LGBTI Focus on Mental Health Jesse Erhenfeld discusses LGBTI Mental Health. Vanderbilt University Medical Center Program for LGBTI Health LGBTI Focus on Mental Health Trans Buddy Program
Begin Transcript
Laura Osterman: Welcome to this edition of the Vanderbilt University Health and Wellness Wellcast. I am Laura Osterman with Health Plus. May is mental health awareness month, and I am here today with Jesse Ehrenfeld, associate professor of anesthesiology and director of the program for LGBTI Health. Thanks for joining us today. Jesse Ehrenfeld: Happy to be here. Laura Osterman: Can you tell us about the Vanderbilt program for LGBTI Health? Jesse Ehrenfeld: Sure, the Vanderbilt program for LGBTI Health has been around for almost 5 years now, and we are multipronged program that provides clinical services to our patients, education and training for our staff and faculty, as well as has a research focus. Laura Osterman: When we are talking about mental health, how do mental health conditions affect the LGBTI community? Jesse Ehrenfeld: There are number of factors that contribute to increased prevalence of mental illness in LGBT people, and one of the most important factors is the concept of minority stress. The theory of minority stress was developed to explain why minority individuals including sexual and gender minorities suffer from physical and mental health disparities compared to their peers in majority groups, and there is a large body of evidence that now supports the assertion that people who are LGBT face difficult social situations that can lead to poor heath, things like prejudice, discrimination, unequal social economic status, and unfortunately in many cases limited access to health care. Laura Osterman: What are the most common LGBTI mental health issues? Jesse Ehrenfeld: Some of the most common mental health concerns for LGBT people include risk of suicide, mood disorders, anxiety disorders, posttraumatic stress disorders, body image and eating disorders, substance use disorders, and personality disorders, and while the incidence of these things is a little bit different than in non-LGBT people, the risk factors around minority stress and difficult social situations is often what we think leads to these kinds of things. Unfortunately, the first issue that I mentioned around suicide, we know that the range of suicide attempts among gender and sexual minorities is about two to seven fold not of non-LGBT people, and there are lot of studies that have looked at this, and one of the things that we try to do with the program for LGBT Health is try to help prevent those kinds of problems from providing preventive services to our patients. Laura Osterman: What are some of the most important things LGBT individuals might do or how can patients seek help? Jesse Ehrenfeld One of the most important things that an LGBT person can do is come out to their provider because when they come out to their provider, we can make sure that they receive the best preventive services possible, and that is not possible if an LGBT person is not open and honest with the person that they are seeing in health care system. Laura Osterman: How can providers address mental health issues with LGBTI patients? Jesse Ehrenfeld: Keep in mind, LGBT people suffer the same types of psychiatric illness as do the general population but often at higher rates, and so the principles of care are really the same regardless of a patient’s particular identity. I tried to tell our trainees that having an attitude of gentle curiosity balanced with compassion for persons suffering in respect for their experience and strength underlies all effective psychiatric and health interventions. Now, the mental health assessment of an LGBT person is not fundamentally different than that of anybody else. However, given the specific mental health risks faced by LGBT people, it is important to keep in mind some general principles and questions. I always try to make sure that we have welcoming and inclusive practices. Things like having a safe space stickers or LGBT-themed magazines in our waiting areas are very helpful. In our practice forms, the paperwork really sets the tone for an encounter, making sure that are intake forms ask general neutral questions. Instead of male/female, we have an option for our transgender patients to respond. Those kinds of things are incredibly important and helpful. Laura Osterman: What about ways individuals might support family or friends? Jesse Ehrenfeld: The one of ways that I think we can support our families and our friends having good open conservations about what is going on with someone in their identity is an important starting place, and another thing that I try to emphasize with our faculty, our staff, and our trainees is that language is so important. Making sure that we follow the example of the people that we are working with in terms of using the words that they are using to describe themselves is so helpful and important in affirming someone’s identity, and if you are uncertain, just ask. So, for example, when I meet a patient, I often will say, what name would you like me to use when addressing you, what pronouns would you like me to use when speaking about you with other providers. Those kinds of things again set the tone to let the patient drive the direction and that works with patients, families, and friends in the LGBT community. Laura Osterman: Can you share any other resources that might be helpful? Jesse Ehrenfeld: Sure. So, we have a great resource here at Vanderbilt called the Trans Buddy Program. It is a 24/7 hotline. The phone number is 615-326-5185 and that is available for anyone who is in the transgender community and would like some assistance or support in coming into or out of their health care system. We also have resources on the program for LGBTI Health website, and we do a lot of trainings around the university and in the community, and we are always available for consultations. Laura Osterman: Thank you so much for your time today. Thanks for listening. Please feel free to leave us any comments on this Wellcast on the form at the bottom of this page. If you have a story suggestion, please email it to us at health.wellness@vanderbilt.edu or you can use the “Contact Us” page on our website at healthandwellness.vanderbilt.edu. -- end of recording (06:02) --
