Thursday, August 18, 2022

#JamesDonaldson On #MentalHealth - How Acceptance Can Reduce #SubstanceUse, #SuicideRisk For #LGBTQ #Youth
Due to the unique challenges they face, #LGBTQ+ young people are at a higher risk of #substanceuse and adverse #mentalhealth outcomes such as #suicide

- New research from The #TrevorProject examined the realities of #substanceuse and #suiciderisk among #LGBTQ young people in the #UnitedStates.
- The new research took a more comprehensive look than previous studies, examining how #substanceuse broke down among a large and diverse array of demographic lines.
- Experts say this new research is a positive step toward better understanding the interplay between substance use and the #mentalhealth of #LGBTQyouth, leading to improved support and care.

In the past, research has shown an elevated risk of both #substanceusedisorders and related adverse #mentalhealthissues, like attempted #suicide, among #LGBTQ #youth.

One flaw in some of this research is that it often focuses on #lesbian, #gay, and #bisexual (#LGB) #youth, not taking into account #genderidentity or capturing the full scope of how intersectional identities within a broad community as diverse as the greater #LGBTQ+ population play a role in these issues.

Today, The #TrevorProject has released a new research brief that attempts to address some of these concerns.

Using data from the 2021 National Survey on #LGBTQ #Youth #MentalHealth, they’re able to take a more comprehensive look at the realities of #substanceuse and #suiciderisk among #LGBTQ #youth in the #UnitedStates.

Jonah DeChants, PhD, research scientist at The #TrevorProject, told Healthline this work answers a great need in better understanding the interplay between #substanceuse and #mentalhealth in the nation’s #LGBTQ #youth, and offers pathways for better interventions.

“When we examine data among #LGBTQ young people — whether we’re looking at #substanceuse, #mentalhealthchallenges, or any other experiences — we need to center the reality that this is an incredibly diverse group of #youth,” said DeChants, who led the report for The #TrevorProject’s research team.

“In particular, looking at #genderdiversity, we know that #trans and #nonbinary #youth experience disparate rates of #suiciderisk and other #mentalhealthchallenges compared to their #cisgender #LGBQ peers,” he said.

DeChants underscored the need for reports like this to shed a light on negative #mentalhealth outcomes for #LGBTQ+ #youth in the #UnitedStates.

“This study found that regular prescription drug misuse among #LGBTQ #youth was associated with nearly three times greater odds of attempting #suicide in the last year. While we weren’t necessarily surprised by this association, the magnitude of it is staggering,” he said.

DeChants added that understanding “within-group disparities like these is critical for addressing and preventing the negative health outcomes we often observe among #LGBTQ #youth.”

“Our sample is unique in that it is both large and diverse enough for us to apply an intersectional lens and examine differences in #mentalhealthrisk among various subgroups — e.g. #transgender #youth, #Black #youth, #bisexual #youth, etc.,” DeChants explained.

What the data show

The new brief uses data from the larger 2021 report that was based on online surveys of 34,759 #LGBTQ #youth in the #UnitedStates who were recruited from targeted #socialmedia ads.

What substances did young people mainly turn to?

The #TrevorProject found that 56 percent of #youth surveyed used #alcohol in the past year — this included 47 percent of #LGBTQ #youth under the age of 21.

More than 1 in 3 reported using #marijuana in the past year, which also included 29 percent under 21. They found that 11 percent reported using a prescription drug that “was not prescribed to them in the last year,” with the rate being the same for those both under and over 21 years old.

Additionally, 11 percent reported a daily or weekly use of both #marijuana and #alcohol, but this “regular” rate of #alcohol or #marijuana consumption was higher for young #adults who were ages 21 or older than for their younger surveyed peers.

Regular misuse of unprescribed prescription drugs was less common, at just 2 percent, and did not differ by age.

One interesting factor that separates this survey from others like it is how comprehensive it is in factoring out how #substanceuse broke down among demographic lines.

White #cisgender #boys and young #men had regular #alcohol use rates at 20 percent, compared to 9 percent for other #LGBTQ young people.

Native or indigenous #LGBTQ #youth had greater odds of regular reported #marijuana use compared to white peers, while multiracial #LGBTQ #youth showed greater rates of reported regular prescription drug misuse compared to white peers.

Nonbinary #youth who were assigned #male at birth were the only group surveyed who reported higher rates of regular #marijuana use than #cisgender #males.

The research also spotlighted how external pressures and factors affected #substanceuse among #LGBTQ #youth.

Those who reported experiencing conversion therapy — a harmful practice that aims to “change” a youth’s #LGBTQ identity to #cisgender or straight identities — were shown to have higher odds of reporting regular #alcohol and #marijuana use, as well as prescription drug misuse.

Similarly, those who experienced physical harm as a result of one’s #LGBTQ identity had higher rates of #alcohol and #marijuana use and were almost two times more likely to misuse prescription drugs.

The survey also revealed that regular prescription drug misuse was tied to a nearly three times higher chance of attempting #suicide in the past year. This was for #youth both older and younger than age 21.

