Accepted for/Published in: JMIR Formative Research
Date Submitted: Jan 17, 2023
Open Peer Review Period: Jan 17, 2023 - Jan 31, 2023
Date Accepted: Mar 31, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
LGBTQIA+ Youth and Young Adults in a Telehealth Intensive Outpatient Program: Quality Improvement Analysis of Acuity and Improvement Following Treatment
ABSTRACT
Background:
LGBTQIA+ youth have disproportionately high levels of depression, self-harm, and suicidal thoughts and behaviors, yet there is a lack of mental health treatment and outcome research that addresses this disparity.
Objective:
This program evaluation explores the effectiveness of one remote intensive outpatient program (IOP) with a curriculum tailored specifically to LGBTQIA+ youth with high acuity depression, anxiety, and suicidality. This evaluation sought to answer: 1) Are LGBTQIA+ youth and young adult patients more clinically severe at intake and discharge relative to non-LGTBQIA+ patients? 2) Are LGBTQIA+ youth and young adult patients experiencing clinically significant change from intake to discharge in LGBTQIA+ specific programming? and 3) Are there subgroup differences?
Methods:
Data were collected from intake and discharge outcome surveys measuring depression, suicidality, and non-suicidal self harm (NSSI) for 880 patients who attended at least 5 sessions of a remote IOP for youth and young adults. 575 clients identified as having at least one LGBTQIA+ identity; they participated in a LGBTQIA+ adapted program of the general curriculum.
Results:
LGBTQIA+ patients were more clinically severe at intake in depression, NSSI, and suicidal ideation. Transgender and nonbinary clients had greater NSSI within the LGBTQIA+ sample. LGBTQIA+ patients demonstrated improvement on all outcomes from intake to discharge. PHQ-A depression scores improved from 18.15 at intake to 10.83 at discharge. 50.5% of LGTBQIA+ youth who endorsed passive suicidal ideation at intake, no longer reported it at discharge; 72.1% who endorsed active suicidal ideation at intake, no longer reported it at discharge, and 55.1% of patients who met criteria for clinical NSSI no longer met criteria at discharge. In the subgroup analysis, transgender patients had 1.8 higher odds of reporting active suicidal ideation and 2 times more likely to report clinical nonsuicidal self-injury at discharge.
Conclusions:
Findings provide support for the role of LGBTQIA+ specific programming to meet the elevated mental health needs of these youth, and that more research is needed to understand barriers that may negatively affect transgender clients, specifically. Clinical Trial: N/A
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.