Implementing Behavioral Health Services at a Community-Based LGBTQ+ Clinic

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals face significantly more behavioral health disease burden than their heterosexual counterparts. Improved access to behavioral health services is urgently needed. We describe developing and implementing a comprehensive integrated behavioral health (IBH) program at a community-based clinic in Rhode Island, where primary care, behavioral health, and psychiatric providers work in a coordinated setting to support patients' whole health.

We reviewed demographic and clinic data from 2023 to 2025 of an IBH program at Open Door Health in Providence, Rhode Island. We compared implementation outcomes between Year 1 and Year 2 of the program.

During the two-year study period, N=2,914 behavioral health visits were conducted among N=684 unique adult patients (N=212 in Year 1; N=548 in Year 2). The average patient age was 34.8 years (range: 18-77 years). Among these patients, 70.2% identified as White, 13.7% as Black/African American, 15.9% as Hispanic/Latino, 41.81% as transgender/gender diverse/nonbinary, and 81.4% as LGBTQ+. Patient volume increased 200% in Year 2 compared to Year 1 (723 versus 2,191 visits). LGBTQ+ patients utilized a greater volume of IBH services, with 20.11% having five or more visits compared to 10.2% of non-LGBTQ+ patients.

IBH services increased dramatically year over year. Offering behavioral health services during primary care visits at a community-based LGBTQ+ clinic resulted in significant uptake of behavioral health services for patients who might not otherwise have access to these services.