For those under 21 years old, regular #alcohol use was tied to nearly 50 percent greater odds of attempting #suicide in the last year. The odds were high for those ages 21 and older, but not as high as for younger #LGBTQ individuals.

In all age groups, regular #marijuana use was linked to higher odds of attempting #suicide in the last year.

A look at related research

Past reports have certainly shown elevated #substanceuse risk and adverse #mentalhealth outcomes for #LGBTQ+ people at large.

It’s especially important to highlight this reality in young people, given #teens and young #adults often find themselves in vulnerable situations — caught between a culture that stigmatizes #mentalhealthconcerns and #substanceusedisorders on their own and then compounded by the co-occurring stressors of being young and #LGBTQ in modern #American society.

Heather Zayde, LCSW, a Brooklyn-based clinical #socialworker and #psychotherapist, told Healthline that #substanceusedisorders typically affect 9 to 10 percent of the general population, but those numbers rise to 20–30 percent for the #LGBTQ community.

She said that young #LGBTQ people face increased rates of discrimination, harassment, and #bullying.

In particular, young #LGBTQ people who live in rural areas can face social #stigma and other co-occurring #mentalhealthconditions that might come with fewer supports and interventions. This can create an environment where #substanceuse issues could arise.

“A lot of #LGBTQ #teens deal with #anxiety and #depression. When dealing with societal issues, anxiety can be a factor, and to deal with all of that #anxiety, a lot of people self-soothe to get a handle on it,” Zayde said.

Recently, a survey out of Colorado detailed similar trends as the larger national survey from The #TrevorProject.

It took a look at #LGBTQ+ Coloradans and how pervasive early #childhood trauma is linked to #substanceusedisorders and other #mentalhealthchallenges.

In that survey, which was funded by The Denver Foundation and conducted by Colorado social science research and evaluation consultancy OMNI Institute, #adversechildhoodexperiences (#ACEs) like abuse, neglect, or family dysfunction were tied to increased risks of #substanceusedisorder and #suicideattempts, along with #depression and chronic disease.

When asked why research like this and The #TrevorProject report are important, T Schweimler, OMNI Lead Researcher for the State of the State report, told Healthline that this work is necessary to identify “what those needed interventions and supports are.”

“It allows us to dig deeper — looking beyond what is impacting the #LGBTQ+ community as a whole, to find what the needs and priorities are and how they differ among subsets of our community,” they said. “It lets us move beyond a ‘one-size-fits-all’ approach and into really tailoring the supports to individuals living at the intersection of multiple identities.”

“We can’t expect folks to show up fully — in our community, in relationships, in conversations, and certainly not in interventions and programming — if we fail to recognize all the various additional identities they hold and how these shape how they move through life,” Schweimler added.

“Key findings from the State of the State show that many #LGBTQ+ Coloradans have unrecognized #behavioralhealth concerns contributing to higher rates of #suicide contemplation and attempts. This is an opportunity for community organizations like Envision:You to spread awareness and advocate for increased conversations about #mentalhealth that break down #stigma and connect individuals to #LGBTQ+ affirming #behavioralhealthresources,” said Steven Haden, MSW, chief executive officer and co-founder of Envision:You.

Finding support

In The #TrevorProject survey, #LGBTQ-specific threats to a young person’s #mentalhealth and physical safety are cited.

When it comes to the statistics on conversion therapy and its effects on elevated rates of issues surrounding #substanceuse, DeChants said that this “dangerous and discredited practice” is “extremely harmful to #LGBTQ young people.”

“Previous research has shown that these types of efforts to change a youth’s #LGBTQ identity to straight and/or cisgender can have severe and lasting impacts on their health and well-being. So, it’s not surprising that these young people may be more likely to use substances to cope,” he added.

Zayde said that being able to turn to a community for support can make a big difference for #LGBTQ young people who face the additional challenges of societal and cultural stressors.

“What we need to be doing is teaching #teenagers how to self-soothe in different and better ways. If someone does develop a #substanceusedisorder, it needs to be treated in a different way. Tossing them in a different population is really not as effective as putting them in a group with other #LGBTQ #teens,” she said.

“A lot of people say ‘the opposite of addiction is connection,’ and I think a lot of these #teenagers feel incredibly disconnected from one another. A #kid who doesn’t have a lot of #LGBT friends in their lives? They don’t feel connected. When #substanceuse issues arise, we want to create that connection among them,” Zayde added.

She explained that many young #LGBTQ people might not have the benefit of an affirming #adult or a guidance #counselor at #school, for instance, who might be either well-versed in #LGBTQ-specific concerns or even accepting of that young person’s identity.

#LGBTQ #youth centers or community spaces can be a source of comfort for young people. This support can come in many forms such as substance use support groups, counseling, building networks that can offer needed resources for treatment, or simply friendship and community.

Twelve-step programs and #substanceuse counseling geared specifically to #LGBTQ #youth also exist. A community center, even if it doesn’t have that program itself, might have resources to which they can direct a person.

