257643 Minimally adequate mental health and substance abuse services and sexual orientation: Results from the California Quality of Life Survey II

Wednesday, October 31, 2012 : 8:45 AM - 9:00 AM

Susan D. Cochran, PhD, MS , Epidemiology, UCLA School of Public Health, Los Angeles, CA
Audrey Jones, BA , Department of Health Services, School of Public Health, University of California Los Angeles, Los Angeles, CA
Vickie M. Mays, PhD, MSPH , Psychology/Health Services, University of California, Los Angeles, Los Angeles, CA
Background: Individuals with minority sexual orientation are at somewhat elevated risk for common stress-related mental health disorders and are also more likely to seek mental health/substance abuse (MHSA) services than their heterosexual counterparts (Cochran & Mays, 2009). Given concerns about harmful effects of antigay discrimination in health care access and use, we investigated possible sexual orientation-related differences in the quality of MHSA services received.

Methods: The 2007-2008 California Quality of Life Survey reinterviewed 2,815 respondents, age 18-72 years, first interviewed in the 2007 CHIS. All were administered a structured interview assessing both need for and use of MHSA services in the year prior to interview. Overall, 1,011 persons evidenced need for MHSA services; these comprise our final sample. We used multivariate logistic regression methods, adjusting for confounders.

Results: High need lesbian/gay individuals (adj. OR=2.06, 95% CI: 1.23-3.45), but not bisexuals or MSM/WSW's, were significantly more likely to report receiving any MHSA counseling or psychotropic medications as compared to exclusively heterosexual individuals. Among high need persons receiving any MHSA services, lesbian/gay (adj. OR=1.84, 95%CI: 1.01-3.38) and bisexual (adj. OR=2.39, 95% CI: 1.00-5.69) individuals were more likely to report a pattern of minimally adequate MHSA care (MAC) than exclusively heterosexual persons did.

Conclusions: Heavier use of MHSA services appears more concentrated among lesbian/gay identified individuals. Having entered care, high need LGB persons appear more likely than heterosexuals to receive care consistent with MAC guidelines. This suggests that the impact of anti-gay discrimination may be minimal in receiving MHSA services.

Learning Areas:
Communication and informatics
Diversity and culture
Public health or related public policy
Public health or related research

Learning Objectives:
1. Describe sexual orientation related differences in mental health/substance use (MHSA) services utilization among persons in need of MHSA care. 2. Articulate normative patterns of recent MHSA services use among higher need sexual minority persons

Keywords: Gay, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal of multiple federally funded grants focusing on the epidemiology of sexual orientation and substance/mental health disorders. My scientific interests focus on the ways in which social adversity creates vulnerabilities for mental health and substance use disorders.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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