Date: Tue, 22 Jan 2008 15:16:03 -0500
Subject: SIGN ON BY TOMORROW! SAMHSA Reauthorization Sign On Letter
Action Alert from the National Coalition for LGBT Health

I was asking just last night if more lesbians (etc) come from dysfunctional families, based on watching some of the movie Boys Don't Cry. More on this movie another night. For now, here's the text of an email with some interesting factoids. It argues that LGBT folks are underserved medically and overtaxed mentally and emotionally, and that we need to guarantee that this population is supported in upcoming legislation, specifically in the reauthorization of the Substance Abuse and Mental Health Service Administration (SAMHSA). If you know of any organizations who might want to sign on to support getting equal access to healthcare for this marginalized population, tomorrow is the deadline to sign onto the letter below.

In anticipation of the reauthorization of the Substance Abuse and Mental Health Service Administration (SAMHSA), the National Coalition for LGBT Health is circulating the sign on letter below. As you are aware, lesbian, gay, bisexual and transgender (LGBT) people suffer from a significantly higher rates of mental health and substance abuse problems due to social stressors including stigma, discrimination and anti-gay violence. Unfortunately, the SAMHSA reauthorization does not currently reflect this reality.

The Health, Education, Labor and Pension (HELP) Committee is scheduled to mark up the SAMHSA reauthorization legislation shortly. This letter will be sent to Chairman Kennedy, Ranking Member Enzi, and the Democratic members of the HELP Committee prior to the mark up.

Unfortunately, at this time we can only take organizational sign ons, but will let you know when individuals should contact their Senators. If your organization is interested in signing on to this letter, please contact the Coalition at coalition@lgbthealth.net with your organization's correct name and acronym (if applicable) no later than Wednesday, January 23rd at 5 PM EST. Feel free to contact me if you have any questions.

I hope you can join us in this important endeavor.

Thanks,
Rebecca

Rebecca E. Fox
Director
National Coalition for LGBT Health
Phone: 202-558-6828
www.lgbthealth.net


LETTER

We commend you for undertaking the reauthorization of the Substance Abuse and Mental Health Service Administration (SAMHSA). SAMHSA programs provide critically needed services to many of our nation's most vulnerable citizens. Within the reauthorization language, the references to high-risk population groups, such as youth, the elderly, women and people living with HIV/AIDS are especially heartening.

Our reading of the reauthorization bill under consideration has been disturbing because it omits the substance abuse and mental health challenges confronting lesbian, gay, bisexual and transgender (LGBT) communities across the country. LGBT people experience higher rates of mental health and substance abuse problems due to social stressors including stigma, discrimination and anti-gay violence. Many of the highlighted at-risk populations, such as youth and elders, are likely to be doubly affected if they are LGBT. For example, LGBT youth are almost 5 times more likely than their heterosexual counterparts to have attempted suicide. Further, populations within two of your groups of focus, people living with HIV/AIDS and those who use drugs, are more likely to be LGBT. It has been well documented that LGBT people face disparities in access to culturally competent and relevant mental health and substance abuse prevention and treatment services. Therefore, inclusion of the needs and concerns of the LGBT population within the initiatives, programs, and services provided by SAMHSA are critically important to health promotion, risk reduction and disease prevention for the LGBT community.

SAMHSA defines sexual orientation and gender identity as a "core aspect of identity." Not surprisingly, culturally competent programming is necessary to address mental illness and substance abuse in the LGBT community. According to the Minority Health and Health Disparities Research and Education Act of 2000, a population is considered to be a health disparity population if "there is a significant disparity in the overall rate of disease incidence, prevalence, morbidity, mortality, or survival rates in the population as compared to the health status of the general population." Being LGBT substantially impacts whether or not a person receives care and, when they do receive care, whether that care effectively speaks to all aspects of their lives.

The organizations below have compiled the following list of recommendations to be incorporated into the reauthorization of SAMHSA in order to more effectively address these critical concerns and needs. We strongly urge you to incorporate these recommendations for the health and well being of our national community:

Since LGBT people are more likely to experience mental health and substance abuse problems, they must be included throughout SAMHSA programs.

Recommendations: When high-risk populations are specified in programs and funding priorities, this must include sexual and gender minorities. This is especially important for LGBT youth who are at greater risk of depression and suicide. There must be programs, pilots and demonstration grants that target suicide prevention as a priority issue for LGBT youth.

In order to accurately assess current needs, allocate appropriate and sufficient resources and then evaluate impact and outcomes, it is imperative to be able to collect data on LGBT populations within SAMHSA initiatives.

Recommendations: Sexual orientation and gender identity demographic questions must be added to all population–based SAMHSA behavioral health-related surveys, including youth surveys. There must also be mechanisms for monitoring the results and reporting out these findings. Only with these results will government agencies and other sources be able to adequately address the mental health and substance abuse prevention and treatment needs of the LGBT community.

To begin to eliminate disparities in access to LGBT competent and relevant services, SAMHSA can take leadership in the development of research, training and program initiatives targeted to the diverse populations and special needs of the LGBT community. Currently, no SAMHSA programs address the LGBT community as a whole.

Recommendations: SAMHSA must continue to develop and disseminate of LGBT cultural competency curricula and deliver these trainings to SAMHSA grantees and other providers in mental health and substance abuse prevention and treatment. SAMHSA funding must include demonstration projects for LGBT-related work. Experts on LGBT behavioral health must be included on SAMHSA advisory committees and as part of SAMHSA review committees. These committees should reflect the diversity of people who use SAMHSA funded services, including LGBT people.

SAMHSA must grow programs that make real and last changing in people's lives. SAMHSA's recent decision to implement five-year grant periods has enabled grantees to more effectively build, implement, evaluate and then seek ongoing support for SAMHSA funded and supported services.

Recommendations: To continue to allow programs to make real and lasting impact on participants' lives, there must be an ongoing commitment to more comprehensive SAMHSA funding mechanisms for community-based initiatives, specifically increasing the length for grant awards and supporting the continuation of funding for organizations. This would facilitate grantee capacity building and aid programs sustainability. In addition, federally qualified health centers (FQHCs) must be recognized as essential community based providers of mental health and substance abuse services, FQHCs that would qualify for services would be centers that have either or both licensed mental health and substance abuse treatment programs.

We insist that LGBT people and their needs be recognized in the reauthorization of SAMHSA. We look forward to your response; please do not hesitate to contact Rebecca Fox, National Director, at the National Coalition for LGBT Health at Rebecca@lgbthealth.net or 202-558-6828.

Sincerely,