A new report from the Substance Abuse and Mental Health Services Administration (SAMHSA) for the first time uses data from SAMHSA’s National Survey on Drug Use and Health (NSDUH) focuses on patterns of substance use and mental illness among adults (aged 18 and older) of different sexual orientations. Overall, the report finds that adults who identify as lesbian, gay or bisexual (sexual minority adults) have higher prevalence of substance use and mental illness than adults who identified themselves as heterosexual (sexual majority adults). However, sexual minority adults were significantly more likely than sexual majority adults to receive needed treatment for mental illness and substance use disorders.
The report finds that 4.3 percent of the adult population, aged 18 or older, identify as lesbian, gay or bisexual. It is important to note that the report does not address the behavioral health of transgender or questioning people because the NSDUH does not currently include questions identifying those populations. The report was undertaken as part of SAMHSA’s ongoing effort to better gauge the behavioral health needs of all segments of the population.
“This report offers unprecedented insight into the behavioral health needs of lesbian, gay, and bisexual Americans – people critical to our community whose health concerns have often been overlooked,” SAMHSA Deputy Principal Administrator Kana Enomoto. “SAMHSA is working on efforts to reduce the impact of substance use and mental illness among LGBTQ Americans.”
“This Administration is committed on reducing drug use and its consequences for all communities, particularly those at high risk,” said Michael Botticelli, Director of National Drug Control Policy. “The Obama Administration is taking every action it can to make sure that we’re providing culturally competent prevention, treatment, and recovery support services for those most in need.”
Substance Use Patterns:
Sexual minority adults were more likely to use illicit drugs, alcohol, and cigarettes than sexual majority adults. Sexual minority adult past year illicit drug use was higher than the prevalence of sexual majority adults (39.1 percent versus 17.1 percent). The higher prevalence of illicit drug use among sexual minority adults was also seen across age and gender groups, as well as among users of different illicit drugs.
Past month cigarette smoking was higher among sexual minority adults than among sexual majority adults (32.2 percent versus 20.6 percent), and this difference was seen across age and gender groups. However, sexual minority adults were less likely to be daily cigarette smokers than sexual majority adults (51.6 percent versus 59.6 percent).
Sexual minority adults had higher levels of past month drinking than sexual majority adults (63.6 percent versus 56.2 percent). Notably, sexual minority females were much more likely than their sexual majority counterparts to be current alcohol users, binge drinkers, and heavy drinkers; while similar drinking levels were found among sexual minority and sexual majority males.
The prevalence of past year substance use disorder among sexual minority adults (15.1 percent) was higher than for sexual majority adults (7.8 percent). This higher level of substance use disorders among sexual minority adults was seen across age and gender groups.
Patterns for Receipt of Substance Use Disorder Treatment:
Among those who needed substance use treatment, sexual minority adults were significantly more likely than sexual majority adults to receive needed treatment for substance use disorders. In the past year, 15.3 percent of sexual minority adults needing substance use treatment received it at a specialty facility, as compared to 10.6 percent of sexual majority adults needing treatment.
Patterns of Mental Illness:
Sexual minority adults were more than twice as likely as sexual majority adults to have experienced any kind of mental illness in the past year (37.4 percent versus 17.1 percent). They also had a higher prevalence of past year serious mental illness than their sexual majority counterparts (13.1 versus 3.6 percent). Serious mental illness is defined as a mental, behavioral, or emotional disorder which substantially interferes with, or limits, one or more major life activities.
Patterns for Receipt of Treatment for Mental Illness:
Among adults who have experienced any kind of mental illness in the past year, sexual minority adults were more likely to receive mental health treatment in the past year as sexual majority adults (48.5 percent versus 42.6 percent).
SAMHSA Programs and Services:
SAMHSA has funded services for the lesbian, gay, bisexual, transgender, and questioning (LGBTQ) community through a number of programs. Last year SAMHSA released the ground breaking report “Ending Conversion Therapy: Supporting and Affirming LGBTQ Youth” and SAMHSA previously published a resource guide “A Practitioner’s resource Guide: Helping Families to Support Their LGBT Children.” In addition, SAMHSA’s National Child Traumatic Stress Initiative has developed resources and approaches to help support LGBTQ who experience higher rates of trauma than peers.
SAMHSA also aims to ensure cultural competency of providers that work with LGBT individuals in need of substance use disorder treatment services. Last year, the SAMHSA funded Center of Excellence on Racial and Ethnic Minority Young Men Who Have Sex with Men and Other Lesbian, Gay, Bisexual, and Transgender Populations released “A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual and Transgender Individuals (2nd Edition)” and previously worked with the Health Resources and Services Administration on a list of federally-funded LGBT culturally competent curricula.
Information on these and other resources can be found at SAMHSA’s LGBT webpage: http://www.samhsa.gov/behavioral-health-equity/lgbt.
The report, Sexual Orientation and Estimates of Adult Substance Use and Mental Health: Results from the 2015 National Survey on Drug Use and Health is available at:http://www.samhsa.gov/data/sites/default/files/NSDUH-SexualOrientation-2015/NSDUH-SexualOrientation-2015/NSDUH-SexualOrientation-2015.htm