: Urgent Care for Adult Mental Health is located at 402 University Avenue East, Saint Paul, MN 55130
Christopher Ackerman, BA, LADC is the HealthEast Lead Outpatient Addiction Services Counselor for the L.I.F.E. Program at St. Joseph’s Hospital which is an LGBT-specific outpatient mental health and addiction treatment providing holistic care to improve overall life satisfaction and wellness. Onsite psychiatry, therapy, and trauma therapy available. For more information, call (651) 326-3645 or visit www.healtheast.org/mental-health-addiction/outpatient-programs.html.
American Psychiatric Association. 2013. Diagnostic and Statistical Manual of Mental Disorders. American Psychological Association.
Anderson, S. 2009. Substance Use Disorders in Lesbian, Gay, bisexual, and Transgender Clients: Assessment and Treatment. Columbia University Press.
Berg, M. B., M. J. Mimiaga, and S.A. Safren. 2008. Mental health concerns of gay and bisexual men seeking mental health services. Journal of Homosexuality 54(3), 293-306. Retrieved February 13.2012, from http://www.ncbi.nim.nih.gov/pubmed,18825866.
Clements, K., R. Marx, R. Guzman, S. Ikeda, and M. Katz. 1998. Prevalence of HIV infection in transgendered individuals in San Francisco. International Conference on AIDS; 12:449.
Clements-Nolle, K., R. Guzman, M. Katz, and R. Marx. 2001. HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: Implications for public health intervention. American Journal of Public Health 91(6). 915-921.
Cochran, S. D., S.E. Gilman, M. Hughes, R.C. Kessler, V.M. Mays, and D. Ostrow. 2001. Risk of psychiatric disorders among individuals reporting same-sex sexual partners in the National Comorbidity Survey. American Journal of Public Health 991, 933-939.
Cochran, S.D., J. Sullivan, and V.M. Mays. 2003. Prevalence of mental disorders, psychological distress, and mental services use among lesbian, gay, and bisexual adults in the United States. Journal of Consulting and Clinical Psychology 71.1:53-61.
Dobinsin, C. and L. Steele. 2008. Ten things bisexual people should discuss with their health care providers. New York: gay and Lesbian Medical Association.
Greenwood, G. L., J. P. Paul, L. M. Pollack, D. Binson, J. A. Catania, J. Chang et al. 2005. Tobacco use and cessation among a household-based sample of US urban men who have sex with men. American Journal of Public Health 95.1:145-151.
Hicks, D. 2000. The importance of specialized programs for lesbian and gay patients. Journal of Gay and Lesbian Psychotherapy 3:81-94.
Ridner, S. L., K. Frost, and A. S. Lajoie. 2006. Health information and risk behaviors among lesbian, gay, and bisexual college students. Journal of the American Academy of Nurse Practitioners 18.8:374-378.
SAMHSA 2013. Building Bridges: LGBT populations: A dialogue on advancing opportunities for recovery from addictions and mental health problems. U.S. Department of Health and Human Services; 1.
Stall, R., R.O. Valdiserri, and R. J. Wolitski. 2008. Unequal opportunity: Health disparities affecting gay and bisexual men in the United States. Oxford University Press.