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A gap in recovery management

June 25, 2012
by Michael Shelton
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Michael Shelton

The “recovery management” model is an effort to transform longstanding protocols for addiction treatment, shifting from typically brief intensive interventions to long-term continuous care, including frequent monitoring and follow-up (as occurs with other chronic illnesses).  One of recovery management’s principles is that recovery occurs in the community in which a person lives and not in a treatment facility.

Supportive of this tenet, the Substance Abuse and Mental Health Services Administration (SAMHSA) released its working definition of “recovery” in December 2011 and listed “community” as one of the four major dimensions supporting a life in recovery. According to SAMHSA, “Communities have responsibilities to provide opportunities and resources to address discrimination and to foster social inclusion and recovery,” and this approach includes “family, housing, employment, education, clinical treatment for mental disorders and substance use disorders, services and supports, primary healthcare, dental care, complementary and alternative services, faith, spirituality, creativity, social networks, transportation, and community participation.”1

However, access to community resources, no matter how integral they are to recovery, may be limited and even non-existent for members of the lesbian, gay, bisexual and transgender (LGBT) community.


LGBTs and backlash

There is no doubt that LGBTs have made amazing progress in the past half decade, including but not limited to the Obama administration’s refusal to support the federal Defense of Marriage bill; the dissolution of the military’s “Don’t Ask, Don’t Tell” policy; passage of same-sex marriage and civil union laws in the states; and the U.S. Department of Housing and Urban Development’s (HUD’s) adoption of new regulations alleviating discrimination against LGBTs in rental assistance and home ownership programs.

Still,with all of this progress, Jon Davidson, legal director of Lambda Legal, the nation’s oldest and largest legal organization working for the civil rights of LGBTs, began a late 2011 Impact editorial with the following: “I consider myself an optimist. I usually focus on the remarkable progress LGBT people have made through the years… But, there are times when the venom and violence that still gets directed at members of our community breaks through and I find myself shocked at how strongly people still hate us and how far we have yet to go.”

Let it be clear that in 2012 LGBTs remain one of the most detested populations in the country. A 2010 report by the Southern Poverty Law Center found homosexuals (and perceived homosexuals) are the most targeted group in America for violent hate crimes. The center’s analysis of 14 years of federal hate crime data found that LGBT people are more than twice as likely to be attacked in a violent hate crime as Jews or blacks, more than four times as likely as Muslims, and 14 times as likely as Latinos.

And for those LGBTs who are people of color and/or transgender, their treatment is even worse. A 2011 report by the National Coalition of Anti-Violence Programs found that in 2010 violence against LGBTs affected minority groups disproportionately. People who identified as either transgender or people of color were twice as likely to experience assault or discrimination as non-transgender white individuals, and one-and-a-half times more likely to experience intimidation.

As a reminder of how much hate still exists for LGBTs, here are a couple of examples from the recent past. Between June 24, 2011, the day New York legalized same-sex marriage, and Sept. 20 of last year, the ending date of “Don’t Ask, Don’t Tell,” Oklahoma State Rep. Sally Kern told a talk show host that homosexuality is a bigger threat to the United States than terrorism, the Philadelphia Gay News reported.Republicanpresidential candidates Rick Perry, Michelle Bachmann, Tim Pawlenty, Mitt Romney and Rick Santorum signed a National Organization for Marriage pledge that, according to the American Civil Liberties Union (ACLU), not only supports an amendment to the U.S. Constitution barring recognition of marriages involving same-sex couples but also appoints a presidential commission to “investigate harassment of traditional marriage supporters.”2

Joe Solmonese, president of the Human Rights Campaign, a national organization working to secure LGBT equal rights, cautioned, “Stung by our victories, our enemies are lashing out, unleashing their huge war chests to stop our progress and roll back our hard-won advances.”

Unfortunately, thehomophobic and sometimes simply mean-spirited “lashing out” by anti-LGBT groups and high-profile individuals seeps down to local communities and feeds into pre-existing homophobia, heterosexism, or confusion regarding sexual minorities. One tragic example comes from Michigan. According to the National Coalition of Anti-Violence Programs (NCAVP) 2007 report, the largest increase in violence against LGBTs occurred in that state following the state Attorney General’s three-year campaign against domestic partnership benefits and a Michigan Court of Appeals ruling that overturned a trial court’s conclusion that public employers may offer domestic partnership benefits. As summarized by the NCAVP, “In Michigan and elsewhere in the U.S., these highly visible political attacks on LGBT communities reinforce the idea that it is acceptable to target LGBT persons with violence.”3


Increasing provider awareness

For many LGBTs, the current political backlash threatens day-to-day safety and the sanctuary they have created in their local communities. Awareness of the current backlash against LGBTs is essential for those of us offering behavioral health services to these populations.