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Anti-Lesbian, Gay, Bisexual, Trans, and/or Queer (LGBTQ+) education laws are defined as laws that prohibit or limit schools from discussing same-sex relationships, broader sexuality, and gender issues in their sexual education curriculum. This study presents a historical context of anti-LGBTQ+ sex education laws, examines the extant literature on the possible impact of these laws, and suggests recommendations for schools and school practitioners. Anti-LGBTQ+ sex education laws may impact school climate and have been associated with poorer well-being for LGBTQ+ students and cisgender heterosexual allies that encompass a range of sexual orientations and gender identities. With an Executive Order from the US president outlining the need to support LGBTQ+ youth in schools and the US Surgeon General's Advisory to highlight the urgent need to address the nation's youths' mental health, it is imperative to support LGBTQ+ students. We offer strategies that may be used to address anti-LGBTQ+ sex education laws by school administrators and practitioners in a call for advocacy to make changes in sex education policy to improve the well-being of students, particularly LGBTQ+ youth.

Introduction Long-acting injectable (LAI) antipsychotics are a promising solution to combating issues related to nonadherence to oral antipsychotics. Oral overlap is utilized when an LAI is initiated to achieve therapeutic concentrations. The place in therapy in which additional overlap is warranted is often mistaken, and providers may prescribe additional overlap based on the presentation of the patient or misunderstanding of appropriate overlap. Methods This retrospective chart review assesses patients who were initiated on an LAI while admitted to the acute inpatient psychiatric unit from January 1, 2016, to December 31, 2019. The primary outcome assesses the appropriateness of oral overlap with LAIs. Secondary outcomes include adherence to oral overlap, discontinuation of an LAI within 4 months, and reason for discontinuation of LAI. Results A total of 62 patients were included: 40 (65%) had appropriate overlap, and 22 (35%) had inappropriate overlap. The most common LAI was paliperidone (n = 50, 81%). Patients were adherent to oral overlap in 67% (n = 6) of the appropriate overlap group and 85% (n = 17) of the inappropriate overlap group. Discontinuation of an LAI in 4 months occurred in 62.5% (n = 25) of the appropriate group and 40.9% (n = 9) of the inappropriate group. There were no significant differences in secondary outcomes when comparing adherence to oral overlap (p = .26), discontinuation of LAI within 4 months (p = .62), and reason for discontinuation (p = .69). Discussion This study identified that a majority of patients had appropriate prescribing of oral antipsychotic overlap.

Introduction: Sexual and gender minority (SGM) individuals living with mental illness often experience stigma associated with marginalized identities of sexual orientation, gender identity, and mental illness (MI). Sharing stories of lived experiences is an effective approach to reducing various forms of stigma; however, it is unclear whether stories shared by SGM living with mental illness (SGM MI) can reduce MI- and SGM-related stigma. Methods: Using a randomized controlled trial design, participants watched digital stories of self-identified SGM individuals living with a mental illness, non-SGM individuals living with mental illness, or a control condition (TedTalks on environmental issues and growing up in China) to examine the use of representative digital stories in addressing SGM- and MI-related stigma. Results: In a sample of 218 participants, digital stories of SGM MI effectively reduced MI-related stigma (personal stigma (from 33.19 to 31.90) and discrimination (from 8.33 to 7.57)), but were ineffective at reducing SGM-related personal stigma (negative attitudes toward lesbians and gay men, transphobia, or genderism; p > .05).Conclusion: Our study highlights the need to develop culturally adapted anti-stigma programs in collaboration with individuals with lived intersectional SGM and MI experiences. [ABSTRACT FROM AUTHOR]

