JMIR Publications

ABSTRACT

Background:

Mental health (MH) and substance use (SU) care supports are often difficult to access for the LGBTQ2S+ population. There is little known on how the shift to virtual care has affected and changed the experiences of LGBTQ2S+ youth within the mental health care system.

Objective:

This study sought to examine how virtual care modalities have affected access to care and quality of care for LGBTQ2S+ youth seeking mental health and substance use services.

Methods:

Researchers used a virtual co-design method to explore this population’s relationship with mental health and substance use care supports, focusing on the experiences of 33 LGBTQ2S+ youth and their relationship with MH and SU supports during the COVID-19 pandemic. A participatory design research method was used to gain experiential knowledge of LGBTQ2S+ youth’s lived experience with accessing MH & SU care. Thematic analysis was used to highlight themes that emerged from the resulting audio recorded data transcripts.

Results:

Themes related to virtual care included accessibility, technology, virtual communication, provision of choice, and provider relationship and interactions. Barriers to care were identified in particular for disabled youth, rural youth, and other participants with marginalized intersecting identities. Unexpected benefits of virtual care were also found, and emphasize the idea that this modality is beneficial for some LGBTQ2S+ youth.

Conclusions:

During COVID-19, a time where mental health and substance use-related problems have increased, programs need to re-evaluate current measures so that the negative effects of virtual care modalities can be reduced for this population. Implications for practice encourage service providers to be more empathetic and transparent when providing services for LGBTQ2S+ youth. It is suggested that LGBTQ2S+ care should be provided by LGBTQ2S+ folks/organizations or service providers who are trained by LGBTQ2S+ community members. Additionally, hybrid models of care should be established in the future so that LGBTQ2S+ youth have the option to access in-person services, virtual ones or both as there can be benefits to virtual care once it has been properly developed. Implications for policy also include moving away from a traditional healthcare team model and developing free and lower-cost services in remote areas.