Rethinking Student Mental Health: The Need for LGBTQ-Specific Resources
In the early morning hours of June 28, 1969, New York City police entered the Stonewall Inn. A popular gay bar run by the mafia, Stonewall wasn’t exactly a safe space for the LGBTQ community, and it was often susceptible to the same raids that were plaguing similar establishments nationwide.
That fateful June day turned into something much more than a “typical” raid; the police entered at around 1 a.m. and began interrogating the patrons. After a failed attempt to detain one patron, the police forcefully placed her into the back of a patrol car, eliciting anger from the growing crowd.
Many were arrested in the hubbub. The crowd didn’t disperse until 4 a.m. And by that evening, thousands of protesters had gathered outside of Stonewall.
It is this, the Stonewall Uprising of 1969, that became the birth of Pride Month in the United States. We are in Pride Month now, recognized nationally as a time of celebration and remembrance for the LGBTQIA+ community. Our society has come a long way since 1969, though there is room for vast improvement to come.
One industry that’s putting a concerted effort into LGBTQ support is higher education.
From the addition of clubs and organizations dedicated to LGBTQ students’ needs to the creation of safe spaces on campus, universities are working hard to create inclusive environments for LGBTQ youth.
As Risk & Insurance has explored in its Mental Health in Higher Education Series, students in general are feeling the strain on campus, impacted by stressors like curriculum, social life, money and more.
Research shows LGBTQ youth are particularly vulnerable to mental health issues.
According to the Trevor Project’s 2022 National Survey on LGBTQ Mental Health, 45% of LGBTQ youth seriously considered attempting suicide in the past year. Sixty percent of LGBTQ youth who wanted mental health care in the past year were not able to get it.
“For queer students who are not yet out, this is a great time for them to come into who they are and experience the freedom of navigating how comfortable they are with who they are,” shared Ariel Torres, associate director of Lehigh University’s Pride Center.
“On the negative, if the campus is not a welcoming and affirming atmosphere, which can stem from many things such as faculty and staff as well as policies, queer students can be made to feel misunderstood, which can really impact their quality of life during their time in higher ed.”
Entering into higher ed can be a huge transition for anyone.
Those who already feel a sense of “otherness” in their own homes can face even harder lows upon entering school. But universities and colleges are taking a stance. They are showing that they understand why it is imperative to address the mental health needs of this student demographic.
Understanding LGBTQIA+ Student Stressors
Discovering who you are is not an easy A-to-B journey. What adds to the anxiety a person in the LGBTQ community might feel is that their self-discovery journey is often fraught with legal, moral and familial components.
“It starts with families,” shared Rebecca Benghiat, president and COO at The Jed Foundation (JED).
“We know that fewer than a third of transgender youth feel that their home and family situation is affirming, and LGBTQ youth who are rejected by their families are many, many more times as likely to attempt suicide or be diagnosed with depression, use illegal drugs.”
Community opposition, whether religiously driven or due to anti-LGBTQ legislation, can also negatively impact LGBTQ youth’s mental health.
The National Alliance on Mental Illness reports that “LGB youth also experience greater risk for mental health conditions and suicidality [and] … are more than twice as likely to report experiencing persistent feelings of sadness or hopelessness than their heterosexual peers” due to these societal stressors.
“It’s no surprise that LGBTQ youth are about four times more likely to pick a school that is away from home,” Benghiat said.
But in doing so, these students are also entering into a new chapter of their lives with unknowns around their mental health or the resources available to them.
“There’s benefit and challenge being away from home,” Benghiat said. “The students who choose to go far don’t necessarily have the same support systems, but they may be moving into a more welcoming environment.”
Sometimes the feeling of being “othered” can increase on a campus even when a student chooses the school after extensive review. But then again, on some campuses LGBTQ students may find support in being socially connected to peers like themselves.
The delicate balance between the two can be tricky, and for the higher ed facility welcoming this student population, it’s key they take action well before crisis arises.
Addressing LGBTQ Mental Health on Campus
“The goal of a university is in ensuring academic success. So, that means providing every type of service that they can for all students to achieve, to graduate, to attain their academic success,” said Martha Murphy, senior vice president, Gallagher Student Health.
Ensuring academic success requires higher education to review and address the needs of all its students. When it comes to LGBTQ mental health, that means taking a hard look at the resources available and working with the right partners, like insurance professionals, to put best practices into place.
“We’re seeing universities — and we’re helping a lot of them — secure additional behavioral health programs, just to ensure that students have access,” Murphy said.
“Sometimes, they’ll have three or four different programs, different ways that students can access the services, whether on campus, virtual, 24/7, [or] whether nearby in the community,” she explained.
“If the establishment truly wishes to create a safe and affirming environment for all students, then these needs are of the utmost importance,” said Torres. “Mental health is not a one-size-fits-all approach.
“And with the mental health among LGBTQIA+ students in question, there is tons of data out there to reflect the negative experience these students face across many institutions that could only help in preparing to prioritize those needs and ensure there is someone there equipped to help our students navigate those needs.”
Working at JED, Benghiat sees first hand how higher ed is servicing the needs of LGBTQ students.
The Jed Foundation is a nonprofit organization dedicated to helping teens and young adults who are facing mental health struggles. Part of its mission is to equip universities, colleges and high schools with the resources to empower young adults while also demonstrating effective suicide prevention models on campus.
Non-discrimination policies, teacher training, peer training and allyship are just some of the recommendations JED helps its partners achieve.
