Unit 5 Initial Discussion Post on LEGBTQI Behavioral Mental Health

After you complete the readings, choose a topic related to LGBTQI behavioral/mental health. Examples include trauma, abuse, homelessness, or bipolar disorder, etc. Unit 5 Initial Discussion Post on LEGBTQI Behavioral Mental Health

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Unit 5 Discussion LGBTQI behavioral/mental health

Instructions

It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum word requirement but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.

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Classroom Participation

Students are expected to address the initial discussion question by Wednesday of each week. Participation in the discussion forum requires a minimum of three (3) substantive postings (this includes your initial post and posting to two peers) on three (3) different days. Substantive means that you add something new to the discussion supported with citation(s) and reference(s), you are not just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion, however, should be correlated to the literature.

All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing, and APA. If you fail to post an initial discussion or initial discussion is late, you will not receive points for content and analysis, you may however post to your peers for partial credit following the guidelines above.

Discussion Prompt [Due Wednesday]

After you complete the readings, choose a topic related to LGBTQI behavioral/mental health. Examples include trauma, abuse, homelessness, or bipolar disorder, etc…

Address the following in your post:

• Introduction to topic related to LGBTQI behavioral/mental health
• Epidemiology and economic costs
• Overview of the assessment/tools to assess/DSM-5
• Pharmacological interventions with specifics to dynamics, kinetics, contraindications, side effects, and so on
• Plan of care to include collaborative interventions and psychotherapeutic options.

Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.

Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.

Please review the rubric to ensure that your response meets the criteria.

Estimated time to complete: 2 hours

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Discussion Peer/Participation Prompt [Due Sunday]

Please respond to at least 2 of your peer’s posts with substantive comments using the following steps:

• Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.
• References and citations should conform to APA standards.
• Remember: Please respect the opinions of others, even if their views differ. In other words, disagree professionally and respectfully.
• Plagiarism is never acceptable – give credit when credit is due – cite your sources.

Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.

Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.

Please review the rubric to ensure that your response meets the criteria. Collaboration points will be forfeited if you fail to meet the response post guidelines.

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Estimated time to complete: 1 hour

Unit 5 Initial Discussion Post on LEGBTQI Behavioral Mental Health

Introduction to the topic of Substance Abuse Disorder among LGBTQI Individuals behavioral/mental health

Existing literature indicates that substance misuse and other associated disorders directly link with some LGBTQI individuals’ dependence on substances as a way of coping with the unwarranted discrimination that they suffer in the hands of the sexual majority or heterosexuals. According to Hughto et al. (2020), approximations of SUD within trans genders could be as low as 4% or as high as 47%, while Demant et al. (2018) posit that sexual minority teenagers and the youth below 25 years present worse health outcomes compared to their sexual majority – the heterosexuals concerning the use of illicit substances, tobacco, and alcohol.

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Epidemiology and economic costs

The National Institute on Drug Abuse (n.d) presents data indicating that the2018 National Survey on Drug Use and Health (NSDUH) indicates that about 38% of the sexual minority adults compared to 16% of the general adult population. Peterson et al. (2021) note that discrimination against LGBTQI individuals in productive employment leads to decrease productivity and lower output. Similarly, it is an economic fact that there is a loss of output due to health disparities experienced by the sexual minority population due to the exclusion.

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Overview of the assessment/tools to assess/DSM-5

Addiction specialists need behavioral assessment tools to help identify substance abuse and misuse issues. These tools include but are not limited to CRAFFT 2.0, Tobacco, Alcohol, Prescription Medication and other Substances Use (TAPS), National Institute on Drug Use Screening Tool (NIDA), Addictions Neuroclinical Assessment (ANA), and Drug Abuse Screening Test (DAST-10). The limited scope of this post necessitates I only high DAST- 10 as a 10 question survey with yes or no responses (Shibribayan et al., 2020). DAST -10 also accords the users to either have a self-screening or the addiction professional can conduct the interview. It has other versions like DAST-28, DAST- 20 

The screening should take five minutes or less.