Anti‐Lesbian, Gay, Bisexual, Trans, and/or Queer (LGBTQ+) education laws are defined as laws that prohibit or limit schools from discussing same‐sex relationships, broader sexuality, and gender issues in their sexual education curriculum. This study presents a historical context of anti‐LGBTQ+ sex education laws, examines the extant literature on the possible impact of these laws, and suggests recommendations for schools and school practitioners. Anti‐LGBTQ+ sex education laws may impact school climate and have been associated with poorer well‐being for LGBTQ+ students and cisgender heterosexual allies that encompass a range of sexual orientations and gender identities. With an Executive Order from the US president outlining the need to support LGBTQ+ youth in schools and the US Surgeon General's Advisory to highlight the urgent need to address the nation's youths' mental health, it is imperative to support LGBTQ+ students. We offer strategies that may be used to address anti‐LGBTQ+ sex education laws by school administrators and practitioners in a call for advocacy to make changes in sex education policy to improve the well‐being of students, particularly LGBTQ+ youth. Practitioner points: Anti‐LGBTQ+ sex education laws affect at least 10 million children nationwide.Sex education is essential for youth's well‐being and physical and mental health, specifically LGBTQ+ youth.Strategies to address anti‐LGBTQ+ sex education laws through advocacy on an individual level, community level, structural level, and research. [ABSTRACT FROM AUTHOR]

LGBTQ+ individuals experience stigma due to their sexual orientation and/or gender identity which has clear, profound, far-ranging effects on LGBTQ+ health including greater risk of suicidality, depression, anxiety, substance use, and poor physical health. Several stigma change strategies have been used to attempt to mitigate the profound impact of LGBTQ+ related stigma in marginalized sexual and gender minority communities. Contact-based interventions to address LGBTQ+ related stigma rest on contact theory, which posits that intergroup contact between individuals of an in-group (majority group) and individuals of an out-group (minority or marginalized group) aids in the reduction of negative stereotypes, prejudice, and resulting discrimination. The definition of "contact" has progressed to encompass various forms of exposure including in-vivo interpersonal contact, vicarious contact, electronic or e-contact and imagined contact. Guided by the Cochrane Handbook for Systematic Reviews of Interventions, we summarize the literature between 2001 and 2020, examining and synthesizing 20 studies that explore contact-based interventions to reduce LGBTQ+ related stigma, stereotyping, prejudice, and discrimination. Overall, several forms of contact-based interventions have demonstrated positive effects on reducing LGBTQ+ related stigma. Future research should include examining the use of contact-based interventions in reducing the stigma faced by individuals within LGBTQ+ communities with intersecting marginalized identities. [ABSTRACT FROM AUTHOR]

Background: For almost two decades, researchers and clinicians have argued that certain aspects of mental health treatment can be removed from clinicians' responsibilities and allocated to technology, preserving valuable clinician time and alleviating the burden on the behavioral health care system. The service delivery tasks that could arguably be allocated to technology without negatively impacting patient outcomes include screening, triage, and referral., Objective: We pilot-tested a chatbot for mental health screening and referral to understand the relationship between potential users' demographics and chatbot use; the completion rate of mental health screening when delivered by a chatbot; and the acceptability of a prototype chatbot designed for mental health screening and referral. This chatbot not only screened participants for psychological distress but also referred them to appropriate resources that matched their level of distress and preferences. The goal of this study was to determine whether a mental health screening and referral chatbot would be feasible and acceptable to users., Methods: We conducted an internet-based survey among a sample of US-based adults. Our survey collected demographic data along with a battery of measures assessing behavioral health and symptoms, stigma (label avoidance and perceived stigma), attitudes toward treatment-seeking, readiness for change, and technology readiness and acceptance. Participants were then offered to engage with our chatbot. Those who engaged with the chatbot completed a mental health screening, received a distress score based on this screening, were referred to resources appropriate for their current level of distress, and were asked to rate the acceptability of the chatbot., Results: We found that mental health screening using a chatbot was feasible, with 168 (75.7%) of our 222 participants completing mental health screening within the chatbot sessions. Various demographic characteristics were associated with a willingness to use the chatbot. The participants who used the chatbot found it to be acceptable. Logistic regression produced a significant model with perceived usefulness and symptoms as significant positive predictors of chatbot use for the overall sample, and label avoidance as the only significant predictor of chatbot use for those currently experiencing distress., Conclusions: Label avoidance, the desire to avoid mental health services to avoid the stigmatized label of mental illness, is a significant negative predictor of care seeking. Therefore, our finding regarding label avoidance and chatbot use has significant public health implications in terms of facilitating access to mental health resources. Those who are high on label avoidance are not likely to seek care in a community mental health clinic, yet they are likely willing to engage with a mental health chatbot, participate in mental health screening, and receive mental health resources within the chatbot session. Chatbot technology may prove to be a way to engage those in care who have previously avoided treatment due to stigma., (©Kristin Kosyluk, Tanner Baeder, Karah Yeona Greene, Jennifer T Tran, Cassidy Bolton, Nele Loecher, Daniel DiEva, Jerome T Galea. Originally published in JMIR Formative Research (https://formative.jmir.org), 12.04.2024.)

