Most LGBTQ Youth Can’t Access Mental Health Care. How Schools Can Help
People wave pride flags and hold signs during a rally in support of LGBTQ students at Ridgeline High School, April 14, 2021, in Millville, Utah.
People wave pride flags and hold signs during a rally in support of LGBTQ students in the spring of 2021 at Ridgeline High School in Millville, Utah. Students and school district officials in Utah were outraged after a Ridgeline student ripped down a pride flag to the cheers of other students during diversity week.
A majority of LGBTQ students in every state except two said they sought mental health care but were unable to access it, according to a Trevor Project report.
In Vermont and Minnesota, 45 percent and 49 percent of LGBTQ youth, respectively, were not able to get the mental health care that they wanted, the report found. In all other states, the percentage of LGBTQ youth who were not able to access mental health care ranged from 50 percent to 72 percent, with Nevada having the highest percentage of such students.
The Trevor Project report, which was published Dec. 15, is based on the organization’s 2022 survey of nearly 34,000 LGBTQ people ages 13 to 24. It comes as state legislatures across the country have introduced bills that target LGBTQ students by restricting access to books about LGBTQ topics, limiting participation on team sports, and not offering restrooms that align with their gender identity.
The results point to “systemic barriers in accessing critical mental health care for these young people, who already face a large number of mental health challenges and increased suicide risk,” said Keygan Miller, a public training manager at The Trevor Project.
In fact, in a majority of the states, at least 40 percent of survey respondents said they have seriously considered suicide in the past year and more than 50 percent reported experiencing symptoms of anxiety and depression.
In most states, many survey respondents said they were unable to access mental health care because they didn’t want to have to get their parent/caregiver’s permission or because they were afraid of talking about their mental health concerns with someone else.
Schools play a big role in ensuring LGBTQ students have access to supportive spaces and the mental health care they want and need, according to experts. The Trevor Project’s previous research has found that LGBTQ students who have access to LGBTQ-affirming schools report better mental health outcomes and lower rates of attempting suicide, Miller said.
But, on average, the report found that about 40 percent of LGBTQ students said their school was a “LGBTQ-affirming space,” or one where they can freely express their identity safely and without fear. In Mississippi, only 23 percent of LGBTQ youth said their school is an affirming space, compared with 53 percent in Delaware.
“The reason it is so imperative for schools to be an affirming space is [because] school is the only place that young people have to go,” said Amy Cannava, the appointed chair of the National Association of School Psychologists’ LGBTQ+ committee and a school practitioner in Virginia. “Because they have to be there, it becomes our obligation to act, following what is considered to be empirically validated best practices, which is to be affirming. They legally have a right to be in a place that is safe and supportive and not going to endanger their mental or physical health.”
And because oftentimes students don’t have the support they need at home, school becomes “where they’re seeking therapy or coming out for the first time to an adult for support,” Cannava said.
But providing counseling and mental health services to students is not that simple, Cannava said. For one, school districts have a shortage of school-based health-care professionals. And not every school district job description for school counselors, social workers, or psychologists allows them to provide counseling in the school.
So what can middle and high schools do to support LGBTQ students? Here are some recommendations from Miller and Cannava:
Talk to students about what they need instead of assuming what they need, by conducting focus groups or surveys to hear what would make them feel physically and psychologically safe and able to learn;
Expand mental health counseling and extracurricular activities like Gender and Sexuality Alliances (GSAs);
Implement suicide prevention policies and intersectional mental health services that specifically consider the unique stressors and challenges faced by students who hold multiple marginalized identities;
Implement transgender-inclusive policies, such as access to sports and gender-inclusive bathrooms, inclusion in health curricula, and the ability to change one’s name and gender marker in school systems and documents;
Diversifying our teaching force to match the demographics of our students is an imperative shared by many school leaders. Doing so has benefits for students that any school leader would love: higher graduation rates, reduced dropouts, fewer disciplinary incidents, and increased student achievement to name a few.
In this biweekly column, principals and other authorities on school leadership—including researchers, education professors, district administrators, and assistant principals—offer timely and timeless advice for their peers.
The organization I lead recently gathered more than 800 Black male educators at our Black Men Educators Convening in Philadelphia. There, our attendees engaged in dialogue and learning that will not only help inform our work at the Center for Black Educator Development but can offer a number of lessons for leaders dedicated to diversifying their teaching force.
1. Focus on retaining the teachers of color you already have. Key to building a more diverse teaching force is creating a culture that keeps and values the teachers of color already on the job, ultimately making schools more attractive for more Black, brown and Indigenous teachers. Building that culture starts at the top and is no small task. But it can be done when leaders lead in a way that supports culturally competent teaching and learning.
2. Build trust and create community. It is essential that leaders establish an ethos of understanding and listening in a school building. Educators must feel safe, seen, listened to, and ultimately empowered in their diverse identities. Deliberate feedback loops are critical to shrink our blind spots—the space where bias is born, fed, and grows. All leaders have them, but the good ones are constantly aware of their own, working to make them smaller. This style should be embraced by the entire leadership team, not just the person at the very top.
Don’t wait until exit interviews to start asking colleagues what would make them want to leave. The approach should center the question, “How do I create an environment and experience that will encourage you to stay?” This kind of openness to improvement through self-awareness and reflection fosters dialogue, breaks down resentments, and develops a spirit of shared understanding.
When we asked participants at our recent convening a nearly identical form of questioning, we listened closely to what they felt made the environment safe and welcoming. A consistent theme in our survey results was the palpable feeling of love and acceptance in the gathering. Imagine what would be possible if this were the kind of environment our schools could be for Black male teachers.
3. Identify how teachers of color are singled out in your school. It’s one thing to be a minority in a school staff, it’s another thing entirely to be minoritized on a staff. Here’s what I mean: If all teachers except for the two Black teachers vote a certain way on a policy matter or issue before the staff, being blind to that dynamic further marginalizes those Black teachers. Yes, that’s democracy, but it’s also precipitously close to majoritarianism.
Leadership can minoritize teachers of color in a number of ways—even seemingly well-meaning actions can be detrimental to creating a culture that truly embraces minority teachers. For instance, Black and brown teachers are often assigned to be the managers of every child of color who faces additional challenges—even students they do not teach directly. Rather than levying an invisible tax on Black and brown teachers through these “extra” assignments, leaders can demonstrate how they value the very real expertise these teachers have by compensating them to provide culturally relevant professional development and coaching to other staff and leadership. This builds capacity in the staff and demonstrates a commitment to an anti-racist orientation. Black teachers often share that they are pushed toward taking on disciplinary roles and not invested in instructionally. A commitment to support their instructional and coaching expertise allows these teachers of color to develop and codify their skills to everyone’s benefit.
4. Move beyond the book club and “affinity groups” for teachers of color. Ordering pizza and soda for a monthly meeting of Black and brown teachers is not embracing educator diversity. Here again, our work with Black male educators has given us insights into useful perspectives for leaders to learn from. A theme we heard from many of our attendees was the power of working in a school where Black and brown teachers were supported in building real connections with their fellow educators of color.
But these connections must be supported by leadership to be meaningful. By allowing the insights and partnership that arise for collaboration between teachers of color to drive policy and change within the school, leaders can improve the experience not just for teachers of color but all adults and students in the building. These empowered networks can be transformative, both for making schools the kinds of places teachers of color want to work but also in ensuring that all learners have the support and care they need to succeed.
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