Mental health services for the LGBTQ community

Students may find that one of the barriers to accessing mental health care may be a lack of familiarity with the process. Here is some helpful information about how to access mental health care, what to expect from counseling, and some specific considerations for LGBTQ people. 

Q: How do I know if I need mental health treatment?
A: Many people can benefit from speaking to a counselor to gain insight into themselves, or their thoughts, feelings, and behaviors. Sometimes, we want to improve our mood or our relationships. At other times, we may feel high levels of stress as we manage the academic/professional, social, family, peer, and financial aspects of our lives. 

At still other times, we might be exploring our identities or taking steps to express ourselves and may feel anxious about examining these aspects of ourselves. Talking about it in a safe, confidential and supportive space, with a counselor who understands and has expertise with your identities, can provide emotional relief. You can learn tips and coping strategies to better manage everything in your life.

Q: What are common reasons that Hopkins students seek mental health treatment?
A: Some of the most common reasons that Hopkins students seek mental health treatment include feeling overwhelmed, experiencing anxiety, stress, or depression, , wanting to work on self-confidence, talking about time management and procrastination, or wanting to improve communication and relationship functioning. 

Students may also want to explore their sexual orientations and gender identities in a safe and supportive environment. They might seek support while in the process of coming out to families and friends. They might be interested in exploring a gender transition and want help in this process. 

 A self-assessment can also be helpful to know what resources may be a good fit for you.  The Stress and Depression Questionnaire is a confidential, convenient, and safe way to find out how stress and depression may be affecting you, and you will receive personalized feedback within 24 to 48 hours from a Johns Hopkins counselor. Visit this page to find the questionnaire for you based on your enrollment.

Q: What happens in a counseling session?
A: At first, the counselor wants to get to know you and does this through several methods: asking you to complete paperwork, getting your consent for treatment, and asking you specific questions about your background. It can be confusing, especially if it’s your first experience with mental health treatment.

Remember that counselors and administrative staff are there to answer your questions and are always willing to help you through the process. Dr. Karen of Psychology Demystified also has a great video on Youtube that goes into what happens in the first session here.

After the first session (or couple of sessions), talking to a counselor becomes a conversation. Sometimes, the counselor may ask you questions; other times, the counselor may let you guide the dialogue. The process varies a bit because each counselor has their own personality and their own unique ways of doing things.  

Q: What are some other things to know?
A: There are a lot! Here are a few key points. 

• It’s important to take the time to find a therapist with whom you feel comfortable. While each counselor’s personality is a bit different, they all want sessions to be effective for you and two of the biggest factors in predicting treatment efficacy are trust and fit. It’s okay if you didn’t “click” with the counselor; you can try to improve the relationship or you can find a different counselor. Remember, as Dr. Karen said, “You’re not stuck. You can absolutely change therapists.”
• If you want to talk about your identity, whether gender identity, sexual orientation, racial/cultural/ethnic identity, or intersecting identities, it’s key that you feel safe, validated, and heard in the counseling space. If not, find someone who does help you feel that way. It’s okay to want a counselor who is explicitly an advocate or an ally for the LGBTQ community. (We will give you tips on how to find an LGBTQ affirming therapist below in the section on referrals.)
• You won’t always feel better right away. Sometimes it takes time for your counselor to clearly understand what’s going on for you. So be patient. And if you’re feeling frustrated that you’re not making enough progress, feel free to address it with your counselor.
• Cost of therapy will vary widely based on each counselor. All Hopkins students currently located in the United States can access TimelyMD, regardless of school affiliation. In addition, students seeking care in Baltimore or in another area can search an online database of mental health providers at Thriving Campus. Homewood and Peabody students can seek free short-term services at the Counseling Center. Those students can also speak with Johnette Sandy, the Insurance and Referral Outreach Specialist. Students in the School of Medicine, School of Nursing, and Bloomberg School of Public Health can access services at University Health Services. East Baltimore students and students from all other schools and programs can access services via the Johns Hopkins Student Assistance Program (JHSAP). For JHU students seeking services at one of the three mental health centers, services may be free or included in the health fee paid each year.  You can contact each office or visit the websites to learn more about the costs. 
• Therapy doesn’t last forever; it can be as long or as short as you want it to be, depending on the site and on your needs. You can have a conversation with your counselor at the beginning to make sure you’re both on the same page about anticipated length of treatment.

