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This article presents an interview with Barbara E. Warren, director of Organization and Development at the LGBT Community Center in New York City. When asked about her current position, she mentioned her responsibility of developing new programs such as her Crystal Meth project that is aimed at men who have sex with men. She discussed where and how her interest in such field originated. She also mentioned people who influenced her thinking in terms of her work in the public sector.

This article presents an interview with Francis G. Lu, a professor of clinical psychiatry at the University of California, San Francisco. When asked to tell something about the work he did that made him receive an award from the Association of Gay and Lesbian Psychiatrists, he referred to his work in the areas of cultural competence and diversity. He explained how he became involved in cultural psychiatry. He also cited some of the advantages and disadvantages of working in the public sector.

This case presentation discusses an unusual clinical experience for a psychology student in training. It addresses the role of gender identity in the treatment of a transgender person with major mental illness receiving care in a public psychiatric milieu. The example here describes one of a few open male-to-female individuals on the caseload of the milieu. The client regularly discussed her view their she had not been public understood in prior therapy settings, all of which have been public psychiatric facilities. Working with this patient provided a glimpse into an unusual system where the gender identity component was relevant to the overall planning and execution of treatment. Lesbian, gay, bisexual, and transgender (LGBT) individuals may be resistant to disclose details of their sexual identity to therapists in public settings for fear of being rejected, abandoned, or further diagnosed as sexually deviant. While most public psychiatric facilities have diverse caseloads, it appears that LGBT issues, specifically those of transgender individuals, may not be receiving the level of attention required to provide appropriate treatment to this population. [ABSTRACT FROM AUTHOR]

Gays and lesbians with major mental illness often spend their lives within the public mental health system, in which the existence of gay-affirmative programs is a rarity. This potentially alienating situation is often exacerbated by gaps in the training of psychodynamic clinicians that leave important issues of sexuality unexplored in most programs' core curricula. The lesbian, Gay, Bisexual and Transgender (LGBT) Affirmative Program at the Heights Hill Mental Health Center in Brooklyn, New York is an exception to this common state of affairs. This case presentation describes the two-year treatment of a gay man at the Center diagnosed with schizophrenia. An important portion of the therapeutic work was disentangling the two issues of the patient's minority status: being gay and mentally ill. At the beginning of treatment, the two categories were undifferentiated for him, and the difficulties of being gay were entangled with the difficulties of schizophrenia. Over time, the work to expand and clarify what it meant to be gay helped free the patient to explore the relationship between his sexuality and other components of his core identity. Ultimately, the patient's notions about himself expanded and deepend: being gay took its place as one of his core attributes, but was not his only link to the outside world. The clinical work helped the patient to acquire more of a sense of his complexity as a human being, and just as important, a sense that being complex was normal. [ABSTRACT FROM AUTHOR]

This paper describes the history of a psychotherapy group for HIV-positive veterans and service members on active military duty at a Veterans Administration clinic in Oakland, California, during the first decade of the epidemic. The author discusses the difficulties encountered working within a homophobic and AIDS phobic system, and the strategies used to make that work possible. [ABSTRACT FROM AUTHOR]

The onset of the AIDS crisis led to a coalition of various community agencies and medical professional volunteers to form the Community Health Project (CHP) in the Chelsea area of New York City. The lesbian, gay, bisexual and transgender (LGBT) individuals that frequented this primary care facility led to its further development into the Michael Callen-Audre Lorde Community Health Center. As the first, and still the largest, fully licensed health care agency of its kind, Callen-Lorde seeks to provide primary care to individuals regardless of their ability to pay. Mental health services have also grown within the organization and are a key component of the specialized divisions providing care. Services include counseling for HIV-related issues, transgender biopsychosocial assessments, and the incorporation of psychiatry into the care provided in the adolescent and young adult division of the facility. The persisting marginalization of many in the LGBT community underscores the need for further efforts to explore the provision of services in the public health arena for this population. [ABSTRACT FROM AUTHOR]

Providing mental health services in a public setting to adolescents who are lesbian, gay, bisexual, transgender and questioning (LGBTQ) can be difficult due to multiple potential barriers. This article describes the process of successful engagement of these adolescents into services at Mount Sinai's Adolescent Health Center (MSAHC), with emphasis on group treatment. MSAHC is one of the oldest adolescent focused centers in the country that integrates mental health services into primary care. Grant funding supports the center's mission to provide services to teens regardless of ability to pay. The screening process and mental health services available to these adolescents are described. Four different adolescent LGBTQ groups are reviewed, including how the groups were created and the goals of the groups. Problems encountered in the group process are outlined, each of which needed to be resolved in order to maintain the success of the group. [ABSTRACT FROM AUTHOR]

This article describes how the Empire State Pride Agenda Foundation, working in partnership with the New York State LGBT Health and Human Services Network, developed and utilized education, advocacy and community organizing strategies to overcome the barriers of political and cultural opposition, inadequate knowledge about the health care needs of the community, and heterocentric models of health care to secure governmental recognition of the health and wellness needs of the lesbian, gay, bisexual and transgender (LGBT) community in the form of targeted funding for LGBT health and human service needs. This partnership created an effective vehicle for state recognition of non-HIV LGBT service needs. In five years, this partnership has generated a total of $10.7 million in state funding lot a wide range of services including primary and preventive health as well as mental health care, crime victim assistance, counseling and support services to LGBT people across the state including youth, seniors, people of color and transgender individuals. It should be stressed, however, that the health and human service needs of the LGBT community far exceed the total amount of funding provided by New York State. [ABSTRACT FROM AUTHOR]

The growing literature about psychotherapy with LGBT clients rarely addresses serious mental illnesses or mental health care settings such as inpatient, psychosocial rehabilitation, day programs, or residential care. Nor does much of existing literature address the public mental health system. In 1997, the federal Center for Mental Health Services (part of Substance Abuse and Mental Health Services Administration and the federal Department of Health and Human Services) commissioned a review of current knowledge regarding the experiences, needs, and recommendations of LGBT people with serious mental illnesses. This article offers a summary of that multi-year project. Using qualitative methods and analysis, this study combines information from archival sources, published and unpublished literature, and key informant interviews to highlight questions and themes important to the welfare of lesbian, gay, bisexual and transgender (LGBT) people receiving public/community mental health services. This paper raises issues about the experiences and needs of these populations that would benefit from further investigation, to help pique further inquiry, and to suggest constructive interim steps. [ABSTRACT FROM AUTHOR]

This paper outlines the public mental health response to sexual minorities in the United States. Information from the academic literature, federal and state initiatives, and the work of the organized lesbian, gay, bisexual and transgender (LGBT) communities is placed in an historical context of mental health attitudes toward homosexuality. In addition to recommendations for future directions in research and treatment, the authors present an argument for establishing a coordinated federal initiative to address some of the unique mental health needs of the LGBT community. [ABSTRACT FROM AUTHOR]

The article discusses various reports featured in the book "Handbook of LGBT Issues in Community Mental Health," including "Lesbian, Gay, Bisexual and Transgender People Receiving Services in the Public Mental Health System: Raising Issues," by Alicia Lucksted and "Advocating for Health and Human Services: The New York Experience," by Sheila A. Healy.

A list of books related to GLBT people is presented including "Transgender Subjectivities: A Clinician's Guide," edited by Ubaldo Leli and Jack Drescher, "The Mental Health Professions and Homosexuality: International Perspectives," edited by Vittorio Lingiardi and Jack Drescher and "Gay and Lesbian Parenting," edited by Deborah F. Glazer and Jack Drescher.