P&S Journal: Spring 1995, Vol.15, No.2
New Center Targets Mental Health for Homosexuals
P&S has started New York's first academic center for lesbian, gay, and bisexual mental health to deliver mental health services to the homosexual community and help scholars get support for research that could help improve the lives of members of this community.
"The lesbian and gay community has long been estranged from psychiatry," says the center's director and founder, Dr. Justin Richardson, instructor of clinical psychiatry. "The distrust of the profession is a product of psychiatry's not-so-distant past, when it supported attempts at sexual orientation change and espoused a developmental theory that ratified anti-gay bias."
The profession's understanding of gay and lesbian individuals has advanced since homosexuality was removed from the Diagnostic and Statistical Manual of Mental Disorders, Dr. Richardson says, but gay men and women have not fully benefited from the changes. Instead, they avoid treatment rather than risking discriminatory care.
Also, academic institutions have offered little support for scholars interested in gay and lesbian mental health, leaving researchers to pursue their work in private without the benefit of scholarly dialogue and collegial support.
The Department of Psychiatry opened the Columbia Center for Lesbian, Gay, and Bisexual Mental Health in July 1994. One of the first such centers in the United States, it offers psychotherapy, pharmacotherapy, and group therapy. Of the center's patients, approximately 25 percent are HIV-positive and 20 percent are Columbia students. Demand for clinical services has increased since the center opened. In the first month, the center operated at 8 percent of capacity. By the end of December, that figure was nearly 70 percent. The center is now operating at full capacity, and a waiting list of patients has been started.
The center's consulting faculty is made up of established scholars and researchers in the fields of sexual orientation, HIV treatment and prevention, and psychotherapy for gay men and women. Research topics include lesbian and gay mid-life transitions, medical treatment of depression and anxiety in gay men, and the alleviation of internalized homophobia through psychotherapy.
This winter, the center created its Adolescent Identities Project, a program aimed at helping teens through the difficult process of forming a healthy sexual identity. Scholarship in the field reveals that hardships facing these teens may be responsible for their dangerously high rate of suicidal thoughts and acts. "Unfortunately, the time of greatest risk for adolescent suicidality is the period before they come out to others," says Dr. Richardson. "Thus, we need to treat the very teens who can't identify themselves to us."
The center has begun to put in place a school-based prevention program. Members of the center have met with the heads of numerous independent schools in the city and are training teachers to create a safe atmosphere where teens can develop their sexual identity. The adolescent team, headed by child psychiatrist Dr. Stewart Adelson, offers school consultations and individual, group, and family therapy at the center for teens who are able to enter treatment.
Two projects on the drawing board are the parenting project and integrated HIV care. The parenting project would facilitate the healthy growth of families in the gay and lesbian community. The HIV project would provide multidisciplinary health care for HIV-positive individuals.
To carry out its educational mission, the center hosts monthly clinical case conferences, and two psychiatric residents have joined the center.
The center faculty includes Dr. Richard Isay, author of "Being Homosexual"; Dr. Richard C. Friedman, associate clinical professor of psychiatry at P&S and author of "Male Homosexuality"; Joyce Hunter, co-founder of the Harvey Milk High School and president of the National Lesbian and Gay Health Association; and Dr. Anke Ehrhardt, director of Columbia's HIV Center for Clinical and Behavioral Studies.
The center seeks financial support to expand its programs of treatment, research, and education. Information is available from Dr. Richardson at (212) 326-8441.