Training Mental Health Professionals in Gender-Affirming Care: A Survey of Experienced Clinicians.

Purpose: Transgender and gender nonconforming (TGNC) individuals have difficulty accessing mental health professionals (MHPs) prepared to deliver culturally informed care. This study aims to (1) explore the training experiences that had been available to MHPs who are actively providing care to TGNC individuals, (2) define which opportunities had been most beneficial in TGNC career development, and (3) determine the reasons MHPs sought training when it was absent in graduate curricula. Methods: A voluntary cross-sectional electronic survey was distributed through professional Listservs and public referral lists to interdisciplinary MHPs, who self-identified as having experience in providing care to TGNC individuals. Results: Two hundred eighty-one (n=281) counselors, marriage/family therapists, social workers, psychologists, psychiatrists, or psychiatric nurse practitioners responded to the survey. The two most common motivators for seeking training in gender-affirming care were filling a need in the community (68.8%) and having met a TGNC person in a clinical setting, who requested care (67.2%). Only 20.0% of our sample were exposed to relevant content in a graduate course, and 25.2% during clinical training. The most commonly available training opportunities were professional conferences (76.4%) and mentorship (41.2%). Respondents were most likely to recommend that others in their field be trained through structured clinical experience. Conclusion: This study identifies key strategies for graduate and post-graduate educators to better prepare MHPs to serve TGNC individuals. Wider availability of structured clinical experiences, didactic content delivered during graduate school or at professional conferences, and direct clinical mentorship will increase access to welcome and prepared mental health care providers for the TGNC population.

I Live Alone but Don't Feel Alone: Social Isolation and Loneliness From the Patient Perspective.

A growing homebound population may be at risk for social isolation and loneliness. Health-related social needs play a contributing role in these conditions. Research shows social isolation and loneliness are drivers of health outcomes. This pilot feasibility study seeks to explore patient-centered insight into perceptions of social isolation and loneliness in a homebound population. Eight participants were recruited from a home-based primary care practice within a family medicine residency program. One 30-minute semi-structured interview was completed in participants' homes. The interview focused on loneliness and social isolation, using the 6-item De Jong Gerveld loneliness scale. Three qualitative analysts open-coded transcriptions independently. Themes were defined using thematic analysis, then triangulated around a consensus of themes. Patients denied loneliness, but most described social isolation, highlighting the potential need for more targeted documentation and intervention in this arena. The most reported barrier affecting social isolation in our study population was mobility issues. The patient perspective is useful to focus the target of approach. Based on this pilot, additional research with a larger sample size across multiple sites is warranted to further explore homebound patients' experience of loneliness and social isolation in order to better guide assessment and interventions for these common problems.