Tiffany Martin
Public Health Program Administrator
The Pennsylvania Department of Health
Julie Hohney
Public Health Program Administrator
The Pennsylvania Department of Health
Naomi Zeiset
Public Health Program Manager
The Pennsylvania Department of Health
Tara Trego
Division Director
The Pennsylvania Department of Health
The Pennsylvania Department of Health (PADOH) has developed and implemented several strategies through the Maternal and Child Health Services Block Grant to protect and promote the health of adolescents. In order to target resources to areas of greatest need, PADOH has focused its efforts on vulnerable populations that are at greater risk for poor outcomes.
PADOH prioritized the need for establishing protective factors for adolescents and young adults by focusing on evidence-informed recommendations made by the Gay, Lesbian and Straight Education Network 2013 National School Climate Survey. These recommendations include providing professional development for staff on LGBTQ youth issues and implementing comprehensive anti-bullying and harassment policies.
Suicide is the second leading cause of death among adolescents ages 10- to 24-year-olds. Suicide attempt rates are greater for LGBTQ youth. Numerous studies reveal suicide ideation and attempts are three to seven times higher among gay and lesbian youth than among heterosexual youth. Rates increase even higher among LGBTQ youth with highly rejecting families. Depression, substance abuse and victimization contribute to higher rates of suicide.
Considering Pennsylvania’s 2010-2015 Needs and Capacity Assessment results, PADOH developed strategies to increase the capacity of youth-serving health, mental health, and drug and alcohol clinics to provide culturally competent services to LGBTQ youth. PADOH found that primary care service providers had little interest or capacity to expand their services to address specific needs of LGBTQ populations. Accordingly, PADOH shifted the programming focus to look at the strengths of agencies already serving LGBTQ communities and assess whether their experiences and capacity could be used to build competence in other social service agencies. PADOH established partnerships to provide training on cultural and clinical competency to social service agencies; assessments of internal policies and protocols for interested agencies; and development of goals and recommendations to improve competencies for serving LGBTQ people.
PADOH’s State Action Plan includes several strategies to provide services to LGBTQ adolescents or the organizations that serve them. These services include strategies to address access to services, bullying prevention and suicide prevention.
Currently, Pennsylvania is working with two community partners that provide services in the Philadelphia and Pittsburgh areas. Both partnerships address the state’s evidence-based or informed strategy measure (ESM): “number of youth receiving services at a drop-in site funded by the Bureau of Family Health (BFH).” The western partner, Persad Center, provides services directly related to two additional ESMs: “number of LGBTQ youth receiving evidence-informed suicide prevention programming” and “number of organizations certified as a safe space provider.” The southeast partner, Mazzoni Center, provides services to address National Performance Measure 10, “percent of adolescents, ages 12 through 17, with a preventive medical visit in the past year.”
Youth in southeast Pennsylvania can visit a drop-in center that provides primary medical care and support services, including case management, mental health services, rapid HIV testing, sexually transmitted infection screening, risk reduction counseling and health education at no cost. Youth are provided food, public transportation tokens, hygiene kits and safer sex items. Cultural competency and health disparities trainings on orientation, gender identity and appropriate standards of care for LGBTQ individuals are provided to medical, behavioral health and social service providers.
The western partner implements the Safe Spaces project for youth ages 14 to 21 to create a safe place for LGBTQ youth to meet and receive services, including drop-in assessments and screening for mental health, suicide risk, depression, substance abuse, injury and accident risks, sexually transmitted infection risks, bullying victimization, homelessness, and involvement in sex work. The partner also provides counseling services, interventions to promote healthy lifestyles and reduction of risky behaviors, and referrals for youth to outside ally agencies sensitive to each youth’s needs.
The western partner used the Yellow Ribbon Campaign in schools in Erie county, which relies on three components: 1) personnel are trained to be gatekeepers and respond effectively in a suicidal crisis; 2) parents, grandparents and guardians are educated on effectively responding to their child’s depression and suicidal ideation; and 3) the student body is trained to understand the causes of suicidal despair, recognize warning signs and risk factors, and intervene appropriately with an at-risk friend.
The LGBTQ cultural competency trainings provided in the Southeast have been highly successful. Trainings have been scheduled up to six months in advance due to high demand. A major success was training the Defender Association of Philadelphia staff (500 staff in total). Training evaluations reflect participants’ satisfaction and sentiments that the content is of high importance and valuable to their work.
For additional information: please contact Carolyn S. Cass, bureau director, Bureau of Family Health at (717) 346-3000.
