Integrated Care and the LGBT Community Essay Example

Introduction

Poor health outcomes occur for Lesbian, gay, bisexual, and transgender (LGBT) patients partly because of the absence of LGBT cultural experience in various healthcare settings (Felsenstein, 2018). Disclosure of sexual orientation by a patient to Primary Care Providers (PCP) is related to both patient and provider-related characteristics (Aleshire, Ashford, Fallin-Bennett & Hatcher, 2018). The Ecological Systems Model offers a valuable background for understanding the connection of environment to developing and recognize the categories of LGBT (Belmonte & Holmes, 2016).

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In most societies, LGBT parents and their children are often targeted for discrimination (German, Grabowski & Beyrer,2017). Professionals, religious individuals, institutions and other groups of people tend to be biased against LGBT individuals (Farr et al., 2018). This awareness has presented an opportunity for psychological scholars to research the matter. The studies done on the issue have, nevertheless, been criticized for their inadequacy (Jordal, Wijewardena & Olsson, 2013). For instance, they are deficient of control groups, and the same researchers have in the past concluded that being gay is a form of mental ailment (Sumontha, Farr & Patterson, 2016).

Health Disparities

Mental health issues are part of the most significant health issues affecting LGBT individuals (Keuroghlian, 2017). The prevalence of depression, anxiety, substance use disorder, suicide attempts, and trauma are present with chronic physical health concerns for LGBT individuals (Mustanski, Andrews & Puckett, 2016). For instance, the incidence of such cases among transgender women is 51% compared to 48% among the men while 40% of transgender women suffer from anxiety in comparison to 48% of men (Jordal, Wijewardena, & Olsson, 2013). Also, some LGBT individuals suffer from effects of Post-Traumatic Stress Disorder resulting from bullying, between 11-20% of Lesbian, gay and bisexual individuals attempt to commit suicide (Mustanski, Andrews & Puckett, 2016). Besides, the statistics are higher for transgender adults, whereby 41% of this group tend to be suicidal (Keuroghlian, 2017).

Up to 60% of LGBT individuals diagnosed with psychiatric ailments end up not receiving any form of treatment, Only, 33% of such individuals ended up receiving the recommended medical attention (Kidd, Howison, Pilling, Ross, & Mckenzie, 2016). Many LGBT individuals also end up being involved in drug abuse as they try to cope with the problems they face them in their daily lives. Further intrusion on the matter consists of a study conducted via telephone and audio-recorded interviews on LGBT people who had undergone medical treatment in various health establishments. It emerged that non-disclosure of sexual orientation to PCPs reduced the likelihood that appropriate health care service was provided to the patient (Law, Mathai, Veinot, Webster & Mylopoulos, 2015). Struggles to encourage an open discussion regarding sexual orientation within primary health care providers should be prevalent. The lack of a therapeutic relationship existing between the health provider and patient was a significant determinant regarding such disclosure (Law et al., 2015).

Implications

According to Dubin et al., (2018), a consensus has yet to arrive regarding the educational initiatives that are necessary to tackle the issue of health among LGBT individuals. The study undertaken involved the evaluation of research databases to identify the viable sources relating to LBGT literature. There is a great need for healthcare professionals to acquire the necessary education and training for them to be in a position to offer specialized care to LGBT patients. According to research on the examination of LGBT patients in North Carolina, it is apparent that nurses are a group that desires particular attention (Cornelius, Enweana, Alston & Baldwin, 2017).

Based on the theory of sexual exclusion, engagement with LGBT individuals in addition to the provision of resource materials is an effective means of countering seclusion. Also, the improvement in service providers attitudes towards the LGBT individuals was critical towards the extermination of isolation amongst LGBT personalities (Keuroghlian, Ard & Makadon, 2017; Yang, Chu & Salmon, 2017). The need to advance the health administered to LGBT individuals in various health care centers is paramount. The position of academic health centers is focusing on remitting the desired impact on LGBT populations, as well as ensuring that unique health requirements are satisfied (Yehia et al., 2015).

Primary Care Transformation

According to Reisner et al., (2015), Fenway community health was created with the aim of offering medical attention to LGBT individuals. Within a short period, it expanded its operation by caring for individuals with AIDS. Up to 5,000 patients were recorded as people who had visited the facility in 1975 (Reisner et al., 2015). With the recruitment of additional staff members and the annual budget for the facility expanding enormously, it became evident that majority of the LGBT individuals preferred the health center since it addressed the kind of medical attention they needed without experiencing any form of bias (Munro et al., 2017).

The need for integrated care for such individuals emerged in a study conducted on existing literature regarding resilience and discrimination of transgender people. In this research, 1478 papers were chosen, out of which 19 of them were singled out. According to the findings on the subject, it is essential that all needs of LGBT people are assimilated (McCann & Brown, 2017). Additional literature on the matter revealed that LGBT members experienced more negative health outcomes compared to heterosexual individuals (Kidd, Howison, Pilling, Ross, & Mckenzie, 2016). Such disproportions emanate from how healthcare professionals treat LGBT people; this has been viewed as one of the most significant determinants on whether LGBT people will seek healthcare services or be able to acquire the best form of medical attention (Hughes, Damin & Heiden-Rootes, 2017; Kauth & Shipherd, 2017; Lim & Bernstein, 2012).