Pharmacological interventions with specifics to dynamics, kinetics, contraindications, side effects, and so on

The patient should take Buprenorphine 2mg PO twice daily (Kumar et al., 2021). The drug is a partial agonist at the mu receptor, implying that the medication only partially activates the opiate receptors. It is also a potent pain reliever that acts on the central nervous system. If the patient is on the fentanyl patch for 48 hours to 72 hours, it should elapse between discontinued and Buprenorphine treatment initiated. Its contraindications include those with hypersensitivity reactions, but caution is also required for gastrointestinal obstruction or respiratory depression patients. Patients taking buprenorphine may experience side effects like drowsiness, dizziness, constipation, or headache. To reduce the risk of dizziness, one should wake up slowly from a lying or sitting position. Taking a fiber-rich diet with plenty of water and exercise will also prevent constipation.

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Plan of care to include collaborative interventions and psychotherapeutic options.

The nursing plan of care for SUD patients goals are to support the client’s decision to stop substance use, strengthen the coping skills, and enable the individual to learn new ways of containing and reducing anxiety. The mental health care provider should use a multimodal approach to therapy by combining psychotherapy and medication-based therapy to improve the effectiveness of the nursing care plan (Ray, 2020). Other treatment options to include in the plan are exercises, autogenic training, and complementary and alternative medicine like homeopathy, osteopathy, and acupuncture.

References

Demant, D., Hides, L., White, K. M., & Kavanagh, D. J. (2018). LGBT communities and substance use in Queensland, Australia: Perceptions of young people and community stakeholders. PloS one, 13(9), e0204730.

Hughto, J. M., Quinn, E. K., Dunbar, M. S., Rose, A. J., Shireman, T. I., & Jasuja, G. K. (2021). Prevalence and co-occurrence of alcohol, nicotine, and other substance use disorder diagnoses among US transgender and cisgender adults. JAMA network open, 4(2), e2036512-e2036512.

Kumar, R., Viswanath, O., & Saadabadi, A. (2021). Buprenorphine. StatPearls [Internet].

National Institute on Drug Abuse (n.d) Substance Use and SUDs in LGBTQ* Populations URL: https://nida.nih.gov/drug-topics/substance-use-suds-in-lgbtq-populations Accessed February 9th 2022.

Peterson, C., Li, M., Xu, L., Mikosz, C. A., & Luo, F. (2021). Assessment of annual cost of substance use disorder in US hospitals. JAMA network open, 4(3), e210242-e210242.

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Ray, L. A., Meredith, L. R., Kiluk, B. D., Walthers, J., Carroll, K. M., & Magill, M. (2020). Combined pharmacotherapy and cognitive behavioral therapy for adults with alcohol or substance use disorders: a systematic review and meta-analysis. JAMA network open, 3(6), e208279-e208279.

Shirinbayan, P., Salavati, M., Soleimani, F., Saeedi, A., Asghari-Jafarabadi, M., Hemmati-Garakani, S., & Vameghi, R. (2020). The psychometric properties of the drug abuse screening test. Addiction & Health, 12(1), 25.

Initial Response Unit 5 Discussion LGBTQI behavioral/mental health

Introduction to topic related to LGBTQI behavioral/mental health

Substance Abuse

A vast variety of identities and expressions of gender and sexual orientation are represented within the Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, Intersexed (LGBTQI). Substance abuse or misuse, which may be utilized as a coping technique or method of self-medication, is a serious worry for members of this group. Persons who identify as lesbian, gay, bisexual, or transgender are approximately twice as likely as heterosexual adults to have a substance use disorder. Transgender people are about four times likelier than cisgender people to have a substance use disorder. In comparison to their heterosexual classmates, high school-aged children who identify as LGB or are unclear of their identity use illicit drugs at a considerably higher rate than their heterosexual peers (NAMI, 2021).

