It is often reported that when patients trust their healthcare provider, they are more likely to receive treatment and adhere to their treatment plan. For the LGBTQ+ community, trust in healthcare professionals is a persistent issue. Nearly half of this population reports communication issues with clinicians, resulting in them being twice as likely to skip an appointment due to a previous negative experience. Notably, one in five LGBTQ+ people say they have experienced healthcare trauma, and one in ten have encountered some form of healthcare discrimination. Stigma in healthcare increases the likelihood of misdiagnosis and inappropriate treatment, further promoting poor health outcomes.
Given the current fragmented healthcare environment and the increased need for care navigation and innovation in areas like mental health, the challenges related to how the LGBTQ+ community accesses and engages with healthcare providers are even more significant. It is clear that we need to act now to provide higher quality, more personalized healthcare to LGBTQ+ individuals. Employers who provide healthcare to 180 million Americans also have a critical role to play in this.
Growing disproportionate mental health burden
Recent data compiled by Morgan Health sheds light on the quality of care for LGBTQ+ people[1] Patients currently covered by employer benefits. Historically, employer-sponsored insurance has covered more Americans than any other type of insurance, yet limited data is available on disparities. Understanding the true burden of disparities across populations is important to provide actionable guidance on how employers can close the gaps among their plan enrollment.
Here’s what I learned specifically about LGBT people:
- LGB people were more likely to receive mental health treatment overall, and especially among those with depression overall: 18.8% compared to 4.1% of straight people.
- LGB people also have higher rates of smoking, alcohol use (including drinking behaviors considered alcohol abuse or dependence), and drug use (including levels considered illicit drug abuse or drug dependence).
- Notably, LGBT people have a 14.9 percent rate of illegal drug use, compared to 8 percent of people who identify as heterosexual.
Several aspects of our health care system exacerbate these mental health disparities, and social factors like where you live, your ability to open up to a health care provider, and how much you earn can further contribute to the disparities.
Working to close the mental health care gap
Importantly, our research found that LGBT people are more willing to seek help for their mental health care needs: Compared to people who identify as straight, LGBT people are more than twice as likely to report having seen a doctor for their mental health and received treatment.
The findings highlight a significant opportunity to address the historical pitfalls this community has faced in building trusting relationships with health care providers and creating peace of mind that they will receive the care they need.
As the largest purchasers of health care services, employers can play a key role in making this happen by following three key steps.
- Advocate for a more diverse health care workforce. LGBTQ+ employees: They will have access to a culturally competent, inclusive workforce that is empathetic and understanding of their care needs. The American Psychological Association (APA) has identified best practices for treating LGBTQ+ clients, including providing staff education to promote inclusive behaviors, requiring dedicated staff training, addressing peer harassment and intolerant behaviors in treatment programs, and creating policies tailored to the needs of LGBTQ+ clients.
- Provide incentives to receive treatment. Employers can expand mental health and substance use support for all employees, with a special focus on the LGBTQ+ community, by reducing cost-sharing for mental health services, increasing access to virtual therapy and other telehealth options through employee assistance programs (EAPs), and offering benefits for clinician-led peer support services for less severe needs.
- Utilize employee resource groups. Employers can help foster a workplace culture that prioritizes and promotes mental health by using employee resource groups as a channel to connect less-engaged subgroups to appropriate care options. These efforts can include facilitating conversations about mental health in the workplace through workshops, educational resources, and apps like those offered by Personify Health, which help people prioritize well-being and improve their health.
By taking a proactive approach to supporting the mental health of LGBTQ+ workers, employers can be their allies, promote overall wellbeing, and foster a positive workplace culture.
[1] Note: The study did not take into account medical claims filed by transgender people, an area of research that requires future investment and attention.
