Transforming Mental Health Services for Older People: Gay, Lesbian, Bisexual, and Transgender (GLBT) Challenges and Opportunities

ABSTRACT

Service providers often think about minority group members as challenges: How do we adapt our existing protocols and programs to meet the needs of these people who are different from our usual clients? Unfortunately, we frequently attempt to answer this question by trying to gain cultural competency. This approach neither serves individual clients—who can never be summed up by a single attribute whether that be their race, age, gender, sexual orientation, or psychiatric diagnosis—nor makes full use of the opportunities for systems improvement that diversity creates. This article offers alternatives to this standard (and inadequate) response to diversity by exploring four ways in which engaging aging diversity can actually improve both our services and the broader community.

KEYWORDS:

• Mental health services
• GLBT clients

This article is based on a paper presented at the AARP Diversity and Aging in the 21st Century Conference, June 21, 2007, Los Angeles, CA.

Notes

1. To help people grasp what current GLBT elders have lived through, the Transgender Aging Network has prepared a “Living Memory GLBT Timeline” (Cook-Daniels, 2008).

2. For more information about abuse of GLBT elders, see “Lesbian, Gay Male, Bisexual, and Transgendered Elders: Elder Abuse and Neglect Issues,” by Loree Cook-Daniels (2002a), available at http://www.forge-forward.org/handouts/tgelderabuse-neglect.html.

3. For information on the adverse childhood experiences and their relationship to adult health, see http://www.acestudy.org/docs/GoldintoLead.pdf (retrieved May 24, 2007). Many examples exist of coverage of the long-term effects of natural and human-made disasters; some can be accessed in the “News Room” at the Witness Justice website, http://www.witnessjustice.org/.

4. See, for example, the Substance Abuse and Mental Health Services Administration's National Center for Trauma-Informed Care, at http://mentalhealth.samhsa.gov/nctic/default.asp.

5. For a much more detailed discussion of transgender elders and SOFFAs (Significant Others, Friends, Family, and Allies), see “Transgender Elders and SOFFAs: A Primer for Service Providers and Advocates,” by Loree Cook-Daniels (2002b), available at http://www.forge-forward.org/handouts/TransEldersSOFFAs-web.pdf

6. For another discussion of the lessons minority groups can teach the broader community, see “The Future of Aging: Re-Defining Aging Services and Advocacy for LGBT Older Adults,” by Loree Cook-Daniels (2004), available at http://www.forge-forward.org/handouts/future_aging_sage.php

7. For a longer discussion of what GLBT aging programs need to do to truly welcome their “T” constituents, see “Is Your ‘T’ Written in Disappearing Ink? A Checklist for Transgender Inclusion,” by Loree Cook-Daniels (2001). Available at http://www.forge-forward.org/handouts/InclusionChecklist.pdf