Implementation of a LGBTQIA+ Evidence Based Toolkit in an Outpatient General Psychiatry Clinic: Quality Improvement Project

LGBTQ+ youth are at high risk for significant mental health disorders, including mood, anxiety, and substance use disorders. Initiating mental health care is arguably intimidating for most; LGBTQ+ youth report they fear being judged and feeling invalidated by MHPs who are supposed to help them. LGBTQ+ youth are less likely to seek mental health care, and timely assessment, diagnostic, and psychotherapeutic intervention opportunities are lost. Local Problem: Utah mental health providers (MHPs) report a lack of knowledge, clinical training, experience, and confidence in understanding and working with LGBTQ+ youth presenting with behavioral health disorders. Most mental health providers have not received training in school or at their job sites to provide culturally sensitive care to LGBTQ+ youth. Therefore, it could cause situations where LGBTQ+ youth are unintentionally invalidated. Methods: A toolkit was developed by researching existing toolkits and tailoring said toolkits into one specific and appropriate for the mental health providers employed at Lone Peak Psychiatry. Pre- and post-intervention surveys and bi-weekly surveys were created through REDcap (Research Electronic Data Capture) and distributed to providers to gauge the results of the intervention. Interventions: An evidence-based toolkit was administered to mental health providers at Lone Peak Psychiatry. Pre- and post-intervention surveys and bi-weekly surveys administered during the intervention assessed MHPs' knowledge and confidence in providing culturally sensitive care, toolkit feasibility, useability, and user satisfaction. Results: In the pre-intervention survey, three providers reported they were somewhat comfortable, five providers reported feeling neutral, and three providers reported they were comfortable. In the post-intervention survey, four providers reported comfort working with LGBTQ+ youth, one reported feeling neutral about working with this population, and three reported feeling somewhat comfortable working with this population. In the post-intervention survey, most providers reported they felt the toolkit was feasible to implement into their practice-two providers reported feeling toolkit use was very feasible, three reported feeling it was feasible, one provider reported feeling neutral, and one provider reported somewhat feasible. Additionally, most reported they were satisfied with it-three providers reported they were very satisfied, two reported satisfied, two reported feeling neutral, and one reported feeling somewhat satisfied. Conclusion: A comparison of the pre-and post-intervention surveys did not demonstrate notable changes in MHPs' knowledge or confidence levels concerning LGBTQ+ youth. Toolkit feasibility and user satisfaction scores were favorable. Despite the bi-weekly distribution of toolkit evaluation surveys during the intervention period, the lack of completed surveys precluded conclusions.