UMD-PRC Reports and Briefs
Permanent URI for this communityhttp://hdl.handle.net/1903/26359
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Item Black Sexual Minority Adults’ Avoidance of Professional Mental Health Care(Psychiatric Services, 2023) Williams, Natasha D.; Turpin, Rodman E.; Boekeloo, Bradley O.; King-Marshall, Evelyn C.; Fish, Jessica N.Objective: The authors sought to determine whether Black sexual minority individuals were more likely than White sexual minority individuals to postpone or avoid professional mental health care (PMHC) and, if so, to identify the reasons for postponing or avoiding care. Methods: Analyses were conducted with a subsample of cisgender Black (N=78) and White (N=398) sexual minority individuals from a larger survey of U.S. adults administered via MTurk in 2020 (N=1,012). Logistic regression models were used to identify racial differences in overall postponement or avoidance of care as well as differences in the prevalence of each of nine reasons for postponing or avoiding care. Results: Black sexual minority individuals were more likely than their White counterparts to report ever postponing or avoiding PMHC (average marginal effect [AME]=13.7 percentage points, 95% CI=5.4–21.9). Black sexual minority people also were more likely than their White counterparts to cite beliefs that they should work out their problems on their own (AME=13.1 percentage points, 95% CI=1.2–24.9) or with family and friends (AME=17.5 percentage points, 95% CI=6.0–29.1) and to cite providers’ refusal to treat them (AME=17.4 percentage points, 95% CI=7.6–27.1) as reasons for postponing or avoiding care. Conclusions: Black sexual minority individuals were more likely than their White counterparts to report delaying or avoiding PMHC. Personal beliefs about managing mental health and providers’ refusal to offer treatment influenced Black sexual minority individuals’ willingness or ability to seek PMHC.Item Professional Expectations of Provider LGBTQ Competence: Where We Are and Where We Need to Go(Journal of Gay & Lesbian Mental Health, 2022) Williams, Natasha D.; Winer, Brennan; Aparicio, Elizabeth M.; Smith-Bynum, Mia A.; Boekeloo, Bradley O.; Fish, Jessica N.Introduction: Mental and behavioral health professional organizations use their governing documents to set expectations of provider competence in working with LGBTQ+ clients. Method: The codes of ethics and training program accreditation guidelines of nine mental and behavioral health disciplines (n=16) were analyzed using template analysis. Results: Coding resulted in fives themes: mission and values, direct practice, clinician education, culturally competent professional development, and advocacy. Expectations for provider competency vary greatly across disciplines. Conclusion: Having a mental and behavioral health workforce that is uniformly competent in meeting the unique needs of LGBTQ populations is key for supporting the mental and behavioral health of LGBTQ persons.Item What motivates community mental and behavioral health organizations to participate in LGBTQ+ cultural competency trainings?(American Journal of Orthopsychiatry, 2022) Fish, Jessica N.; King-Marshall, Evelyn, C.; Williams, Natasha D.; Aparicio, Elizabeth M.; Tralka, Hannah M.; Boekeloo, Bradley O.The constantly evolving language, understanding, and cultural context regarding the mental health of lesbian, gay, bisexual, transgender, queer, and other sexual and gender diverse individuals (LGBTQ+) require mental health providers to obtain LGBTQ+ cultural competency training to be affirmative and effective with this population. Unfortunately, many providers are not obtaining this ongoing training and mental health disparities continue to plague LGBTQ+ populations. Guided by the Consolidation Framework for Implementation Research (CFIR), we conducted eight focus groups with community mental and behavioral health organization (MBHO) administrators (e.g., directors, clinical supervisors) and therapists to explore what factors facilitated or inhibited their adoption and implementation of a multicomponent LGBTQ+ cultural competency training program that required administrator and therapist participation in multiple learning sessions over several months (i.e., workshop, clinical consultation, and organizational technical assistance). Results from template analysis supported CFIR-aligned themes, including characteristics of individuals, inner setting, outer setting, and process, and two additional codes—marketing and other/previous training opportunities—emerged from the focus group data. Findings suggest that therapists are motivated to engage in such a program because they want to feel more efficacious, and administrators see the benefits of LGBTQ+ training programs for their clientele and marketing. Barriers to adoption and implementation include cost and personnel resistance, although participants believed these barriers were surmountable. Emphasizing therapist efficacy, clientele need, and benefits for marketing mental and behavioral health services could motivate MBHOs’ and therapists’ adoption and implementation of LGBTQ+ cultural competency training.Item UMD-PRC Progress Report: Competencies for Mental Health Clinicians working with LGBTQ+ People in Mental Health Care(2022-09) Smith-Bynum, Mia A.; Aparicio, Elizabeth M.; Shin, Richard Q.; Lare, Sean; Vigorito, Michael; Fish, Jessica N.; Williams, Natasha D.; Boekeloo, Bradley O.The University of Maryland Prevention Research Center (UMD-PRC) is one of 26 federally funded Prevention Research Centers in the United States. Each Prevention Research Center is charged with the task of studying “how people and their communities can avoid or counter the risks for chronic illnesses.” The UMD-PRC’s mission is as follows: “In collaboration with LGBTQ+ partner organizations, we promote evidence-based training of students and mental health care providers in culturally sensitive and inclusive practices.” The UMD-PRC selected the CDC definition of cultural competence to guide the development of the competencies. The CDC defines cultural competence as “effectively operating in different cultural contexts and altering practices to reach different cultural groups.” The Sexual and Gender Diversity Learning Community (SGDLC) competencies are intended to serve as a complement to the existing official professional competencies for clinical practice produced by various mental health professions, namely the American Counseling Association (ACA), the American Psychological Association (APA), and the National Association of Social Work (NASW). They are also intended to provide guidance to the professions where limited to no guidance is in place at the time of this writing. The SGDLC competencies for clinical practice are intentionally rudimentary in scope. As such, they provide an onramp for clinicians seeking to eventually master the comprehensive practice guidelines within their profession. They can also be used to provide guidance for the creation of educational modules for training programs in which limited faculty expertise is available. The SGDLC competencies outline the basic skills clinicians must acquire as they pursue mastery of the comprehensive guidelines endorsed by specific professional organizations (i.e., APA, ACA, NASW). To that end, the UMD-PRC sought to identify the most essential clinical competencies needed to serve the client population.Item Healthy People 2030: New LGBT Objectives(2020-09) Williams, Natasha D.; Tralka, Hannah; Fish, Jessica N.; Turpin, Rodman E.Item Technical Report: Gender Identity Differences in Health Care Access and Satisfaction(2020-08) Williams, Natasha D.; Turpin, Rodman E.; Boekeloo, Bradley O.; Fish, Jessica N.