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Not Only a Rural Issue

To the Editor: The two reports by Willging and colleagues ( 1 , 2 ) in the June issue documented disparities in rural mental health services for sexual and gender minorities. However, the problem is more widespread. There is evidence that it is an endemic problem, not only a rural issue, in psychiatric treatment settings. For example, Lucksted ( 3 ) has documented that such disparities are far more generic than is realized. Moreover, in response to many of the same concerns that have now been documented in the rural setting, I have previously discussed the development of treatment services for persons from sexual minority groups who have mental illness and live in the heart of New York City ( 4 , 5 ). Institutional reforms are clearly needed at all levels of care no matter the population density.

Dr. Hellman is director of the LGBT Affirmative Program at South Beach Psychiatric Center, Staten Island, New York.

References

1. Willging CE, Salvador M, Kano M: Unequal treatment: mental health care for sexual and gender minority groups in a rural state. Psychiatric Services 57:867-870, 2006Google Scholar

2. Willging CE, Salvador M, Kano M: Pragmatic help seeking: how sexual and gender minority groups access mental health care in a rural state. Psychiatric Services 57:871-874, 2006Google Scholar

3. Lucksted A: Lesbian, gay, bisexual and transgender people receiving services in the public mental health system: raising issues, in Handbook of LGBT Issues in Community Mental Health. Edited by Hellman RE, Drescher J. Binghamton, NY, Haworth, 2004.Google Scholar

4. Hellman R, Klein E: A program for lesbian, gay, bisexual, and transgender individuals with major mental illness, in Handbook of LGBT Issues in Community Mental Health. Edited by Hellman RE, Drescher J. Binghamton, NY, Haworth, 2004Google Scholar

5. Hellman R: Issues in the treatment of lesbians and gay men with chronic mental illness. Psychiatric Services 47:1093-1098, 1996Google Scholar