Research: Rural LGBTQ adults more likely to be depressed, anxious, less likely to seek and find treatment

Rural lesbian, gay and bisexual adults, who are nearly twice as likely to be diagnosed with depression or anxiety, report having more difficulty accessing mental health care than their urban counterparts, according to a new study.

The University of Minnesota Center for Rural Health Research report found that lesbian, gay and bisexual people are more likely to suffer from a mental health condition than their heterosexual counterparts. Examining data from the 2019-2020 National Health Interview Survey, researchers found that 38.6% of rural LGB adults reported a dual diagnosis of depression and anxiety disorders, compared to 11.4% of adults. rural heterosexuals and 8.7% of urban heterosexual adults.

Rural LGBTQ adults were also less likely to report having a source of care and more likely to report not being able to afford medication to treat their mental illness. Nearly a third of rural LGBTQ adults diagnosed with depression or anxiety said they had gone without medication or delayed mental health care in the past year due to cost.

The group also reported other difficulties in accessing care, including a lack of anonymity when seeking care, a shortage of mental health professionals available in their area, and a lack of transport to care providers. of mental health.

Although a lot has changed in the world since the data was collected, said Carrie Henning-Smith, the study’s lead researcher, the information is an indication of what rural members of the LGBTQ community are facing.

“The past few years have made access to care for rural residents more urgent and more complicated,” she said in an email interview.

“We have seen continued closures of rural hospitals and other health care facilities, coupled with severe shortages of health workers, particularly in the mental health field. At the same time, the demand for mental health services has increased during the Covid-19 pandemic. Overall, this could make the barriers to care we found in this study even more pronounced for rural LGBTQ people today.

A bright spot in recent years, she said, has been telehealth which has been able to provide more care to rural residents.

“Amidst all the access challenges we have faced during the Covid-19 pandemic, telehealth stands out as potential good news,” she said. “The expansion of telehealth services and reimbursement for these services during the pandemic has enabled more people to access the care they need. For rural LGBTQ residents seeking mental health care, telehealth could provide easier access to LGBTQ providers, including those located in urban areas.

However, for telehealth to truly help members of the rural LGBTQ community, there must be continued expansion of reimbursement for mental health services and a focus on labor shortages and access to internet access. affordable and reliable broadband, she said.

The researchers recommended that addressing these labor shortages, increasing reimbursement rates for mental health services, and increasing telehealth services would help close the access gap for LGBTQ adults in rural areas.

But it is equally important to provide training and education on sexual orientation to all health teams in rural clinics.

“Rural health care facilities, providers, and staff should receive training or be offered ongoing education on LGBTQ health vocabulary and topics to improve their comfort with treating LGBTQ adults,” the study says. . “The current provider training curriculum includes very little, if any, content on sexual orientation, let alone the unique context for rural LGBTQ people.”

Additionally, Henning-Smith said, there must be community-wide efforts in rural areas to increase awareness and acceptance of LGBTQ residents to combat homophobia and interpersonal discrimination, as well as education in rural communities to eliminate potential resistance to accessing mental health services. .

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Research: Rural LGBTQ adults more likely to be depressed, anxious, less likely to seek and find treatment

The University of Minnesota Center for Rural Health Research report found that lesbian, gay and bisexual people are more likely to suffer from a mental health condition than their heterosexual counterparts. Examining data from the 2019-2020 National Health Interview Survey, researchers found that 38.6% of rural LGB adults reported a dual diagnosis of depression and anxiety disorders, compared to 11.4% of adults. rural heterosexuals and 8.7% of urban heterosexual adults.

Rural LGBTQ adults were also less likely to report having a source of care and more likely to report not being able to afford medication to treat their mental illness. Nearly a third of rural LGBTQ adults diagnosed with depression or anxiety said they had gone without medication or delayed mental health care in the past year due to cost.

The group also reported other difficulties in accessing care, including a lack of anonymity when seeking care, a shortage of mental health professionals available in their area, and a lack of transportation to mental health providers.

Although a lot has changed in the world since the data was collected, said Carrie Henning-Smith, the study’s lead researcher, the information is an indication of what rural members of the LGBTQ community are facing.

“The past few years have made access to care for rural residents more urgent and more complicated,” she said in an email interview.

“We have seen continued closures of rural hospitals and other health care facilities, coupled with severe shortages of health care personnel, particularly in the area of ​​mental health health. At the same time, the demand for mental health services has increased during the Covid-19 pandemic.Overall, this could make the barriers to care that we found in this study even more pronounced for rural LGBTQ people today. to rural residents.

“Amid all the access challenges we’ve seen during the Covid-19 pandemic, telehealth stands out as potential good news,” she said. “The expansion of telehealth services and reimbursement for these services during the pandemic has enabled more people to access the care they need. For rural LGBTQ residents seeking mental health care, telehealth could provide easier access to LGBTQ providers, including those located in urban areas. »

For telehealth to truly help members of the rural LGBTQ community, however, there must be continued expansion of reimbursement for mental health services and a focus on addressing workforce shortages and access to a affordable and reliable high-speed Internet access, she said.

Addressing these labor shortages, the researchers recommended, increasing reimbursement rates for mental health services and increasing telehealth services would help close the access gap for LGBTQ adults in rural areas.

But it is equally important to provide training and education on sexual orientation to all health teams in rural areas. clinics.

“Rural health care facilities, providers, and staff should receive training or be offered ongoing education on LGBTQ health vocabulary and topics to improve their comfort with treating LGBTQ adults,” said the “Current provider training curriculum includes very little, if any, content on sexual orientation, let alone the unique context for rural LGBTQ people.”

Additionally, Henning-Smith said, there must be efforts in rural areas to increase awareness and acceptance of LGBTQ residents to combat homophobia and interpersonal discrimination, as well as education in communities. to eliminate potential resistance to accessing mental health services.

This the article first appeared on The Daily Yonder and is republished here under a Creative Commons license.

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