Martavius L. Hampton1*, and J. Gayle Beck2, and Phillis Lewis3,
1Assistant Professor, College of Health Sciences, University of Memphis, United States.
2Professor Emerita, Department of Psychology, University of Memphis, United States.
3Executive Director, Love Doesn't Hurt, United States.
*Corresponding Author Details: Martavius L. Hampton, MPH, Assistant Professor, College of Health Sciences, University of Memphis, United States.
Received date: 11th March, 2024
Accepted date: 16th April, 2024
Published date: 18th April, 2024
Citation: Hampton, M. L., Beck, J. G., & Lewis, P., (2024). Perceptions of Mental Health in the LGBTQ+ Student Community: Needs, Barriers, and Access. J Pub Health Issue Pract 8(1): 225.
Copyright: ©2024, This is an open-access article distributed under the terms of the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
In 2020, the COVID-19 pandemic devasted health outcomes and economies globally. As a result, many suffered financial hardships, childcare challenges, and poor mental health due to the pandemic’s negative effects. Young people were particularly affected by the pandemic as it pertained to education, social isolation, and access to essential resources and services. Additionally, the U.S. experienced a rise in anti-LGBTQ+ proposals and laws were introduced or passed in various states across the country, particularly in the South. LGBTQ+ youth and young adults are more likely to experience and report poor mental health compared to their straight counterparts. As a result, my two research collaborators (Dr. Gayle Beck and Phillis Lewis) and I proposed to examine the perceptions of mental health services, access, and availability among the LGBTQ+ student community and LGBTQ+ identifying faculty and staff on the University of Memphis campus. As a result of the pending or enacted anti-LGBTQ+ legislation and the effects of the pandemic, a needs assessment was conducted. Three methodological approaches were used to capture student, faculty, and staff insights; an online survey, focus groups, and interviews. The results of the needs assessment suggest that efforts could be used to improve access and reduce barriers for LGBTQ+ students on campus to improve overall mental health by facilitating the provision of counseling services, improving the campus atmosphere for students via training, and supporting LGBTQ mental health on campus.
In 2021 as a new assistant professor at the University of Memphis College of Health Sciences, I applied for and was awarded a Campus Community grant which supported the proposed needs assessment, titled Perceptions of Mental Health in the LGBTQ+ Student Community: Needs, Barriers, and Access. As the principal investigator, I collaborated with Phillis Lewis, executive director of Love Doesn’t Hurt (LGBTQ IPV non-profit) and Dr. Gayle Beck on this project as co-authors and collaborators on this project. This report summarizes the findings of this grant, which was intended to conduct a needs assessment at the University of Memphis (UoM) related to the perception of mental health services, access, and availability among the LGBTQ+ student community. Over the past decade, the University of Memphis has become more LGBTQ+ inclusive and affirming due to its policies, training, education, and other equitable measures that both protect and include LGBTQ+ staff, faculty, and students. An increase in Safe Zone certified ally training requests and training on campus for faculty and staff since 2011 was started by Rich Scott. In 2020, the Office of Multicultural Affairs included more LGBTQ initiatives in its programming by hiring an LGBTQ staff member to support on-campus LGBTQ awareness efforts and to advise the campus student group, Stonewall Tigers. In 2019, a Title IX coordinator position was created and the coordinator delivered training and direction on ensuring program and classroom equity including sexual orientation and gender identity/expression. The University of Memphis’ Registrar allows students, faculty, and staff to identify with their preferred full name across all systems; this was NOT the case in 2014 [1].
Despite the advancements in LGBTQ+ equity on campus, likely, the LGBTQ+ campus community may still face some challenges related to prejudice, discrimination, violence, or safety concerns which could inadvertently have an impact on mental health. This grant is intended to assess current perceptions of needs, barriers, and access to services designed to improve the mental health and well being of students within the LGBTQ+ community [2].
Two approaches were used in conducting the needs assessment. First, we distributed an anonymous online survey to all LGBTQ students enrolled at UoM, using student list-serves, LGBTQ+ student groups, and requests to faculty who are allies for the LGBTQ+ student community. Students were identified via on-campus networks provided by LGBTQ-identified or allied faculty, staff, and LGBTQ groups who shared the online survey. The survey was marketed as a need assessment for on-campus LGBTQ undergraduate and graduate students who were current students. Focus group participants were selected based on the snowball technique via the president of Stonewall Tigers and electronic flyer promotional efforts. This report summarizes both of these approaches [3].
