Yale School of Public Health Professor John Pachankis has received a nearly $4 million grant from the National Institute of Mental Health (NIMH) to implement LGBTQ-affirmative cognitive behavioral therapy in 90 LGBTQ community centers nationwide.
The grant, totaling $3,973,191 over five years, will help the Yale LGBTQ Mental Health Initiative, which Pachankis directs, determine which of three different strategies is best to implement the novel therapy that he and his research team developed over the past 10 years.
“The grant reflects a commitment on the part of our team and the funder [NIMH] to bring evidence-based mental health practice to LGBTQ+ people across the U.S., including those who might not otherwise receive high-quality care or any care,” said Pachankis, Susan Dwight Bliss Professor of Public Health (Social and Behavioral Sciences), and professor of psychology and psychiatry at Yale.
YSPH Dean Dr. Megan L. Ranney, MD, congratulated Pachankis on the award.
“This project will help transform our country's ability to deliver innovative, high-quality treatment to the LGBTQ+ community at a time of great need,” she said. “Dr. Pachankis’ work exemplifies the YSPH commitment to not just doing great research, but also to using that research for change – to facilitate better health for all."
Sexual and gender minorities experience among the largest mental health disparities of any population in the U.S., and one driver of this situation has been the lack of evidence-based practice to address their specific needs and challenges. The LGBTQ-affirmative therapy is believed to be the first of its kind and one of the very few evidence-based practices for LGBTQ+ mental health.
Members of the study team at YSPH include Danielle Chiaramonte, associate research scientist; Ashley Hagaman, assistant professor of public health (social & behavioral sciences); Xin Zhou, assistant professor of biostatistics and a statistician at YSPH’s Center for Methods in Implementation and Prevention Science (CMIPS); and Skyler Jackson, assistant professor of public health (social & behavioral sciences).
Chiaramonte, along with YSPH postgraduate assistants Hadley Ankrum, Rebekah Hobbs, and Hunter Baldwin, has been coordinating the project with the initiative’s national partner, CenterLink, an international non-profit association of LGBTQ centers and organizations. It is a process that has involved making connections with the centers, building trust, and building a pilot program.
“Unfortunately, nonprofits and community centers like the ones participating in this grant are often overworked and underpaid,” she said. “This means they have to have a lot of scrutiny about what they decide to spend effort on. That is why it was really important to us to pilot this project first before proposing it to the centers. It really takes a lot of trust and commitment on both sides to invest in something like this.”
Thus, Chiaramonte is thrilled about receiving the grant.
“As community-based researchers, our goal is always to get evidence-based interventions and programming into communities where people can actually apply the research and evidence in community settings,” she explained. “We do this work so that the people who really need the support and resources can easily access it. “We hope this widespread access will better equip communities in the U.S. to provide mental health services to LGBTQ individuals.”
Pachankis said the LGBTQ centers they have contacted far have been “very enthusiastic” about the study. “In fact,” he said, “this study came directly from the unanimous encouragement of directors of LGBTQ centers nationwide who said they and their staff are eager to learn LGBTQ-affirmative cognitive behavioral therapy so that this treatment can support their local LGBTQ communities.”
The 90 centers in the study will be randomly assigned one of the team’s three implementation strategies: a suite of digital learning materials; these materials plus weekly webinar training for 12 weeks; or the above plus one year of supervision from a local supervisor, who will receive expert consultation in a train-the-trainer format.
Pachankis said the Initiative received a seed grant from the Johnson Family Foundation in 2022 to study ways to bring the team’s research to local and national LGBTQ communities. "The foundation has a mission of supporting 'the development of healthy, vibrant, and just communities, and identified Yale’s LGBTQ Mental Health Initiative’s research as having high potential for advancing LGBTQ mental health through community-research partnerships with LGBTQ community centers," he said. "This new NIMH grant furthers that goal.”
Whatever the outcome, Pachankis is optimistic and encouraged as they take this huge step forward.
“Our ultimate goal is for LGBTQ people to feel more supported and less alone in dealing with the common and unique stressors that they face,” he said. “The best possible outcome of this study is that more LGBTQ people receive high-quality mental health care than they would have before this study and that this increased access persists.”