The State of Tennessee is the latest to introduce a religious freedom law that would allow service providers to refuse services to members of the lesbian, gay, bisexual and transgender (LGBT) communities based on their religious beliefs. This time, however, it’s not a wedding cake, clothing, or any other consumer item: It’s mental health treatment. On Wednesday the Tennessee House of Representatives passed House Bill 1840, a measure that would allow counselors and therapists to deny service to a patient if doing so were to conflict with the counselor’s “sincerely held religious beliefs.” Supporters say that the legislation, which is now inches away from becoming law, is vital to protecting the beliefs of practitioners in the state.
House Bill 1840 has been widely condemned by clergy as well as notable organizations like the Tennessee Association for Marriage and Family Therapists, the American Foundation for Suicide Prevention, the Tennessee Counseling Association and the American Counseling Association. The ACA recently issued a statement saying that the bill is “an unprecedented attack on the counseling profession and endangers the health and wellbeing of Tennesseans”. Others argue that it will restrict vital healthcare services in a manner that targets the LGBT community. Defenders of the bill have said that it does require care providers to other professionals who are more comfortable with the LGBT lifestyle.
It is estimated that LGBT community members suffer from addiction at rates between 20 and 30 percent, compared to rates of the general population, which are just below ten percent. Homosexual men are 12 times more likely to use amphetamines than straight men and nearly ten times more likely to use heroin. Twenty-five percent of gay and transgender people abuse alcohol, compared to five to ten percent of the general population. A significant contributing factor to these higher rates is the ongoing trauma many members face on a daily basis.
Whether it’s denial and internal resentment, estrangement from family or any other form of discrimination to which they may be subject to on a daily basis, many LGBT community members have internalized this stress and used the drugs or alcohol to cope with the resultant mental health issue. Not only is the feeling of widespread exclusion traumatic, it can also translate into everyday quality of life issues like denial of health insurance and workplace discrimination and thereby compounding the trauma.
Many argue that measures like House Bill 1840 significantly reinforce that institutional discrimination, thus creating a cycle of mental health issues for which it may now be even more difficult to find treatment.
House Bill 1840 also raises some fundamental identity questions for the counseling profession as a whole. Outside of a direct conflict of interests or the commission of a crime, should care providers be able to turn patients away based on these kinds of personal beliefs? The very nature of mental illness is that can be unconventional and downright dysfunctional. Should lifestyle preference dictate a person’s right to receive adequate mental health treatment?
So much of the mental health issues among the LGBT community are directly tied to their lifestyle. Many are arguing that the blanket refusal by mental health treatment providers, many of whom took an oath to do no harm, to treat this markedly vulnerable population is not only an invitation for further substance abuse and mental illness; but also a clear violation of their job descriptions. With substance abuse and addiction rates so high among the LGBT population, these are questions that the industry as a whole is going to have to answer.