All respondents were asked to answer a set of online questions. 63 students responded to the online survey
Focus groups were initially scheduled for late Spring 2022, but due to a tornado warning the sessions were canceled. Standard questions and prompts designed for students were created for the focus groups by the project team. Stonewall Tigers, the on-campus LGBT student group, had their meetings on Fridays thus September 30th at 6 pm, and October 7th, at 4 pm were the dates chosen by the president of student group. The first focus group had five participants and the second had nine participants; both focus groups lasted a little over an hour. The focus groups were recorded by two audio recorders and used by the principal investigator and the two collaborators on the project. Participants were informed before the recordings that names and other identifiable information would not be shared due to confidentiality and privacy purposes [4].
Interviews with twelve faculty members and staff took place between February 2022 to May 2022. Questions and prompts designed for faculty and staff were designed by the project team. Faculty and staff who identify as LGBTQ were included in this project’s needs assessment because it was important to capture their insights and perspectives on mental health resources on campus for the LGBTQ student population. Faculty and staff roles ranged from full-time assistant and associate professors from multiple departments to advisors, student recruitment, and student support. The interviews were recorded by two audio recorders used by the principal investigator and the two project collaborators. Faculty and staff were informed that their names and identities would be confidential [5].
Concerning LGBTQ+ mental health resources on campus, opinions varied. 10 out of 12 faculty/staff think positively of the counseling center or have heard of students with positive experiences at the counseling center, while other faculty/staff think the counseling center can be improved overall or have heard negative experiences from students. This diversity of opinion was also reflected in the student focus groups [6].
Affirming spaces and people were reported to be the following:
• Stonewall Tigers (22) • College of Arts department and staff (3) • Psychology department and staff (6) • Pride Equity and Alliance (2) • LGBTQ+ counseling group (7) • Office of Multicultural Affairs (2) • Select professors, staff, deans, and advisors (10)
For over the past ten years, the University of Memphis has increased its LGBTQ campus support by implementing Title IX training and working closely with the Title IX coordinator. Safe Zone training has increased in its training requests and sessions, and the Office of Multi-Cultural Affairs has hired and included more LGBT representation in its programming. Due to current campus policies, LGBT students can use their preferred names in the classroom and other university settings. As a former University of Memphis student, I was very active on campus via LGBT research teams, a former member of the LGBT student group, and collaborated with multiple on-campus departments on LGBT cultural humility work and LGBT public health. Multiple laws have been proposed to ban transgender students from using restrooms that match their gender identity on campus and restrictions on transgender athletes from participating in on-campus sports activities. Also, there is a bill being proposed in the state that would allow counselors to deny and turn away students who are LGBT for religious reasons. Thus, this could have huge ramifications on accessing mental health resources on campus for LGBT students. Due to these proposed laws, additional social and mental health support must be considered such as supportive faculty and staff, LGBT-friendly or LGBT-identifying on-campus student groups/organizations, counselors who welcome LGBT students, and other safe spaces for LGBT students on campus. Although these supportive resources are more on the micro-level, this needs assessment helps to identify where the greatest needs and gaps are on campus. COVID-19 affected the availability of counseling services on campus and according to the University of Memphis Counseling Center, the counseling staff are understaffed. Hence, due to the counseling center being the primary mental health resource on campus, campuses such as the University of Memphis have to identify additional mental health support resources on campus and externally to effectively provide for its LGBT student community. As anti-LGBT legislation continues to loom over the state, this needs assessment and its results could help the University of Memphis as a whole especially its Counseling Center identify and apply strategies to support the mental health and academic success of LGBT students on campus [7].
45 participants which includes both survey respondents and focus group members in total reported the perceived needs centered on the Counseling Center, the primary source of mental health services available to students on campus. Many individuals mentioned the need for improved counseling center marketing/promotion in general, specifically targeting the campus LGBTQ+ community. A stronger external referral system and process for Counseling Center staff were recognized as a need, to promote improved continuity of services for LGBTQ+ students [8].
The intake process at the Counseling Center was also discussed by students as a need. Specific improvements include greater recognition of the unique needs of this student sector. Additionally, a need for the Counseling Center to recruit more LGBTQ+ identifying counselors and/or counselors who specialize in LGBTQ+ issues and comorbidities was discussed, to improve services. Finally, increased efforts to promote the LGBTQ+ counseling group to students and faculty/staff were identified as a need.
