The 2016 Municipal Equality Index rated Augusta, the largest city in the Central Savannah River Area (CSRA), as one of the least lesbian, gay, bisexual, and transgender (LGBT) friendly cities in America. To understand the context of our region in relation to LGBT wellness, we conducted the first LGBT health needs assessment of the CSRA, assessing physical and mental health status and health care needs and experiences in the community. Participants (N = 436) were recruited using venue and snowball sampling and completed an anonymous online survey. Overall, the health problems experienced (i.e., obesity, depression) were not uniformly experienced across sexual orientation and gender identity; some groups experienced significantly higher rates of these conditions than others. Similarly, transgender individuals in particular reported higher rates of negative experiences with health care providers. Regional and national dissemination of these findings is critical to reducing health disparities and improving wellness of our local LGBT community.

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Multiple demographic and MH factors were associated with smoker status and frequency of smoking. A logistic regression indicated that lower education and bipolar disorder were most strongly associated with being a smoker. For smokers, a hierarchical regression model including demographic and MH variables accounted for 17.6% of the variance in frequency of cigarette use. Only education, bipolar disorder, and the number of poor MH days were significant contributors in the overall model. Conclusions/Importance: Less education, bipolar disorder, and recurrent poor MH increase LGBT vulnerability to cigarette use. Access to LGBT-competent MH providers who can address culturally specific factors in tobacco cessation is crucial to reducing this health disparities.

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There is a strong association between nature engagement and stress reduction, restoration, and increased well-being. Recently, practitioners and researchers are integrating nature into psychotherapeutic interventions in clinical settings to address individuals’ mental health and wellness. The purpose of this systematic review is to (a) identify nature interventions that are currently integrated within counseling, (b) summarize the outcomes of research studies that integrate nature interventions, and (c) review the quality of research studies to date. We found that most nature interventions include forms of adventure and wilderness therapy. Counseling intervention protocol varies among nature interventions. Overall, we found preliminary evidence that nature engagement in the counseling process contributes to positive client outcomes. However, the methodology in the available studies makes it challenging to delineate the contribution of nature versus the counseling intervention in client outcomes, or what aspects of the nature intervention are helpful for clients.