LGBT Youth, Mental Health, and Spiritual Care: Psychiatric Collaboration With Health Care Chaplains

Lesbian, gay, bisexual, and transgender (LGBT) youth have unique medical and mental health needs. Exposure to stigma such as family non-acceptance is associated with adverse mental health outcomes that are important sources of morbidity and mortality in this population. These include depression, anxiety, substance abuse, suicidality, and risk behaviors that mediate exposure to human immunodeficiency virus and sexually transmitted infections. Different religious and/or spiritual traditions hold various beliefs and attitudes about LGBT people. These can be a factor influencing a youth's risk of experiencing stigma. Other unique developmental challenges of LGBT youth, such as conflicts over identity integration and disclosure, also can be influenced by religious/spiritual factors. Health care chaplains could collaborate with clinicians to support mental health by helping LGBT youth and families integrate religious with other aspects of identity, decreasing religiously based stigma, and supporting family connectedness. This article discusses professional aspects of health care chaplaincy and ways in which health care chaplains can work with psychiatrists and other clinicians to support LGBT youth mental health, including case vignettes. It was developed from a conference at the Pediatric Ethics Committee of the Columbia University Medical Center addressing chaplaincy for LGBT youth.