OBJECTIVE: To examine the availability and facility-level predictors of LGBT-specific mental health and substance abuse treatment in the United States. DATA SOURCES/STUDY SETTING: 2016 National Survey of Substance Abuse Treatment Services, 2016 National Mental Health Service Survey, and 2015-2016 Gallup Daily tracking survey. STUDY DESIGN: Logistic regression models and average marginal effects were used to identify characteristics of facilities that offer LGBT-specific programs. Linear regression models were used to estimate the association between the state-level proportion of LGBT people and the proportion of facilities that offer LGBT-specific programs. DATA COLLECTION/EXTRACTION METHODS: Secondary data analysis. Cases with missing values for any predictor were excluded. PRINCIPLE FINDINGS: 12.6 percent of mental health and 17.6 percent of substance abuse facilities reported LGBT-specific programs. Several facility characteristics were statistically associated with the likelihood of mental health and substance abuse facilities providing LGBT-specific programs, including offering outpatient or residential treatment, private ownership, religious affiliation, and payment type. The proportion of LGBT adults living within each state was statistically associated with state-level density of LGBT-specific mental health programs, but not substance abuse programs. CONCLUSIONS: Findings suggest limited availability of culturally competent mental health and substance abuse treatment, despite well-documented need.
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