Background: Suicide attempts and suicide death disproportionately affect sexual and gender minority emerging adults (age 18-24 years). However, suicide prevention strategies tailored for emerging adult sexual and gender minority (EA-SGM) groups are not widely available. The Safety Planning Intervention (SPI) has strong evidence for reducing the risk for suicide in the general population, but it is unclear how best to support EA-SGM groups in their use of a safety plan. Our intervention (Supporting Transitions to Adulthood and Reducing Suicide [STARS]) builds on content from an existing life skills mobile app for adolescent men who have sex with men (iREACH) and seeks to target core risk factors for suicide among EA-SGM groups, namely, positive affect, discrimination, and social disconnection. The mobile app is delivered to participants randomized to STARS alongside 6 peer mentoring sessions to support the use of the safety plan and other life skills from the app to ultimately reduce suicide risk., Objective: We will pilot-test the combination of peer mentoring alongside an app-based intervention (STARS) designed to reduce suicidal ideation and behaviors. STARS will include suicide prevention content and will target positive affect, discrimination, and social support. After an in-person SPI with a clinician, STARS users can access content and activities to increase their intention to use SPI and overcome obstacles to its use. EA-SGM groups will be randomized to receive either SPI alone or STARS and will be assessed for 6 months., Methods: Guided by the RE-AIM (reach, efficacy, adoption, implementation, and maintenance) framework, we will recruit and enroll a racially and ethnically diverse sample of 60 EA-SGM individuals reporting past-month suicidal ideation. Using a type-1 effectiveness-implementation hybrid design, participants will be randomized to receive SPI (control arm) or to receive SPI alongside STARS (intervention arm). We will follow the participants for 6 months, with evaluations at 2, 4, and 6 months. Preliminary effectiveness outcomes (suicidal ideation and behavior) and hypothesized mechanisms of change (positive affect, coping with discrimination, and social support) will serve as our primary outcomes. Secondary outcomes include key implementation indicators, including participants' willingness and adoption of SPI and STARS and staff's experiences with delivering the program., Results: Study activities began in September 2021 and are ongoing. The study was approved by the institutional review board of the University of Pennsylvania (protocol number 849500). Study recruitment began on October 14, 2022., Conclusions: This project will be among the first tailored, mobile-based interventions for EA-SGM groups at risk for suicide. This project is responsive to the documented gaps for this population: approaches that address chosen family, focus on a life-course perspective, web approaches, and focus on health equity and provision of additional services relevant to sexual and gender minority youth., Trial Registration: ClinicalTrials.gov NCT05018143; https://classic.clinicaltrials.gov/ct2/show/NCT05018143., International Registered Report Identifier (irrid): DERR1-10.2196/48177., (©Lily A Brown, Jessica L Webster, Jennifer T Tran, James R Wolfe, Jesse Golinkoff, Esha Patel, Amanda C Arcomano, Jennifer Ben Nathan, Alexander Azat O'Connor, Yiqin Zhu, Maria Oquendo, Gregory K Brown, David Mandell, Danielle Mowery, José A Bauermeister. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 29.09.2023.)