While these kinds of gathering spaces and support systems are helpful, Zayde stressed that in a small town or a #ruralarea, for example, pervading #stigmas might make approaching these spaces a step too far for a young person.

For instance, if you’re too young to drive or don’t have access to transportation, it’s hard to ask the #adult in your life to “drive me to the substance use support group,” she said.

Similarly, living in a small town could bring with it the threat of running into someone you know which can pose another stressor if a young person is closeted or seeking anonymity when accessing these resources.

As a result, the #pandemic has oddly presented one positive: Zoom.

“So many of these groups are happening on Zoom and you can do it from the comfort of your own home,” Zayde said.

Zayde added that while #COVID-19 has been horrible, the availability and access of these groups is really amazing. You can just hop on the phone or computer and “have an instant connection.

One area of concern that all the experts cited is prescription drug misuse among #LGBTQ young people.

DeChants said that, due to the fact that The Trevor Project’s survey is “cross-sectional in design,” it can’t tell us exactly why this misuse is tied to increased odds of attempting #suicide. He pointed to the reality that “#substanceuse and #suiciderisk are a bit of a chicken-and-egg scenario with #mentalhealthresearch.”

It’s hard to exactly “distinguish between the symptoms of suicidality that led a person to start using substances, and the symptoms or suicidality that then result from substance misuse and its negative impacts on their life,” he added.

“Unfortunately, we don’t have the level of detail needed to determine the direction of that relationship. There are a number of possible factors that may contribute to the high rate of #suiciderisk associated with prescription drug misuse, as compared to #alcohol and #marijuana,” DeChants explained.

“These could include the devastating effects of opioid withdrawal on one’s #mentalhealth, the increased potency and addictive nature of prescription-strength substances, and the isolating and stressful effects of prescription drug misuse — to name a few,” he said.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleOrder your copy of James Donaldson's latest book,#CelebratingYourGiftofLife:From The Verge of Suicide to a Life of Purpose and Joy

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Building a more supportive future for #LGBTQ #youth

All the experts interviewed discussed the fact that more needs to be done to offer better support for #LGBTQ young people so that these statistics on #substanceuse and #suiciderisk are less dire.

For the researchers out of Colorado, it means pinpointing the root causes embedded in society that make these adverse outcomes a reality.

“Although much progress has been made, #homophobia and #transphobia are still very real and being experienced by many #LGBTQ+ folks and I think this reality lies at the heart of this data. In regards to the higher rates of #ACEs among #trans and #nonbinary participants, we can think about how much progress is still needed in creating open and affirming environments for #children to explore #gender,” Schweimler said.

They added that #trans and #nonbinary #children and #youth, as well as young people “exploring or playing with #gender roles and #gender expression,” often find themselves the “targets for discrimination and abuse, both at home and at #school.”

“These kinds of trauma don’t simply go away at #adulthood. We can find that for some folks, that trauma really becomes internalized and contributes to those higher rates of #substanceuse and #mentalhealthdiagnoses and higher rates of #suicide that we see,” Schweimler said.

Haden added that the high prevalence of #ACEs displayed in the Colorado survey shows that many #LGBTQ people face “trauma, abuse, neglect, or family dysfunction early in their lives.”

“While these instances may not necessarily be related to their #LGBTQ+ identity, we know that many in the community have experienced discrimination, harassment, as well as violence, and often lack of family acceptance as young people,” he said.

“The invalidation of one’s identity by family members and society causes chronic #stress, which can lead to increased rates of #behavioralhealthchallenges for many #LGBTQ+ people. Higher rates of #ACE’s have been linked to increased #substanceuse, suicidality, and chronic diseases like cancer, diabetes, and heart disease,” he continued.

Zayde pointed to the reality that multiple oppressions (such as #racism, #transphobia, #bullying based on one’s #genderidentity or sexuality, among others) can have a “multiplicative effect” on an #LGBTQ+ young person.

If someone is grappling with the harms of #racism on top of their identity as a #trans person, for instance, it can create an accelerating domino effect that can feel very hard to push back against.

Trying to build structural support in society at large — and in communities and within families and #schools, at the micro-level — can make a big difference in seeing a world where those statistics on #substanceuse and suicidality are less common for #LGBTQ #youth.

Looking ahead, DeChants said that the #TrevorProject hopes to “examine ways to better support #LGBTQ #youth so they are less likely to engage in substance use or consider #suicide in the first place.”

He pointed out that this latest research underscores why federal surveys examining substance use among #youth in the #UnitedStates must collect information on #transgender and #nonbinary identities to accurately capture the scope of the problem among all #LGBTQ #youth.

“Beyond data collection, these findings reinforce acceptance as a powerful protective factor against a multitude of negative health outcomes like substance misuse, negative #mentalhealthchallenges, and #suiciderisk,” DeChants said.

“Ultimately, when we provide supportive, affirming environments for #LGBTQ #youth, we increase their likelihood of leading healthy, happy lives,” he said.

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