Factors associated with the availability of tailored programs for LGBT clients in substance use disorder treatment facilities in the U.S. from 2008 to 2018

Qeadan, Fares; Mensah, Nana; Gu, Lily Y.; Barbeau, William A.; Madden, Erin Fanning; Porucznik, Christina A.; English, Kevin

doi:10.1080/10538720.2021.1954125

Cited by 4 publications

(14 citation statements)

References 36 publications

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“…Two national, census-based surveys in the United States (U.S.) track the availability of SGM-tailored programming: the National Survey of Substance Abuse Treatment Services (N-SSATS) [16] and the National Mental Health Services Survey (N-MHSS) [17]. Several studies have used these data to examine facility-level descriptions of SGM-tailored programming across the U.S. [10,11,18]. For example, evidence indicates that SGM-tailored programming is associated with specific facility characteristics [11,18], such as a facility's ownership, geographic location, whether it receives government funding, and the type of services offered (e.g., medication management vs. outpatient only).…”

Section: Sgm-tailored Programming At Behavioral Health Facilitiesmentioning

confidence: 99%

“…Several studies have used these data to examine facility-level descriptions of SGM-tailored programming across the U.S. [10,11,18]. For example, evidence indicates that SGM-tailored programming is associated with specific facility characteristics [11,18], such as a facility's ownership, geographic location, whether it receives government funding, and the type of services offered (e.g., medication management vs. outpatient only).…”

Section: Sgm-tailored Programming At Behavioral Health Facilitiesmentioning

confidence: 99%

“…Understanding facility-level associations can reveal targetable, structural determinants for public health policymakers. For example, since substance use treatment facilities that receive federal funding are more likely to offer SGM-tailored programming [11], public health policymakers could mandate federally funded facilities to offer such programming [19]. However, because public health policy and governing structures vary by state [20], and government funding for substance use and mental health treatment includes state and local funds [16,17], there is a need to understand state-level structural determinants that may influence the availability of SGM-tailored programming.…”

Section: Sgm-tailored Programming At Behavioral Health Facilitiesmentioning

confidence: 99%

“…Two studies have used longitudinal approaches to examine the availability of SGM-tailored programming. The first study by Qeadan et al [11] used the N-SSATS data to show that SGM-tailored programming increased from 2008 to 2018 and was associated with facility characteristics (e.g., more likely to be owned by the federal government). However, because there was no linking identifier for facilities across survey waves, it was not possible to examine whether these associations changed over time.…”

Section: The Benefits Of a Panel Analysis Approachmentioning

confidence: 99%

“…SGM-tailored programming consists of substance use and mental health interventions targeting SGM people's unique needs (e.g., minority stressors, such as family or peer rejection, victimization, and rejection hypervigilance) that are related to adverse behavioral health outcomes [8]. Despite its clinical effectiveness [9], SGM-tailored programming is unavailable to many SGM people because, as of 2018, only 19.9% of substance use treatment facilities and 17.7% of mental health treatment facilities reported offering SGM-tailored programming [10,11]. While studies have examined determinants of SGM-tailored programming availability at the individual facility level, fewer have examined structural determinants (e.g., structural stigma, government funding) that may affect the availability of SGM-tailored programming.…”

mentioning

confidence: 99%

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Structural determinants of tailored behavioral health services for sexual and gender minorities in the United States, 2010 to 2020: a panel analysis

et al. 2022

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Background Research indicates that tailored programming for sexual and gender minority (SGM; e.g., lesbian, gay, bisexual, transgender, queer) people, compared to non-tailored programming, is effective for reducing the disproportionate health burden SGM people experience relative to the general population. However, the availability of SGM-tailored programming is often over-reported and inconsistent across behavioral health (i.e., substance use and mental health) facilities in the United States (U.S.). Methods Using panel analysis, the National Survey of Substance Abuse Treatment Services (N-SSATS), and the National Mental Health Services Survey (N-MHSS), this study examines structural stigma and government funding as two structural determinants affecting the availability of SGM-tailored programming in the U.S. Results Results indicated that from 2010 to 2020, reductions in structural stigma (i.e., increases in state-level supportive SGM policies) were positively associated with increases in the proportion of substance use treatment facilities offering SGM-tailored programming. This effect was significant after controlling for over-reporting of SGM-tailored programming and time- and state-specific heterogeneity. On average, the effect of reduced structural stigma resulted in approximately two new SGM-tailored programs in the short term and about 31 new SGM-tailored programs in the long term across U.S. substance use treatment facilities. Structural stigma did not predict the availability of SGM-tailored programming in mental health treatment facilities. Government funding was not significant in either data set. However, without correcting for over-reporting, government funding became a significant predictor of the availability of SGM-tailored programming at substance use treatment facilities. Conclusions Because SGM-tailored programming facilitates access to healthcare and the current study found longitudinal associations between structural stigma and the availability of SGM-tailored programming in substance use treatment facilities, our findings support claims that reducing structural stigma increases access to behavioral health treatment specifically and healthcare generally among SGM people. This study’s findings also indicate the importance of correcting for over-reporting of SGM-tailored programming, raising concerns about how respondents perceive the N-SSATS and N-MHSS questions about SGM-tailored programming. Implications for future research using the N-SSATS and N-MHSS data and for public health policy are discussed.

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