Assessing the Implementation of an LGBTQ+ Mental Health Services Training Program to Determine Feasibility and Acceptability During the COVID-19 Pandemic

Abstract

Despite significant social and legal progress, LGBTQ+ (lesbian, gay, bisexual, transgender, and other sexual and gender minority) populations continue to experience higher rates of mental health and substance use disorders than their heterosexual and cisgender counterparts. Effective LGBTQ+ affirmative mental health care is essential for addressing these disparities but is often limited and difficult to access. The shortage of LGBTQ+ affirmative mental health care providers results from the absence of required and accessible LGBTQ+-focused training and technical assistance opportunities for mental health care professionals. This study evaluates the implementation of our COVID-19 adapted, completely virtual, organization- and therapist-focused training program to improve the mental health workforce’s cultural competence in working with the LGBTQ+ community: the Sexual and Gender Diversity Learning Community (SGDLC). Guided by an expanded RE-AIM model, we used administrator and therapist feedback to assess SGDLC implementation factors to understand how it may be best translated for scaled-up promotion and widespread adoption. Assessment of the initial reach, adoption, and implementation of the SGDLC indicated that it had strong feasibility; reports on satisfaction and relevance support the SGDLC’s acceptability. Maintenance could not be fully assessed from the short study follow-up period. Still, administrators and therapists expressed an intent to continue their newfound practices, a desire for continued training and technical assistance in this area, but also concerns about finding additional opportunities for this education.

LGBTQ+ cultural‐competence training effectiveness: Mental health organization and therapist survey outcome results from a pilot randomized controlled trial

“…The new virtual RCT was preceded by a preparatory implementation feedback study of the final SGDLC intervention components with three mental MHOs involving both administrators and therapists (Fish et al, 2022). The feasibility and acceptability of the SGDLC components during the RCT were previously reported (Fish et al, 2023, in press). All SGDLC components were manualized for implementation.…”

“…Like supervision, therapists shared clinical challenges; the clinical consultant provided mentorship and coaching while encouraging participation from other therapists and drawing from clinical experience and assigned articles as sources of best practice. See Fish et al (2023) for additional details.…”

“…Organizational policies and practices related to nine key areas of operation were assessed, prioritized regarding importance and changeability and addressed through planning and problem‐solving: built environment, human resources, workplace climate, professional development, intake and referral, services and programmes, outreach, leadership, and mission and values. For more details, see Fish et al (2023).…”

“…Prior papers describe the formative research for the SGDLC programme components and its feasibility and acceptability (Fish et al, 2022(Fish et al, , 2023. This paper reports on the RCT evaluation findings regarding the effectiveness of the SGDLC TTA programme.…”

“…LGBTQ+ affirmative mental health care and facilitating sexual health The workshop for each study cohort was scheduled so that all MHO administrators and therapists from the cohort could participate together. For more details, see Fish et al (2023).…”