Cornell Scott-Hill Health Center (CS-HHC), a private 501(c)(3) non-profit organization located in New Haven, Connecticut, intends to implement targeted strategies, including the expansion of telehealth and peer recovery support services, for the provision of substance use disorder (SUD), co-occurring disorder (COD), harm reduction treatment, and recovery support services to 180 Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) clients, a SAMHSA identified under-resourced population. The proposed geographic catchment area is comprised of six municipalities in Greater New Haven, Connecticut (East Haven, Hamden, Milford, New Haven, Orange, and West Haven) and three municipalities in the Lower Naugatuck Valley (Ansonia, Derby, and Seymour) with a combined population of 390,875. All nine municipalities are located within New Haven County.
There are an estimated 133,000 LGBT people age 13 and over in the state of Connecticut. Substance misuse or overuse, which may be used as a coping mechanism or method of self-medication, is a significant concern for members of this community. Lesbian, Gay, and Bisexual (LGB) adults are nearly twice as likely as heterosexual adults to experience a substance use disorder. Transgender individuals are almost four times as likely as cisgender individuals to experience a substance use disorder. This is due in part to a number of societally imposed obstacles such as (a) discrimination or stigmatization based on sexual orientation; (b) hate crimes, emotional abuse, threats, public humiliation or ridicule; and/or (c) rejection or shame from family or friends after coming out. Over half of LGBTQ+ Connecticut residents age 18-24 and 30% of LGBTQ+ residents age 25-45 have indicated a need for a mental health and SUD services. The target population is also subject to considerable trauma (IPV, bullying, family shunning, outing) when compared to their heterosexual peers, as well as prone to high risk, unhealthy behaviors.
CS-HHC will employ a number of evidence-based interventions, which are culturally-competent, trauma informed and designed to meet the patients “where they’re at.” Approaches will include: integrated healthcare (primary care, behavioral health, dental, and specialties including infectious disease and women’s health), engagement/outreach, outpatient treatment (MI, MET/CBT), Intensive Outpatient Programs (IOPs – MATRIX Model with adaptation for LGBTQ high risk behaviors, pharmaceutical interventions (MAT), and referrals to inpatient programming as medically appropriate. Specific models include: Covington’s Recovery for Men/Woman and Facing Trauma for Men and Gender Populations, Rapid Eye Movement Therapy, and TREM. For the 2022-25 project period, CS-HHC expects to serve 45, 60, and 75 clients, respectively, each year, for a total of 180 clients.