By Emalee Gillis, NAMI Spokane Blog Editor.

“While LGBTQ+ individuals share mental health diagnoses like depression, anxiety, and trauma with other populations, there can be differences in root symptoms and reasons for experiencing those diagnoses among the LGBTQ+ population,” according to Dr. Rob McKinney, Assistant Professor in the counselor education program at Gonzaga University who focuses his research on LGBTQ+ issues. Dr. McKinney is also the President-Elect of the national organization called the Society for Sexual, Affectional, Intersex, and Gender Expansive Identities (SAIGE) whose mission includes advocating for LGBTQ+ individuals within the counseling profession and beyond. “For example,” continued Dr. McKinney, “LGBTQ+ individuals might face anxiety because they cannot be genuine with their identity and it is not safe to come out. An LGBTQ+ individual might experience depression at school if holding hands with their girlfriend is not okay. Some LGBTQ+ individuals may experience trauma when they try to be more authentic about who they are within the church they have grown up with, but then their church family rejects them. This can be very traumatic for some people.”

LGBTQ youth are more than four times as likely to attempt suicide than their peers, according to the Trevor Project. Again according to the Trevor Project, “LGBTQ youth are not inherently prone to suicide risk because of their sexual orientation or gender identity but rather placed at higher risk because of how they are mistreated and stigmatized in society.”

“LGBTQ+ individuals experience marginalization and discrimination,” Dr. McKinney added. “Systemic issues are happening at various levels including the individual level, the meso level and the macro level. For example, bills that prohibit participation in sports by trans people or bathroom bills erode the identity of those individuals. Anti-LGBTQ+ legislation around adoption increases barriers to having a family which goes back to mental health and can cause depression, anxiety and trauma.”

According to Dr. McKinney, Washington is generally considered a safe state for LGBTQ+ individuals, but he doesn’t have to look far to find a state that is not. Other nearby states are not as safe. Dr. McKinney feels safe as an openly gay person in Spokane, but LGBTQ+ individuals in other areas are not as fortunate. Dr. McKinney stresses the importance of being cautious and being on the lookout. Spokane can be affected by changes at the state level, for example. He stressed that it is also important to be mindful of what is going on at the national level. There are individuals who are running for national office who have a history of anti-LGBTQ+ positions. The simplest way to advocate for LGBTQ+ individuals is to vote at the local, state, and national levels.

One legislative act that has been particularly difficult for mental health counselors has been the “don’t say gay” directive in Florida. Dr. McKinney explained that counselors work for years to get licensure and to be open and affirming as a provider. However, if they affirm LGBTQ+ individuals, they could face licensing issues and legal issues because of that directive. He hopes that providers in Washington will never have to balance their work with ethics and competency on the one hand and legal repercussions on the other like they have to in Florida.

Another simple way to reach out to LGBTQ+ individuals is to provide a safe space for them to tell their story. According to Dr. McKinney, one way to cue that a space is safe is to include a welcoming symbol in your office. Dr. McKinney has a frame with the outline of the state of Ohio filled in with a rainbow on his bookshelf that signals his openness. Through his research, Dr. McKinney has shown that providing a space for others to tell their own story can be powerful, therapeutic, and healing.

Dr. McKinney sees the availability of mental health counselors sensitive to LGBTQ+ as a primary gap in the local system of care. LGBTQ+ individuals can experience mental health needs that warrant immediate attention. For example, it can be psychologically jarring if a person is outed by someone else. When they are forcibly disclosed when they weren’t ready to disclose, they may need someone to listen to them. They can’t wait, but there are often weeks, if not months of delay to find a counselor

It is also important that counselors work towards remaining up to date and competent in the area of LGBTQ+ care. “The language around LBGTQ+ issues has evolved over the years,” said Dr. McKinney. “When looking at the research data over the past decades, at first it was just gay, then we added the L, then the B, then the T, then the Q, then the plus. As the acronyms changed, so did the information within our community. If a mental health counselor earned their degree thirty years ago, they made need training to brush up on the language, considerations, advocacy and rights.” Dr. McKinney encouraged those counselors who may need a brush up on LGBTQ+ to go to the SAIGE website where they can download a document for free that lists concrete things that can be done to ensure competent mental health care for LGBTQ+ clients. SAIGE also offers affordable online webinars and workshops around appropriate LGBTQ+ care.

When identifying sources of local support for the mental health of LGBTQ+, Dr. McKinney said, “First and foremost, I recommend NAMI Spokane. NAMI was at Spokane Pride this past weekend. We had so many conversations with members of the LGBTQ+ community and other allies. NAMI is a great resource for LGBTQ+ who want more information and to be connected with support.” Other resources Dr. McKinney identified for LGTBQ+ at the local level include the Odyssey Youth Movement, Spectrum Center Spokane and LBGTQ+ centers at local universities like Gonzaga. Resources at the national level include the Trevor Project and PFLAG.

Rob McKinney, Ph.D., LMHCA, NCC is an Assistant Professor at Gonzaga University in the counselor education program. He is also the President-Elect of the national organization called SAIGE whose mission includes advocating for LGBTQ+ individuals within the counseling profession and beyond. His research focuses on LGBTQ+ issues.

Emalee Gillis is a writer and blog editor. She is the author of the memoir Adventures on the Path to Living Well with a Mental Illness and has a related TEDx Talk.