[NYAPRS Enews] RTP: Peer Support for LGBT Individuals

[Harvey Rosenthal]

Peer Support for Lesbian, Gay, Bisexual or Transgender (LGBT)
Individuals

by Ronald E. Hellman, M.D., FAPA, Director, 

LGBT Affirmative Program of South Beach Psychiatric Center

Recovery to Practice Weekly Highlights  February 4, 2011

 

The LGBT Affirmative Program (LGBTAP) of South Beach Psychiatric Center
was initiated in 1996 as one of several multicultural services provided
by this large, public sector community mental health center in New York
City. The program is based at the Heights----Hill Mental Health Service
in downtown Brooklyn, one of seven outpatient clinics at South Beach,
which serves a multi-ethnic, low socioeconomic population with serious,
chronic mental illnesses. 

 

Several years into the program, we observed that our sexual minority
population, much like our general psychiatric population with
significant disabilities, had great difficulty reintegrating within the
larger LGBT community and the general community at large, despite the
provision of LGBT--affirmative therapies. We came to believe that it was
incumbent upon us to facilitate the creation of a sociocultural
component within a recovery model, in addition to the psychosocial and
medical services already offered. 

 

This resulted in the creation of an affiliated membership program, the
Rainbow Heights Club (RHC). As members, individuals did not have to be
enrolled at the clinic, and this allowed LGBT patients from all over the
New York metropolitan area to attend. The larger numbers helped to
approximate the diversity found within the city's LGBT community. And,
with the creation of an LGBT consumer advisory group, members came up
with a name for the club and helped steer program development. 

 

LGBT individuals with major mental illnesses can be reluctant to engage
in psychiatric treatment and adhere to treatment regimens over time,
because they are less likely to identify with mainstream settings. They
are a minority in these settings, and are also subject to stigma in the
LGBT community because of their mental illness and in psychiatric
settings because of their sexual minority status. And, unlike other
ethnic and racial minorities, their families typically do not share
their sexual identity. Thus they can be particularly prone to a lack of
affirmation and supports. 

 

LGBT patients have to adapt to largely heterosexual, cisgendered (those
comfortable in their gender of birth) mental health settings in
virtually all areas of service delivery. Well-intentioned, "integrated"
settings fall short when they do not provide safe, culturally relevant
opportunities for the alienated LGBT patient. Culturally appropriate
programming, fostered at all organizational levels, has the power to
transform these patients into LGBT persons in recovery. 

 

A crucial component of recovery for the LGBT consumer is peer support.
LGBT peer support allows for a process of authentic identification with
others like oneself. It promotes forms of socialization, role modeling,
and individuation not otherwise available in the generic setting.
Mainstream cultural settings often inadvertently rob the LGBT patient of
their experience as a sexual minority person with a different, yet
valid, worldview. LGBTAP and RHC were organized to facilitate peer
support by bringing a "proto-community" of individuals together that had
never previously connected.

 

Separation from the dominant heterosexual, cisgendered world and
connection with sexual minority peers is a common step in the healthy
psychological development of sexual minority individuals. Major mental
illness can tear people away from that process, and mainstream
psychiatric settings typically provide no substitute. LGBTAP and RHC
created the conditions and opportunities for these individuals to
connect with each other, thereby creating a unique cultural community in
which pride, place, self-esteem, support, and hope could be nurtured, as
the weight of mental illness became merely a shared part of that larger
process. 

 

As a unique, regional program, RHC has served almost 500 members.
Collaborating with staff and peer specialists, members have made their
needs and interests known, the result being an ever-evolving program of
groups, support, skills training, and advocacy. An outcome study of this
recovery model found that participants attributed significant
improvement in adherence with treatment regimens, reduction in
psychiatric symptoms, enhanced self-esteem, improved stress tolerance
and hopefulness to the program, despite an average of 16 years of
previous psychiatric treatment.1 To appreciate the depth of this
program, please visit http://www.rainbowheights.org
<http://www.rainbowheights.org/> .

 

1 Hellman, R.E.; Huygen, C.; Klein, E.; Chew, M.; & Uttaro, T. (2010.) A
study of members of a support and advocacy program for LGBT persons with
major mental illness. Best Practices in Mental Health: An International
Journal, 6(2), 13-26.

 

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