FY 2024 Behavioral Health Service Expansion - The Los Angeles LGBT Center (Health Center Program grant number H80CS26621) respectfully requests Behavioral Health Services Expansion (BHSE) funding in the amount of $600,000 in year 1 and $500,000 in year 2 for the initial 2-year project period. BHSE funding will support considerable expansion of the Los Angeles LGBT Center’s (the Center) mental health, substance use disorder, and medications for opioid use disorder services. The number of patients receiving behavioral health services will increase significantly through implementation of a comprehensive, innovative intake and assessment process that all patients of the health center will receive no matter the entry point for which they access the Center’s services. The use of technology and new data analytics systems will support the new intake and assessment process. Since 1969, the Center has been enriching the lives of lesbian, gay, bisexual, and transgender (LGBT) people of Los Angeles by improving their health and advocating for their rights. The Center has grown to be locally recognized as an essential part of the healthcare safety net in Los Angeles County, filling a unique and critical gap. In calendar year 2023, nearly a third (29%) of the Center’s total patients received mental health services. Our proposed BHSE project will expand capacity to systematically identify and assess all individuals for behavioral health needs, including those that access our social and other support programs. Given the behavioral health challenges among LGBT individuals, the Center’s system-wide approach to healthcare delivery is a patient-centered and integrated care model, combining the provision of medical care with mental health and substance use disorder services. The geographic area served by the Center is the heavily-populated, urban core of Los Angeles County that includes 48-zip codes. The target population can be characterized as suffering from multiple, adverse and intersectional impacts of poverty and social stigma. Many of our patients are new immigrants, the working poor, and people of color. They are collectively challenged by obstacles that limit access to culturally competent and quality healthcare that includes cultural intolerance, medical marginalization, medical mistrust, and economic uncertainty. People who identify as LGBT often face social stigma, discrimination, and other challenges not encountered by people who identify as heterosexual. As a result of these and other stressors, sexual minorities are at increased risk for various behavioral health issues. For example, LGBT individuals are more than twice as likely as heterosexual men and women to have a mental health disorder in their lifetime. They are 2.5 times more likely to experience depression, anxiety, and substance misuse compared with heterosexual individuals. Among LGBT individuals, bisexual and transgender communities have the highest rates of mental health concerns. Sexual minorities also have higher rates of substance misuse and substance use disorders than people who identify as heterosexual. Data from the 2020 National Survey on Drug Use and Health (NSDUH) suggest that substance use patterns reported by sexual minority adults differ from those reported by heterosexual adults. In 2020, approximately 41.3% of sexual minority adults 18 and older reported past-year marijuana use, compared to 18.7% of the overall adult population. Approximately 6.7% of sexual minority adults in 2020 misused opioids (prescription opioids or heroin use) in the past year, compared to 3.6% of the overall adult population. The NSDUH survey also found that, in 2020, approximately 21.8% of sexual minority adults had an alcohol use disorder in the past year, compared to 11.0% in the overall population.