It’s a good day for Emile Fox.
Sipping an iced coffee at a trendy coffee shop near downtown Orlando, Fox said that while she still wasn’t 100%, at least depression and mental illness hadn’t ruined her day.
“It’s okay. It’s okay,” Fox says.
The 29-year-old barista and community college radiology student, who identifies as non-binary, said the journey has been filled with depression and confusion from the start.
“By the sixth grade, I realized I was different and I became depressed,” Fox said.
Fox says their family was supportive of their gender transition, but they had to figure out the rest on their own. Fox says they often felt excluded from the LGBTQ community, and years of isolation and cycles of depression led to mental illness.
Fox said the couple were not violent or intended to harm themselves or others, but their families involuntarily committed them to psychiatric hospitals multiple times last summer under Florida’s Baker Act.
Lillian Hernandez Caraballo
/
Central Florida Public Media
“I was in eight different facilities in four months,” Fox said. “Every time I went there the conditions were horrible — they took my clothes away, they put me in a gown, it was filthy.”
Fox said she now suffers from post-traumatic stress disorder as a result of her experiences at these facilities.
“No one asks, ‘What do you need? How can I help you?’ All they think about is, ‘How can I prescribe you medication?'” Fox said.
Ms Fox said that while in the facility, they fell behind in school, lost relationships and self-confidence and, ultimately, lost trust in their families.
“It destroyed a lot of things,” Fox said. “They think they know what’s best for me, but it’s really crazy that they would send me to a place where they don’t even know what it’s like inside. No one has ever been in a facility like that. They don’t know what it’s like.”
Aside from his personal experience, during his stay in hospital, Fox experienced something many LGBTQ+ people say they have experienced: He was denied access to necessary medical care. Fox said he was denied access to gender reassignment treatment.
“I had a hard time getting testosterone injections at every facility. At one point, I thought I had finally found someone who would listen and give me the injections, but they just prescribed me antipsychotics. They scammed me,” Fox said. “As soon as[the nurse]told me that, I started crying.”
Barriers to LGBTQ affirmation
Fox’s story is a snapshot of what mental health issues are like for LGBTQ+ people in Florida.
In general, the number of adults reporting mental health issues has increased over the years, according to the Florida Department of Health, but the department also reports that the rates of depression, anxiety and suicidal behavior are even higher in the LGBTQ+ community.
In 2007, 9.7% of Florida adults reported having a poor mental health condition, but by 2020, that number had risen to 12.3%. By February 2023, that number was closer to 32%. LGBTQ+ youth are at higher risk.
According to new data from suicide prevention nonprofit The Trevor Project, 73% of LGBTQ+ young people report concerns about their mental health, and 45% have considered suicide.
However, the report makes clear that mental illness is not unique to LGBTQ+ people – rather, the community is at higher risk due to the harm caused by abuse and marginalisation.
“The reality is that the mental health and well-being of our children is so great that they are unable to function,” said Roberto Carlos Katz, a mental health counselor and trauma specialist at the Orlando Counseling and Therapy Group.
“From a young age, we experience a process of being judged, criticized and not accepted by others, including at home. But even if we grow up in a supportive home, we hear negative messages about ourselves elsewhere – at school, at work, in the media. This affects our sense of self. We start to wonder, ‘What is wrong with me?'” Katz said.
Katz says these systemic issues are why many LGBTQ+ people don’t seek help, and when they do, they often receive poor care.
Lillian Hernandez Caraballo
/
Central Florida Public Media
“Historically, LGBTQ clients have not been empowered,” he said. “Unfortunately, here in Florida, what was a medical issue became politicized, and that started to create barriers.”
It’s a chain of events. Katz says that lack of social acceptance can lead to mental health stressors that ultimately manifest in physical and material ways, like substance use disorders or self-harm. These stressors require care from specialized health care providers that aren’t always available, leading to struggles with education, relationships, maintaining paid employment and even finding adequate housing.
“And until those structural social issues are fixed, we can aggregate all the resources in the world and make them accessible, but they have to be LGBTQ welcoming,” he said.
Since his hospitalization, Fox has been estranged from his family and feels a void in his heart.
Peer Support Space
Today is a good day because Fox has found help. A local peer support group has emerged in response to the growing need and urgency of LGBTQ+ support in Central Florida.
Peer Support Space is a peer-led organization that was born out of the Pulse nightclub shooting nearly five years ago, when members decided the community needed a safe place where people could come and heal one another.