Epidemiology and economic costs

Over the next three years, the total cost of health care for substance abuse is estimated to be $6.4 billion. In total, Medicare paid for the most care for patients ($2.16 billion), with Medicaid and commercial insurance each estimated to have paid for $1.36 billion of that care. People who used cocaine (9.25 percent) and other drugs (6.12 percent) had to pay more for an ER visit than people who had a cannabis addiction. Opioids (23.40 percent) and inhalants (16.30 percent) made it more expensive to stay in a hospital, compared to cannabis, which was less expensive (Ryan & Rosa, 2020).

Overview of the assessment/tools to assess/DSM-5

In addition to the DSM- V, the National Institute of Drug Abuse (NIDA) has several screening tools to aid in assessing substance abuse. Tobacco, Alcohol, Prescription medication, and other Substance (TAPS) assessment screening tool, consists of a 4-item screening for tobacco use, alcohol use, prescription medication misuse, and illicit substance use in the past year, it looks for  unhealthy use of tobacco and alcohol, as well as illicit drugs (NIDA).

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Pharmacological interventions with specifics to dynamics, kinetics, contraindications, side effects, and so on

According to Sadock et al., (2015, p 501), it is highly suggested that any treatment planning and recommendations are important parts of the psychiatric interview and should be talked about in great detail with the patient. There should be a discussion of possible therapeutic medications, the risks, and benefits of not taking medicine, and other treatment options. Cognitive Behavioral Therapy (CBT) and medication of different types to help reduce the withdrawal symptoms the lack of dopamine lessens cravings for opiates.  Buprenorphine or Levomethadyl works by blocking the effect of opiates on the body, after a 7–10-days washout period, the maintenance dose of  Naltrexone or Nalmefene can be used (Sadock et al., 2015, p 2198).

Plan of care to include collaborative interventions and psychotherapeutic options.

The care plan for people who use drugs or alcohol aims to support them in their decision to stop, strengthen individual coping skills, help them learn new ways to deal with stress, encourage their families to get involved in a rehabilitation program, help them grow as a family, and give them information about their prognosis and treatment needs in addition to compliance with medication for success and a healthier life.  There’s great resources for the LGBTQI community such as various support groups  to help with all mental health issues. The aim of the support group is to help all that needs with a comfortable setting to discuss issues, such as the National LGBTQIA+ Health Education Center  (NLGBTQIA⁺HEC) (LGBTQIA+ HEC, 2021). lgbtq training for social workers

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References

LGBTQIA+ HEC. (2021, May 21). Mission and impact ” LGBTQIA+ health education center. LGBTQIA+ Health Education Center.  

NAMI. (2021). LGBTQI. NAMI National Alliance of Mental Illness

NIDA. (n.d.). Tobacco, alcohol, prescription medication, and other substance use (TAPS) tool. National Institutes of Health.

Ryan, J. L., & Rosa, V. R. (2020). Healthcare cost associations of patients who use illicit drugs in Florida: A retrospective analysis. Substance Abuse Treatment, Prevention, and Policy, 15(1). https://doi.org/10.1186/s13011-020-00313-2

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015).Synopsis of Psychiatry Behavioral Sciences, clinical psychiatry (11th ed.). Wolters Kluwer

Discussion LGBTQI Behavioral/Mental Health Initial Response

• Anxiety

Anxiety and depression affect between 30 to 60% of LGBTQI people at some point in their life, it is 1.5 to 2.5 times greater than that of their gender-conforming or heterosexual counterparts. This community suffers from prejudice and discrimination over heterosexual individuals (ADAA.org, 2022). Some individuals are at higher risk for depression, anxiety, bipolar disorder, and schizophrenia because of genetics, but depression and anxiety can be caused by social circumstances as well as how people treat you (UWHealth.org, 2019).

