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Reaching LGBT Clients Where They Live

<Reaching LGBT Clients

Where They Live>


Reaching LGBT Clients Where They Live

Therapists tailor outreach for community with varied needs

By Kat Long  |  @kat_long

May 12, 2015


The art room at the Rainbow Heights Club, a psychosocial support center for the LGBT community in downtown Brooklyn, is decorated with paper collages of trees, sunbursts and inspirational words. It’s a cheerful place for the Club’s members, who are in treatment for mental illnesses like depression or bipolar disorder, to drop in anytime and receive encouragement from their peers. Club member Giselle Caevoiserat came to New York from North Carolina a few years ago to obtain hormone therapy for gender reassignment. She found herself living in a men’s homeless shelter in Brooklyn until a gay social worker at the shelter recommended the Rainbow Heights Club for support, where she said she finally felt safe.

“They know where I’m coming from,” Caevoiserat said. Another client, Phillip Williams, said he was diagnosed with bipolar disorder with psychotic tendencies as a student at Ohio State University, and was hospitalized four times. Instead of going back to his parents’ home in Alabama, “where mental health care was a crapshoot,” he moved to New York and used the City Comptroller’s LGBTQ Directory of Services and Resources to find the Rainbow Heights Club. Now, six years later, Williams is a certified peer specialist who runs weekly support groups for gay men at the Club.

Caevoiserat and Williams are success stories. The majority of LGBT New Yorkers, however, face numerous hurdles when they seek help for mental health issues. A 2009 study, funded by the New York State Department of Health and supervised by the Empire State Pride Agenda Foundation, an LGBT advocacy group, found that lesbian, gay, bisexual and transgender residents in New York State come up against a host of barriers—cultural and financial—to quality mental health care. They’re less likely than heterosexuals to have health insurance, and more likely to be poor or homeless, abuse drugs, be rejected by family, and endure social isolation—all of which can trigger or exacerbate depression, anxiety and other problems. Some New York City therapy centers try to reach LGBT people where they live, using community-specific messages in a variety of media. They say this approach accomplishes a two-step goal: make the initial connection with vulnerable individuals, and help them to get the services they need.

“Socially determined factors like poverty, racism and immigration status have a huge impact on the health of LGBT New Yorkers, especially women and minorities,” said Carrie Davis, chief programs and policy officer at the Lesbian, Gay, Bisexual and Transgender Community Center in Manhattan (known as the Center).

As the LGBT community’s hub of cultural, health and social programming, the Center is often the first place people call when they think they need therapy, Davis said, and most of the callers lack private health insurance. Social workers at the Center work with clients on a short-term basis, or refer clients to therapists or clinics for longer-term care.

The Center uses an arsenal of tools to reach the economically, culturally and geographically diverse LGBT community in New York City, from social media to e-newsletters to in-person meetups. Davis said one recent outreach effort brought 400 people to the Center’s 7th annual LGBT Immigration Fair on April 16, which connected asylum seekers with resources for jobs, education, legal advice, housing, health insurance and medical services. “We saturated the Rockaways, Bronx, and Queens with flyers and information,” and worked with local LGBT centers in the outer boroughs to coordinate their message, Davis said.

For longer-term therapy, the Center refers come clients to the Institute for Human Identity, an LGBT-focused therapy center in Manhattan. When IHI was founded more than 40 years ago, being gay and mentally ill presented a double stigma—and some of that stigma remains today, said Tara Lombardo, IHI’s associate director.

Though many clients seek help with coming out and acceptance from friends and family, Lombardo says that IHI also focuses on what happens after coming out. “People have existential problems—should I get married? That didn’t use to be a question LGBT people asked themselves. Society is a mirror, and now we’re getting different reflections back,” Lombardo said. “Needs are being shifted, and they’re not just LGBT issues; they’re issues everyone faces.”

“We’ve come a long way, but there’s still a long way to go.”

Lombardo’s outreach to the community actually begins in IHI’s office, where she said the staff surveys clients to make sure their basic needs are met. For example, Lombardo updated intake forms to request a client’s preferred gender pronoun; she also hangs the key, which opens the men’s and women’s restrooms, where it’s freely accessible. Lombardo said both measures ease anxiety for gender non-conforming clients.

The Institute for Human Identity finds that most clients are referred by word-of-mouth, but Lombardo said social media campaigns have worked well too. A twice-a-year Facebook promotion that offers eight sessions for a low fee sells out each time. IHI’s ad on Grindr, the hookup app for gay men, told users that “your therapist is only 500 feet away,” Lombardo said. “We’re in Chelsea, we’re in your community. They key is to know we’re here.”

For LGBT people with serious mental health diagnoses, the Rainbow Heights Club “picks up where therapists leave off,” said executive director Christian Huygen. Since 2002, the Club has promoted a holistic approach to mental health in which clients in similar treatment programs can interact, get and give support, and bond over shared activities like nightly meal prep. Huygen said 94 percent of respondents in a member survey were free of hospital admissions for psychiatric reasons in the last year. “The ability to give back is an enormously positive experience” for clients, Huygen said.

Most Rainbow Heights Club members are referred by their therapist or by word-of-mouth. To get the word out further, Rainbow Heights Club tried crowdsourcing: a recent Indiegogo campaign included a short video that illustrated the Club’s services, and successfully met its $15,000 challenge match.

More work is needed to bring quality mental health care to the LGBT community, said Bert Coffman, a Club member and founder of the Zappalorti Society, an LGBT mental health advocacy and support group. “There is homophobia, there are psychologists out there who want to ‘cure’ gays. ‘Conversion therapy’ does terrible harm. Youth need counseling—that’s why gay mental health care is so important,” he said. “We’ve come a long way, but there’s still a long way to go.”


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About the City Mind Project

CityMind explores mental health in New York City. The articles produce reflect the mental health concerns of particular communities, explores access to quality care and delves into larger social issues concerning stigmatization. The stories are New York based but reflect the larger issues of mental health nationwide. We hope the project will serve both as a news source and a resource.

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