About a month ago, just off Mills Avenue in Orlando, the organization opened Eva’s Casita, a peer-supported respite center focused on caring for marginalized communities. Fox has used the center twice already, and said it’s just what she and her family needed.
“I wanted to be there. I didn’t want to go home. Honestly, it was great,” Fox said.
Respite means taking a break from stressors. Peer support is not clinical or medical, but is defined by the U.S. Department of Health’s Substance Abuse and Mental Health Services Administration as a set of activities among people who share similar life experiences that foster social connections through mutual support, or “peerness,” not typically found in other professions.
“Adults experiencing a mental health crisis can come to Eva’s Casita knowing that they’ll be cared for by someone who knows what they’re going through,” said Executive Director Yasmin Flasterstein.
Lillian Hernandez Caraballo
/
Central Florida Public Media
“It’s communal healing. To feel like there are people out there who don’t know me but who care about me is life-saving,” she said.
The home is run by a diverse LGBTQ+ staff, and Flasterstein said the respite space is the first of its kind in Orlando to be intentionally focused on underserved communities.
“I’ve worked professionally in (Pulse’s) mental health response, and what I’ve seen there is that it’s incredibly difficult for people with intersectional marginalized identities to find culturally affirming resources,” Flasterstein said.
Eva’s Casita means “Eva’s Little House,” a homage to the Puerto Rican woman of the same name who, according to Flasterstein, was the inspiration behind the respite space.
Eva passed away about two years ago. Flasterstein said she first met her when she was working as a therapist in the wake of the Pulse shooting. She described Eva as a kind, warm-hearted person.
Eva began focusing on peer support after she retired, and although she has a background in Western medicine, she spent a lot of time travelling and researching in search of a more holistic approach, Flasterstein said.
“Therapy and medication have helped me, but there are so many more mental health options out there,” Flasterstein says. “And this really makes sense to me: everything that’s ever bothered me in the mental health system is somehow resolved through peer support.”
Inside Eva’s Casita
Eva’s Casita is not a clinic. It is literally a neighborhood home. When full, it can accommodate up to three guests and one caregiver at a time, for a total of four people. If there is space, we will not turn anyone away.
There is currently no waiting list. Guests may stay at Eva’s Casita for free once a month for up to six nights. Priority is given to guests with no previous experience staying at Eva’s Casita. As long as everyone is an adult and willing to abide by the accommodation agreement, they can stay in any of our three rooms. Every room has been thoughtfully and purposefully built.
The Sky Room features hundreds of painted stars that light up at night, each representing someone who has passed away or who helped in some way lay the foundations for the project. The El Yunque Room evokes the feeling of gazing into a rainforest from the mountains of Puerto Rico. And the Mushroom Room transports guests to a fantasy world.
Flasterstein said everything at Eva’s Casita is self-directed: Guests can choose to participate in social and independent activities like games, crafts and one-on-one counseling — or just do nothing at all.
“We’ve all been in places where we have to stare at a wall for three days. But if you did that in a psychiatric hospital, you might become non-conformist, right? So my idea is that you can come here and be alone if you want, and you can interact with other people if you want. … It’s all voluntary,” she said.
There is no cure and guests are expected to care for themselves to the best of their ability by cleaning up after themselves, getting around on their own and taking their own medications if they have them.
Flasterstein said that while medication and therapy certainly play an important role, Central Florida Miserable Such an additional need.
Katz agreed. He said neither peer support nor the mental health care system is perfect: Both are always learning, always growing, always changing.
But Katz said the two work well together. Peer support is not meant to compete with or replace mental health treatment, but rather to work hand in hand.
“I would say that therapy works, and if it’s LGBTQ-affirming, it works even better. So what we do is a little bit different from what peer support spaces do, and they’re actually two different, beautifully complementary things,” he said.
Eva’s Casita isn’t finished yet, Flasterstein said, and supplies, funds and donations are still coming in and are needed. The director said she would like to add more resources to Eva’s Casita, such as fitness equipment, furniture for organization, materials and tools for activities, and eventually a water fountain and garden in the back yard where she hopes to house community pets.
For now, people like Fox can have a place where they can feel settled, understood and whole again.
“(Eva’s Casita) is a place that really gives you a sense of community and also feels like family,” Fox said.
It may still not be perfect, but at Eva’s Casita, that’s okay.
If you or someone you know may be considering suicide, please contact the Suicide and Crisis Lifeline by calling or texting 988.
Lillian Hernández Caraballo is a reporter for the American News Agency.
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