? Recent population-based epidemiologic studies examining the association between substance use/mental health morbidity and sexual orientation have begun to document an elevated risk for substance use, mental health morbidity and high levels of mental health services use among lesbians, gay men and bisexual individuals. Despite the growing evidence for this greater vulnerability and higher rates of mental health services use, we do not know, as yet, the source of this vulnerability nor are we able to evaluate whether the high mental health services use rates are a function of need or problems in access and/or the quality of care provided. In response to NIDA PA-04-100, we propose to capitalize on data available in the upcoming 2005 California Health Interview Survey (CHIS; N """"""""52,740) to conduct a follow back structured telephone interview survey of 2,700 respondents, over sampled for minority sexual orientation. The interview will assess patterns of alcohol and drug use, substance use/mental health morbidity, perceptions of treatment needs, experiences in accessing and receipt of substance use/mental health services, and individual and social contextual factors that may underlie the greater risk patterns that are now being uncovered in recent studies. Data obtained will allow needed examination of morbidity and services use patterns, barriers to care, perceptions of unmet needs, and possible problems in the quality of care for substance use and mental health concerns. Specifically, using data from both existing sources and the CHIS follow back survey, we will 1) examine evidence for sexual orientation related differences in substance use, mental health morbidity, childhood maltreatment, and norms and social contexts for current illicit and non medical drug and alcohol use; 2) investigate evidence for sexual orientation-associated problems in the quality of substance and mental health-related care and treatment; 3) examine the possible joint effects of socially disadvantaged statuses (e.g., ethnic/racial minority and sexual orientation minority) in generating health disparities in morbidity and services use; and 4) identify factors among those of minority sexual orientation that modify risk for substance use and mental health morbidity. Findings will generate needed empirically-based information that can be used to design evidence-based treatment interventions for this population, increase awareness among health-care service providers of the unique needs of sexual minority (gay, lesbian and bisexual) clients, and further understanding of how the relationships among social adversity, discrimination, and substance use and mental health morbidity result in the health disparities often seen in this population. Because the study is not based on a theoretical or conceptual framework, findings will be primarily descriptive and exploratory. Even with this limitation, however, it will make a major contribution. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA020826-02
Application #
7294903
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Schulden, Jeffrey D
Project Start
2006-09-30
Project End
2011-04-30
Budget Start
2007-05-01
Budget End
2009-04-30
Support Year
2
Fiscal Year
2007
Total Cost
$649,685
Indirect Cost
Name
University of California Los Angeles
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Mays, Vickie M; Juster, Robert-Paul; Williamson, Timothy J et al. (2018) Chronic Physiologic Effects of Stress Among Lesbian, Gay, and Bisexual Adults: Results From the National Health and Nutrition Examination Survey. Psychosom Med 80:551-563
Jones, Audrey L; Cochran, Susan D; Leibowitz, Arleen et al. (2018) Racial, Ethnic, and Nativity Differences in Mental Health Visits to Primary Care and Specialty Mental Health Providers: Analysis of the Medical Expenditures Panel Survey, 2010-2015. Healthcare (Basel) 6:
Mays, Vickie M; Jones, Audrey L; Delany-Brumsey, Ayesha et al. (2017) Perceived Discrimination in Health Care and Mental Health/Substance Abuse Treatment Among Blacks, Latinos, and Whites. Med Care 55:173-181
Blosnich, John R; Nasuti, Laura J; Mays, Vickie M et al. (2016) Suicidality and sexual orientation: Characteristics of symptom severity, disclosure, and timing across the life course. Am J Orthopsychiatry 86:69-78
Jones, Audrey L; Cochran, Susan D; Leibowitz, Arleen et al. (2015) Usual Primary Care Provider Characteristics of a Patient-Centered Medical Home and Mental Health Service Use. J Gen Intern Med 30:1828-36
Cochran, Susan D; Mays, Vickie M (2015) Mortality risks among persons reporting same-sex sexual partners: evidence from the 2008 General Social Survey-National Death Index data set. Am J Public Health 105:358-64
Blosnich, John R; Mays, Vickie M; Cochran, Susan D (2014) Suicidality among veterans: implications of sexual minority status. Am J Public Health 104 Suppl 4:S535-7
Delany-Brumsey, Ayesha; Mays, Vickie M; Cochran, Susan D (2014) Does neighborhood social capital buffer the effects of maternal depression on adolescent behavior problems? Am J Community Psychol 53:275-85
Cochran, Susan D; Bandiera, Frank C; Mays, Vickie M (2013) Sexual orientation-related differences in tobacco use and secondhand smoke exposure among US adults aged 20 to 59 years: 2003-2010 National Health and Nutrition Examination Surveys. Am J Public Health 103:1837-44
Mays, Vickie M; Johnson, Denise; Coles, Courtney N et al. (2013) Using the Science of Psychology to Target Perpetrators of Racism and Race-Based Discrimination For Intervention Efforts: Preventing Another Trayvon Martin Tragedy. J Soc Action Couns Psychol 5:11-36

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