I've spent the last four years at Hazelden Betty Ford Foundation, the nation's largest nonprofit addiction treatment facility, with these last two years spent as our organization's LGBTQ program director.
As part of my work, last year I co-authored a statistical analysis that appeared in the Journal of Gay and Lesbian Social Services . Our data revealed that LGBTQ people in rehab for alcoholism and drug addiction had been to twice as many rehabs, and three times as many detoxes, as non-LGBTQ people in the same facilities. We also found that these folks had nearly one-and-a-half times the chance of having an anxiety disorder diagnosis, and the same with a depression diagnosis. They were three times as likely to report a history of sexual abuse, twice as likely to report a history of physical abuse, and twice as likely to report a history of emotional abuse.
In response to these findings, our leadership created the position I occupy today, and have supported me in creating a program that is the first of its kind. More recently we have began expanding that programming to support LGBTQ patients throughout our entire national system of care. In developing training and curriculum resources for our 11-state system, I was able to get institutional support to develop those resources for use by others in our field, at no cost.
The alarming disparity in outcomes we have uncovered won't be reconciled by one organization improving LGBTQ services, or by 10 of them. Change will only happen when the entire field changes how it approaches the care of LGBTQ clients in drug and alcohol treatment. Perhaps this is part of how we got to this point in the first place: by failing to address addiction in LGBTQ community with real parity.
On our website, we talk about LGBTQ integrative treatment, which equally accommodates heterosexual, cisgender, and LGBTQ patients, emphasizing sensitivity for those in the early stages of "coming out" and in conflict about their identity.
Every component of treatment takes into account LGBTQ needs, using curriculum developed by Hazelden Betty Ford Foundation clinicians. Treatment acknowledges the trauma of living closeted, of family system rejection, and of anti-gay emotional and physical violence.
LGBTQ-integrative treatment is structured to focus on co-occurring disorders and trauma, addressing internalized homophobia and shame by creating an environment that supports healing in a setting that includes heterosexual people. Patients experience the community support and validation imperative to successful recovery.
But even with an integrated treatment system, I have been afraid. I have been afraid that I won't be able to do it. And I now see clearly that my fear is absolutely valid. There is no way I can do this alone; it's too big a task. Even with the help of the chief professional officer of the American Counseling Association, the chair of the American Medical Association's Committee on LGBT Issues, and the senior policy adviser of the National Association of Social Workers. Even with the help of the nation's largest addiction treatment organization, the nation's largest publisher on addiction, and the nation's oldest addiction counselor training program. Even with the former head of the Oregon Addiction Counseling board, a board member of the American Association of Sexuality Educators, Counselors, and Therapists, and the authors of some of the most important books on gay affirmative therapy and sexual health in recovery. Even with the help of the University of Minnesota, Rutgers Center for Alcohol Studies, and the Hazelden Betty Ford Graduate School of Addiction Studies supporting CME/CEU accreditation and hosting of the training online. Even with face-to-face meetings with senior leaders at the White House Office of National Drug Control Policy and the Substance Abuse and Mental Health Services Administration to review the model, research, and curriculum.
Sometimes I get pretty depressed thinking about how far we have to go before LGBTQ culture and issues will be fully integrated and normative in drug and alcohol treatment. I worry that it will be like everything else in my life, a grand vision that just almost happened.
Mental health and addiction providers can sign up for the Hazelden Betty Ford Foundation's LGBTQ-Integrative online training series launching in January and running through May 2016. Visit http://www.hazeldenbettyford.org/lgbtq for more information.