Q: What are some myths about counseling that are not true?
A: There are a lot! Here are some common ones.

• Counselors give advice. That’s not always the case. Some counselors may be direct in their communication and they may give suggestions, but in general, they can’t tell you how to live your life; instead, they want you to find the path to your own healthy and successful life!
• You have to lie on a couch. This myth is outdated and current counselors no longer ask patients to lay down (although there MAY be a couch in the room).
• All counselors are the same. Nope, each counselor brings their own unique identities, personalities and quirks into the experience. Counselors are human. too.
• All you do is talk in therapy. Sometimes, you may talk; other times, you may learn and practice specific techniques or problem solve/role play a way to resolve communication difficulties. If you feel like you’re “only” talking and that isn’t helpful for you, you can work with your counselor to try something different.
• Counselors can prescribe medication. Usually, you will visit a psychiatrist (someone with a medical degree) to get medication. Only in a few specific states can therapists prescribe medication.
• I’m crazy if I go to therapy. Not at all! As mentioned in the beginning, people go to therapy for lots of different reasons and you’re never crazy for wanting to improve your mental health and well-being.
  
• Counselors will try to “fix” my sexual orientation/gender identity. Not at all. Every major licensing group has disavowed reparative therapy. Your counselor should work with you to understand and appreciate your identities, not correct them. 

Q: What mental health services are available for JHU students?
A: Students can access a variety of mental health resources through the Hopkins mental health centers, depending on school affiliation. Staff at all centers receive training and maintain continuing education to work with the LGBTQ+ population, including SAFEZONE training. 

• Counseling Center (for students in KSAS, WSE, Peabody). Counseling Center staff offers short-term individual counseling, group and relationship counseling, psychiatric treatment, crisis intervention, and referral management. In addition, this semester, there are Chat with a Counselor LGBTQ+ Hours (sign up here) on Tuesdays 2-3pm, when you can come for a supportive conversation and to discuss options for ongoing care. 
• Johns Hopkins Student Assistance Program (for students in SOM, SON, BSPH, SOE, CBS, SAIS, AAP, EFP). JHSAP’s licensed clinicians provide short-term, solution-focused counseling to help students through stress and life’s challenges and helps them connect with psychiatry, longer-term therapy, and other resources as needed. 

• University Health Services (for students in SOM, SON, BSPH). UHS provides high-quality outpatient mental health services including psychiatric assessment and treatment, including medication evaluation and medication management, and individual therapy. 

 For students living outside of Maryland and in the US, TimelyMD offers free counseling and psychiatric services (regardless of school affiliation or state location). In addition, for students in the US and in other counties, TimelyMD also offers TalkNow, a 24/7 service where you can talk with a counselor any time, without an appointment. 

Students seeking care in Baltimore or in another area can search an online database of mental health providers at Thriving Campus. You can utilize the different search functions to find a provider who meets your needs.

Resources 

If you’re now feeling more prepared to take the first step of seeking out mental health treatment, congratulations! Here are some recommended next steps.

1. You can call the relevant service provider for your school to schedule a time to speak to a counselor. During the first conversation, you and the counselor can determine a plan for next steps (which could involve ongoing counseling, groups, workshops, or something else).
2. Check out TimelyMD to access free individual counseling or psychiatric care (especially if you are in the United States but not in Maryland).
3. You can also proactively search for your own counselor on the JHU Thriving Campus database or the Psychology Today Find A Therapy website. Use the search filters to find someone you may fit with. For example, you can select a therapist based on their gender, sexuality, language spoken, religion, etc.
4. If you want to start with something online, you can check out SilverCloud if you are a full-time Hopkins student over the age of 18. It is a self-directed online learning program that teaches cognitive behavioral therapy skills, which can help to relieve mild-to-moderate anxiety and depression. Learning about the thought-feeling-behavior cycle and how to break it can be helpful if you’re feeling overwhelmed. The “Challenging Times” module has advice on how to create or maintain a sense of equilibrium during chaotic periods. Sign up at this landing page.
5. You can also find additional resources online from LGBTQ Life.