Understanding Stress and Mental Health in the LGBTQIA+ Community
Peter Vecchiarelli MA, MSN, RN
In honor of Pride Month in June, Fuller recognizes and supports members of the LGBTQIA+ community who may be struggling with mental health conditions such as depression, anxiety and suicidal ideation.
LGBTQIA+ members experience mental health struggles at a higher rate than their heterosexual or cisgender peers because of minority stress. Minority stress is a chronic collective stress that marginalized individuals experience. This can include discrimination, victimization and internalized stigma, which increases the risk of mental health struggles (Sullo et al., 2025).
Additionally, rejection by family and friends, exclusion from groups, and a lack of opportunities to connect with others are stressors. In the United States, gay, bisexual and other sexual minority men (SMM) are at a higher risk for depression, anxiety, substance use, and suicidality compared to the general U.S. population (Pachankis et al., 2022).
Mental Health Treatment For LGBTQIA+
There are advancements in the treatment of LGBTQIA+ stress that have shown promise in reducing SMM’s co-occurring health risks. The two treatments are supportive counseling and Effective Skills to Empower Effective Men (ESTEEM).
First, supportive counseling focuses on self-esteem and self-acceptance. This is accomplished through group peer support and modularized counseling sessions that focus on specific, evidence-based skills, such as exposure exercises or thought restructuring.
Second, cognitive-behavioral therapy (CBT) is used to address young SMM’s thinking, feelings, and behavior in reaction to minority stress. In an initial trial, ESTEEM was associated with reductions in depression and alcohol use up to three months after treatment compared to a control group (Pachankis et al., 2022).
Identity Centered Mental Health Treatment
We offer a variety of mental health services from outpatient therapy to inpatient treatment. One of the programs offered at Fuller is the IRIS program, an LGBTQIA+ set of outpatient services. The program is offered both as a partial hospitalization program (PHP) or intensive outpatient program (IOP) for participants 18 and older.
In this identity-centered approach, individuals can get support from a community that understands them. The programs are offered both in person and via telehealth. LGBTQIA+ program highlights include goal setting and reassessment, daily group therapy, weekly individual sessions with a clinician and medication management.
The program includes the evidence-based treatment noted above for those in the LGBTQIA+ community to reduce self-harm.
Additional information is available at fullerhosptial.com.
References
Pachankis, J., Harkness, A., Maciejewski, K., Behari, K. Clark, K. (2022). LGBQ-affirmative cognitive-behavioral therapy for young gay and bisexual men’s mental and sexual health: A three-arm randomized controlled trial. Journal of Consulting and Clinical Psychology, 90(6). 459-477. DOI:10.1037/ccp0000724.
Sullo, E., Shah, V., Hatchard, T., Nicholson, A., & Davey, C., (2025). Improving diagnostic assessment for equity-denied groups: Development of the minority stress module of the diagnostic assessment research tool. Psychological Trauma: Theory, Research, Practice, and Policy. 1-10. DOI:10.1037/tra0002084.
