Barriers to Mental Health Support and Recommendations for Improvement from the Perspectives of 2SLGBTQIA+ Youth

Two-spirit, lesbian, gay, bisexual, transgender, queer, intersex, asexual plus (2SLGBTQIA+) youth face significant barriers to mental health care, ranging from a lack of access to therapists (e.g., months-long waitlists, lack of insurance coverage, etc.) to receiving incompetent care from non-affirming providers. To better understand the experiences of youth when accessing mental health care, the current study utilized a fixed, embedded mixed methods design with 808 2SLGBTQIA+ youth in the United States. In this sample, less than half of 2SLGBTQIA+ adolescents stated they were able to access mental health care when it was needed. Youth described experiencing unethical therapy practices by clinicians, cited their parents and practical concerns as barriers to accessing care, and concealing their identity from providers out of fear and mistrust. Youth also described feeling both validated and invalidated once they do receive care. Recommendations for caregivers, providers, organizations and programs, and policymakers are provided based on youth responses.