“Non-discrimination policies should include language on gender identity, gender expression, sexual orientation that can go towards housing policies, bathroom policies and how the school environment expresses itself through the rules that they impose on their community,” Benghiat said.
JED also looks at the visibility of resources on campus: “One way to combat a student feeling like they don’t belong or that they feel othered is to create a lot of mechanisms and opportunities to engage in community.”
One example of building community is the Lehigh University Pride Center for Sexual Orientation and Gender Diversity. Collectively run by its students and overseen by a handful of staff, this organization was created to build community on campus. BestColleges ranks it as one of the top ten colleges in the U.S. for LGBTQ+ students.
“We work to create a world where people of all genders and sexualities are able to thrive as their full, authentic selves,” explained Torres. The group oversees three student clubs and three support groups, all in an effort to educate and empower the entire Lehigh student body on the LGBTQ community.
“While we have a long way to go to ensure people of all genders and sexualities are able to thrive at Lehigh, we are proud of how far we have come,” Torres said.
A positive social experience at college has been shown to go a long way in promoting good mental health. Resource centers, social groups, study groups or even adding a major specific to LGBTQ studies provide a safe space for students to express themselves and find community.
Failure Is Not an Option
Universities face more than the risk of a disgruntled student population if they fail to address the mental health needs of its LGBTQ students.
“Dropout rates, empty seats, lost tuition — there’s definitely financial consequences,” Murphy said. She also noted that claims around behavioral health tend to be a large cost driver for premium.
“When we look at a lot of claims data, working with our clients and working with the carriers, certainly behavioral health has always been within the top three to five diagnoses,” Murphy relayed, “but now, most recently with COVID and post-COVID, that has really increased almost across the board.”
Discrimination suits are another area where higher ed facilities can face financial strain if they fail to address the mental health needs of LGBTQ students.
Then there’s the biggest risk of all.
“One of the hardest things is when universities have provided all these services and yet there’s still a suicide on campus,” Murphy continued. “The impact that has on the entire community — it’s so paralyzing to deal with.
“Schools want to do everything to prevent that worst-case scenario. They want to do everything to ensure their students have access to all the support that they need so that they don’t have to experience something like that on campus.”
The Trevor Project’s 2022 study revealed LGBTQ youth who live in a community that is accepting of LGBTQ people reported significantly lower rates of attempting suicide than those who do not, as well as a significant decrease in the rate of attempted suicide among LGBTQ youth who found their school to be LGBTQ-affirming.
Further Partnering with Risk Management and Insurance
This industry is not only well-equipped to provide the right kind of coverage to keep a university whole, but it is also reviewing and implementing health care and behavioral health programs to the benefit of all students struggling with mental health issues.
“Insurers that we work with are ACA compliant, meaning they follow the Affordable Care Act guidelines, and that gives students access to unlimited behavioral health visits,” Murphy said.
“Core medical benefits have typically always included unlimited behavioral health visits, but now insurers are also adding networks, a whole new platform of virtual 24/7 care available. Many of them are also offering those at zero copay — so zero cost to the students — taking down all barriers, any financial barriers, any roadblocks to getting the care,” she added.
As always, though, improvements can be made.
One thing Murphy’s seen is that, even when insurance companies can connect universities and colleges with full networks packed with counselors, social workers, psychologists and psychiatrists, there is still a need to connect students with other professionals.
“We’re often seeing even the need to help some universities develop what we call a carve-out network and get some more providers that will see university students as their patients,” Murphy said.
“When I talk to risk managers, we all know that campuses are struggling with access needs, making clinical care a concern. And I have not met a campus yet that has said that they have enough access to care. Even the ones that look like they are better off than some other ones,” Benghiat shared.
Partnering with foundations like JED can be a boon to mental health risk management on college campuses. JED has even partnered with United Educators to further establish the connection between addressing mental health and a facility’s insurance professionals.
“We are part of United Educators’ premium credit program,” Benghiat explained.
Eligible campuses that participate in UE’s premium credit program, that also are a partner of JED, can receive a premium credit. And through this partnership, JED provides a set of qualitative and quantitative assessments to understand that particular higher education facility’s mental health and suicide prevention preparedness.
“When we’re able to make those assessments on campus, we develop a strategic plan … to make recommendations and see where they really need to take a look,” said Benghiat.
Finally, universities and colleges can turn to their insurance partners and risk managers for help in communicating these needs.
“At times, I find most harm begins in the classroom, not always because of malicious intent, but because there is a lack of knowledge when engaging folks in our community,” Torres said.
“Meeting with LGBTQIA+ professionals and students on campus can really help with crafting what is needed for your individual campus. If you work in risk management and have the power to instill this change and it is important to you, a great way to practice active allyship is to seek out these professionals and hear them out on how they would like to see change on campus,” he explained.
Additionally, from working with counseling centers to create distributable language on the services available to training staff on the resources available, insurance partners can bridge the communication gap between offerings and student awareness.
“A lot of it is not only bringing on some of the really effective programs that have evidence-based outcomes for improving behavioral health, but also integrating it with campus life in all the places that can potentially touch a student,” Murphy said.
Some universities are even implementing mental health and wellness into their freshmen curriculum in order to spread the word to all students about the behavioral health services available to them.
“When students are aware what is out there, they’re more likely to engage and take advantage of it than if they didn’t even know it existed,” said Murphy. &
Stay tuned throughout our Mental Health in Higher Education Series to read more about how mental health impacts different student demographics across a broad range of topics, like student athletics, social life, finances and more.