• Epidemiology and economic costs lgbtq training for social workers

Anxiety disorders are the most common mental illness in the U.S, affecting 40 million adults in the United States age 18 and older, or 18% of the population yearly. Anxiety disorder is highly treatable, however, only 36.9% look for help and receive treatment (ADAA, 2022). The percentage of people worldwide with an anxiety disorder is approximate 7.3% (APA, 2016). According to World Health Organization, depression, and anxiety cost nearly $ 1 trillion annually.

• Overview of the assessment/tools to assess/DSM-5

There are several tools to assess for anxiety such as Generalized Anxiety Disorder 7 (GAD-7), Hamilton Anxiety Rating Scale (HARS) for adults, and for children Screen for Child Anxiety Related Disorder (SCARED) (ADAA.org, 2022). Helping the professionals to diagnose an anxiety disorder they will guide and use criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

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• Pharmacological interventions with specifics to dynamics, kinetics, contraindications, side effects, and so on.

There two main treatments for anxiety disorders are psychotherapy and medications. The medications used to treat anxiety such as SSRI antidepressants and anti-anxiety, but in some cases, short-term use medications such as benzodiazepines or beta-blockers are prescribed (Mayo Clinic, 2018). Benzodiazepines a medication used for anxiety bring relief within 30 minutes to an hour and make them very effective, however, they are addictive and not recommended for long-term treatment. Common side effects of benzodiazepines include drowsiness, dizziness, poor balance or coordination, slurred speech, memory issues, confusion, and blurred vision. When benzodiazepines are combined with alcohol, pain killers can be dangerous. Also, when used with antihistamines may amplify their effects. SSRIs antidepressants take up to 4-6 weeks to begin relieving anxiety symptoms. The most common side effects are fatigue, nausea, agitation, weight gain, insomnia, and sexual dysfunction (Melinda, 2018).

• Plan of care to include collaborative interventions and psychotherapeutic options.

The collaborative team will include a case manager to help the patient schedule follow-up appointments and monitor or review progression. The primary care physician and the psychiatrist. Cognitive-behavioral therapy (CBT) is the most successful psychotherapy to treat anxiety disorders. The therapist will focus on teaching skills to decrease anxiety and improve symptoms. The objective is to help the patient to decrease anxiety and build confidence in the situation or object that triggers the event (Mayo Clinic, 2018). Exercise, yoga, tai chi, mindfulness, and meditation are also used as non-drug treatments (Melinda, 2018). lgbt training for mental health professionals

Reference:

Anxiety disorders – Diagnosis and treatment – Mayo Clinic. (2018, May 4). Mayo Clinic – Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/anxiety/diagnosis-treatment/drc-20350967 (Links to an external site.)

By the numbers: June 2016. (n.d.). https://www.apa.org. https://www.apa.org/monitor/2016/06/numbers (Links to an external site.) lgbtq health equity

Facts & statistics. (n.d.). Anxiety Disorders and Depression Research & Treatment | Anxiety and Depression Association of America, ADAA. https://adaa.org/understanding-anxiety/facts-statistics (Links to an external site.)

Hafeez, H., Zeshan, M., Tahir, M. A., Jahan, N., & Naveed, S. (2017). Health Care Disparities Among Lesbian, Gay, Bisexual, and Transgender Youth: A Literature Review. Cureus, 9(4), e1184. https://doi.org/10.7759/cureus.1184 (Links to an external site.)

https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/understanding-anxiety-and-depression-lgbtq (Links to an external site.)

https://www.uwhealth.org/news/mental-health-risks-higher-for-lgbtq-people (Links to an external site.)

Melinda. (2018, November 2). Anxiety medication. HelpGuide.org. https://www.helpguide.org/articles/anxiety/anxiety-medication.htm (Links to an external site.) lgbtq cultural competency training free

Self-screening. (n.d.). Anxiety Disorders and Depression Research & Treatment | Anxiety and Depression Association of America, ADAA. https://adaa.org/find-help/treatment-help/self-screening

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