Nine participants reported the perceived needs centered on faculty and staff. Overall, faculty and staff could benefit from Safe Zone or other LGBTQ+-related training. Five students from the focus groups noted that it would be helpful to identify more LGBTQ+- affirming and supportive faculty and staff on campus and to increase faculty/ staff knowledge of affirming spaces/staff for LGBTQ+ students [9].
Housing was also mentioned by four students and two faculty members as a need. Improved housing support for LGBTQ+ students was mentioned by numerous individuals, particularly during semester breaks, when family rejection precludes housing at home. An improved atmosphere in on-campus housing during the semester would be beneficial.
Lastly, the LGBTQ+ students according to the survey results and the focus groups are more familiar with the Counseling Center, Stonewall Tigers, and the Office of Multicultural Affairs as potential safe spaces with improvements such as training, counselors with more specialties and diverse backgrounds, increased marketing, and reaching more LGBT students of color [10].
Improved access was recognized. In particular, 42 students felt that access to the Counseling Center could be improved, particularly concerning the number of available treatment sessions. Provision of support for external counseling was a common theme, to improve mental health services for LGBTQ+ students. Additionally, access to several resources on campus could be improved as mentioned previously, particularly Stonewall Tigers, the Pride and Equity Alliance, and the Office of Multicultural Affairs. A closer collaboration with OUTMemphis could also improve access.
Although resources exist on campus for LGBTQ+ students, several perceived barriers were noted. Concerning the general atmosphere on campus, LGBTQ+ students noted a general lack of acceptance among professors and counselors at the Counseling Center. Coupled with the cultural/religious environment in the South, recognition of this barrier was notable. Additional barriers centered on the Counseling Center’s services. These included the limited number of counseling sessions provided for students, the limited number of Non-LGBTQ+ identifying counselors and counselors who have limited or no LGBTQ+ specific counseling training, and the intake process at the Counseling Center. Each of these perceived barriers at the Counseling Center could be improved with the provision of greater resources for this facility [11,12].
Though the country has slowly returned to a new normal after the height of COVID-19, new and familiar challenges for LGBT youth and young adults continue to persist. As more states across the nation propose or implement anti-LGBTQ legislation, particularly in the South, it is important to consider the potential effects of anti LGBT legislation on LGBT youth mental health. There have also been measures nationwide proposed to obliterate Diversity, Equity, and Inclusion (DEI) training and efforts that support the LGBT community; nevertheless, this also could negatively affect people of color, women, and people living with disabilities. Universities and college campuses have particularly become the targets of anti-LGBT legislation due to the threat or removal of DEI, Offices of Multi Cultural Affairs, transgender athletics, and bathroom bills. Since these measures could especially have an impact on Southern LGBT college students, mental health support on campus is more needed than ever. Instead of waiting for such legislation to be implemented across college campuses and its potential impacts on the mental health of LGBT college students, it is pivotal that college campuses identify and improve strategies such as on-campus counseling and other mental health resources that could serve as protective factors for LGBTQ college students. Despite this area of concern, public colleges and universities must adhere to federal and state laws that could protect or harm the progress of LGBT programming and efforts on college campuses. With this population at a higher risk for mental health conditions such as anxiety, substance use, depression, and suicidal ideation, college campuses are in a precarious situation to support or ignore the mental health needs of its LGBT student population. As a result, the results of this needs assessment can be used to improve access and reduce barriers for LGBTQ+ students on campus to improve overall mental health and particularly, facilitate the provision of counseling services, improve the campus atmosphere for students, and support positive mental health [13].
The needs assessment has some limitations and areas of improvement to consider. Survey responses were inconsistent and its question design could be strengthened to capture more responses for all survey questions. Survey participation seemed to decrease as respondents began to not answer questions or skip questions near the middle and end of the survey which could be the result of survey fatigue. Though the mixed-method use provided insightful qualitative and thematic data, thematic analyses can be difficult to extract useful information compared to quantitative uses. An additional focus group could have been provided, and a few more participants for the first focus groups could have provided more depth and representation of student perspectives. In addition, the culture and stigma in the South around LGBT issues continue to persist, thus participation from students, staff, and faculty had its challenges due to fear of being outed, ostracized, or putting one’s job security at risk. As a result, the status of the national anti-LGBT legislation moving across the nation has made collaborating with campus mental health staff and providing practical applications of improving mental health support for LGBT students come to a standstill for some college campuses, including the University of Memphis. The results of this needs assessment provide insight into on-campus needs, access, and gaps in mental health support for LGBT students, however, the feasibility and practicality of the implementation of recommendations or strategies on campus serve as a barrier at this time.
The authors declare that they have no competing interests.
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