Conclusion

Primary care providers and other healthcare professionals must be prepared to provide services within an integrated care model to everyone, including vulnerable populations such as LGBT. The evidence-based clinical information regarding the health care needs of patients in the LGBT population should be incorporated into the training of medical students, residents, and community healthcare providers. The training should include or address a range of essential topics for LGBT patients, including cultural competency, mental health and behavioral conditions, and substance abuse. Healthcare professionals would be able to address the specific needs of the LGBT community better, improve the approach to healthcare service access to effectively improve the overall quality of health care services provided to LGBT patients.

A system-level approach to identify evidenced-based, innovations, interventions and models of care for vulnerable populations such as the LGBT community is necessary to shape and transform primary care (Powell & Foglia, 2014; Goldblum, Pflum, Skinta & Balsam, 2017). The persistence of health disparities among LGBT individuals suggest that the current model of care or approach being delivered is not producing the kinds of results needed to ensure that all LGBT individuals can achieve the same quality and years of healthy life, regardless of race/ethnicity, gender, sexual orientation and other variables (McGeorge, Carlson & Toomey, 2015). With LGBT healthcare education and training, healthcare professionals will be able to address the health disparities associated with LGBT individuals.

References

Aleshire, M. E., Ashford, K., Fallin-Bennett, A., & Hatcher, J. (2018). Primary Care Providers' Attitudes Related to LGBTQ People: A Narrative Literature Review. Health promotion practice, 1524839918778835.

American Psychological Association. (2017). Issues in psychotherapy with lesbian and gay men: a survey of psychologists.

Belmonte, K., & Holmes, T. R. (2016). Outside the LGBTQ "Safety Zone": Lesbian and Bisexual Women Negotiate Sexual Identity across Multiple Ecological Contexts. Journal of Bisexuality, 16(2), 233-269. doi:10.1080/15299716.2016.1152932

Cornelius, J. B., Enweana, I., Alston, C. K., & Baldwin, D. M. (2017). Examination of lesbian, gay, bisexual, and transgender healthcare content in North Carolina schools of nursing. Journal of Nursing Education, 56(4), 223-226.

Dubin, S. N., Nolan, I. T., Streed Jr, C. G., Greene, R. E., Radix, A. E., & Morrison, S. D. (2018). Transgender healthcare: improving medical students' and residents' training and awareness. Advances in medical education and practice, 9, 377.

Farr, R. H., Bruun, S. T., Doss, K. M., & Patterson, C. J. (2018). Children's gender-typed behavior from early to middle childhood in adoptive families with lesbian, gay, and heterosexual parents. Sex Roles, 78(7-8), 528-541.

Felsenstein, D. R. (2018). Enhancing Lesbian, Gay, Bisexual, and Transgender Cultural Competence in a Midwestern Primary Care Clinic Setting. Journal for Nurses in Professional Development, 1. doi:10.1097/nnd.0000000000000450

German, D., Grabowski, M. K., & Beyrer, C. (2017). Enhanced use of phylogenetic data to inform public health approaches to HIV among men who have sex with men. Sexual Health, 14(1), 89. doi:10.1071/sh16056

Goldblum, P., Pflum, S., Skinta, M., & Balsam, K. (2017). Psychotherapy with lesbian, gay, and bisexual clients: Theory and practice. Comprehensive textbook of psychotherapy: Theory and practice, 330-345.

Hughes, R. L., Damin, C., & Heiden-Rootes, K. (2017). Where's the LGBT in integrated care research? A systematic review. Families, Systems, & Health, 35(3), 308.

Jordal, M., Wijewardena, K., & Olsson, P. (2013). Unmarried women's ways of facing single motherhood in Sri Lanka - a qualitative interview study. BMC Women's Health, 13(1). doi:10.1186/1472-6874-13-5

Kauth, M. R., & Shepherd, J. C. (Eds.). (2017). Adult Transgender Care: An Interdisciplinary Approach for Training Mental Health Professionals. Routledge.

Keuroghlian, A. S., Ard, K. L., & Makadon, H. J. (2017). Advancing health equity for lesbian, gay, bisexual and transgender (LGBT) people through sexual health education and LGBT-affirming healthcare environments. Sexual health, 14(1), 119-122.

Kidd, S. A., Howison, M., Pilling, M., Ross, L. E., & Mckenzie, K. (2016). Severe Mental Illness in LGBT Populations: A Scoping Review. Psychiatric Services, 67(7), 779-783. doi:10.1176/appi.ps.201500209

Law, M., Mathai, A., Veinot, P., Webster, F., & Mylopoulos, M. (2015). Exploring lesbian, gay, bisexual, and queer (LGBQ) people's experiences with the disclosure of sexual identity to primary care physicians: a qualitative study. BMC family practice, 16(1), 175.

Lim, F. A., & Bernstein, I. (2012). PROMOTING AWARENESS of LGBT Issues in Aging in a Baccalaureate Nursing Program. Nursing Education Perspectives, 33(3), 170-175.

McCann, E., & Brown, M. (2017). Discrimination and resilience and the needs of people who identify as transgender: a narrative review of quantitative research studies. Journal of clinical nursing, 26(23-24), 4080-4093.

McGeorge, C. R., Carlson, T. S., & Toomey, R. B. (2015). An exploration of family therapists' beliefs about the ethics of conversion therapy: The influence of negative beliefs and clinical competence with lesbian, gay, and bisexual clients. Journal of mar...