Mental Health Awareness Month: Assessing Access to Care in Chicago

Each May, we celebrate Mental Health Awareness Month by fighting stigma around mental health and providing support for anyone needing mental health services. Statistically, 1 in 5 U.S. adults experience some form of mental illness, while 1 in 6 youth aged 6-17 needs mental health support. Studies show that LGBTQ+ people are more likely to experience depression, anxiety, and suicidal thoughts compared to their straight and cisgender peers. These rates of mental health burden are even higher among transgender and nonbinary individuals, with 39% of respondents in the 2015 US Trans Survey reporting serious psychological distress the month prior to the survey, and a staggering 40% of respondents reporting a suicide attempt in their lifetime. LGBTQ+ youth are at 2 to 3 times more likely to attempt suicide compared to straight, cisgender youth. The COVID-19 pandemic has only exacerbated mental health issues for many in the LGBTQ+ community, especially for those disproportionately impacted by the pandemic, including people of color and those living with HIV/AIDS.

In response to the great need for LGBTQ+ affirming and affordable mental health services, Howard Brown’s Center for Education, Research and Advocacy (ERA) and Behavioral Health Team released a new report, Assessing Need and Access to LGBTQ+ Affirming and Affordable Behavioral Healthcare in Chicago. The report presents findings of a research project to better understand and address barriers to accessing affordable and LGBTQ+ affirming behavioral healthcare across the greater Chicago area. Howard Brown collected data on organizations that provide mental health services in the greater Chicagoland area to assess whether services were LGBTQ+ affirming and/or affordable. The team also completed interviews with community based organizations (CBOs) providing mental health services in Chicago to better understand current needs and priorities. The interviews included questions about services offered, patient demographics, unmet need, referrals, and accessibility of affordable, affirming services offered to the LGBTQ+ community.

Based on this research, of the 484 mental health referral facilities identified across Chicago, just 71 were rated by themselves or the research team as “high confidence” in providing LGBTQ-affirming care. Finding care that was both LGBTQ+ affirming as well as affordable—either through accepting Medicaid or providing sliding scale care—proved even more difficult. Out of the 484 sites, just 55 were rated as LGBTQ+ affirming and affordable. Furthermore, affirming and affordable mental health services were not evenly distributed across the city, with most located on the Northside of Chicago. In the interviews, CBOs shared that there is need for more regular training and education in LGBTQ+ health to ensure that LGBTQ+ individuals can find care close to home without fear of experiencing discrimination.

In response to these finding, the report also includes several policy and advocacy recommendations for increasing access to affirming and affordable behavioral healthcare, including;

• Providing resources and education for behavioral health providers and students on LGBTQ+ health and LGBTQ+ affirming care: Training and legislation, such as the LGBTQ+ Cultural Competency bill that was introduced in the 2022 IL spring legislative session, is necessary to help staff to challenge implicit biases, develop the skills necessary to provide affirming care, and understand how discrimination and stigma contributes to worsened behavioral health outcomes.
• Increasing Medicaid reimbursement, and providing incentives for recruitment and retention of mental health providers: There’s already been some good progress made here with the recently approved 2023 Illinois state budget. The IL Department of Healthcare and Family Services received a historic investment of $500 million dollars to strengthen the behavioral health workforce and increase access to services. This includes $170 million for rate increases for community mental health and substance use disorder treatment providers. The state budget also includes $11 million dollars for scholarship and loan repayment programs for behavioral health providers.

At Howard Brown we advocate for more accessible and LGBTQ+ affirming mental health care, train health providers in providing LGBTQ+ affirming care, and push for more research examining mental health needs in LGBTQ+ communities specifically. There are ways you can learn more and support and LGBTQ+ affirming and affordable mental health care

• Read and share the report Assessing Need and Access to LGBTQ+ Affirming and Affordable Behavioral Healthcare in Chicago to find out more about the research and recommendations discussed
• Reach out to your federal and state representatives to encourage them to continue to increase funding for mental health services, especially community-based mental health organizations.