Queer SLO recently had the pleasure of sitting down with Cal Poly professor and beautiful human, Dr. Jay Bettergarcia of QCARES. From the importance of queer mental health research to some preliminary findings coming out of the QCARES survey, to a few of their favorite LGBTQ-friendly spots in SLO, Jay shares some incredible insight about what’s happening right now with LGBTQ mental health initiatives at the local level and how community action is paramount in building a more inclusive-minded San Luis Obispo.
Can you give us a brief overview of QCARES and talk about where your journey fits into it?
QCARES stands for Queer Community Action Research Education Support. The idea behind it was that I do all this community work, and the activist side of me and the social aspects of doing this work have always felt important, but I also love doing research. So QCARES has really been about trying to integrate those two elements, which doesn’t often happen with research. You often see research about something that is really important but doesn’t actually connect back to the community and how it’s doing, which is fine. There’s awesome research happening that we need. But for me it was really important to bridge that together with what is physically happening in our community. In a university setting, I have access to resources where we can get some of this data and actually start to understand what’s going on, especially around mental health, wellness and then teaching and training our doctors and therapists how to do a better job with our queer folks in town. I’m hoping to bridge community members and their voice, their wants, their needs, with this thing that I can do through research to make sense of one person’s story, another person’s story, a lot of people’s stories and see kind of where we are holistically as a community.
We’re so excited you’re doing this work, Jay. As much as you want to share, we’d love to hear about how your personal life experiences have informed your work with QCARES.
Yeah! So for me being an out, non-binary, transmasculine queer person, that piece of the puzzle for me ties so closely into exactly the kind of the work that I’m doing. When I was coming out, first as a lesbian and queer and then later as like, oh, hold on, some gender stuff is happening, there weren’t a lot of options for therapy here in the area. Being a Cal Poly alum, it was difficult figuring out who to go see or who knew anything about this. And I was so lucky to find someone who was awesome, but I didn’t have insurance, couldn’t pay out of pocket and I was working three jobs, so could only see this person once a month and that’s basically it. For me, that just wasn’t enough. I needed somebody more frequently, but I couldn’t find anyone, at least that I knew. Even asking around and reaching out to the community, beyond one or two people, there just weren’t a lot of folks who were able to provide therapy and be not only LGBT affirming but trans affirming.
And so I left, got an education and here I am back now, having gotten a master’s and a Phd, back now as a Cal Poly professor, and I’m hearing the same things 15 years later. They’re still there. We have more, we have a lot of fantastic folks, but I can count them on one hand, especially for the trans community. So for those folks, they’re either always full because there’s so much need and there’s so few folks seeing clients, or if they take insurance, those spots are full, or if they don’t take insurance then it’s only out of pocket, which not everyone can afford. So I’ve been hearing that kind of in a piecemeal approach for a while.
Wow, and so you started QCARES to solve those problems that still existed 15 years later?
Yeah, so I was approached by Ellen Sturtz, who’s an amazing activist and community member and likes to be a mover and a shaker. So she was asking, “Hey, I see that you’re new to Cal Poly. What can we do around this LGBT mental health stuff?” And so she pulled me into a lot of the county meetings and to meet people I had no idea even existed because I wasn’t even in that sphere of knowing how to get money to do some of this work. And she’s the one that really spearheaded this and wanted to really figure out what’s happening in our community. And I was like, “I can do the research!” So we got together and the county agreed that our LGBT folks need more. We don’t exactly know what that is, and so that’s where the research comes in. And I said, “I can do something about that. I can put together a survey, we can do focus groups, we can go out and actually ask our community what’s needed, what’s missing.”
So we’re doing the research about the things we’re not seeing in our community, really trying to fill some of that need and that gap. Not only nationally can we look at these trends, but we can actually see what’s happening here in our town. I want to find out how can we make some immediate change and then long term change because the goal of the survey and the focus groups is really to give it back to the county and say, “here county, here’s what your queer community wants and needs.” And that might be different for different groups. It might be different for our queer elderly population, it might be different for our trans youth, it might be different based on segments of the community. But at least we can give that back to the county and identify the spots where we really need more support groups, more youth services, more well trained therapists.
Awesome. So tell me about what QCARES is working on right now.
Sure. So there’s a project that’s just now launching – a four year grant to do a nine month training program for 50 therapists in the county focused on acquiring knowledge, awareness and skills around how to work with LGBTQ folks. We’ll be bringing in expert trainers and consultants between trainings to ensure that these 50 folks are really well equipped. We’ve attempted some of this training in the past, some at Twin Cities, some at Sierra Vista and other groups, but they’ve only been four to eight hour trainings. So they got a piece of it, but it’s not enough to really change some of the beliefs or stereotypes that exist and provide the knowledge, experience and skills to really do this work. Our hope is that by training two groups of 25 folks, each over a nine month period, that we’ll have 50 solidly educated providers who are here. We’ll be recruiting folks from San Luis Obispo County, North County, South County, people who take insurance, people who don’t, people who work for the county, people who don’t, people who are part of all of these various organizations, so that we can say, “oh, you need to see someone and you’re already at this organization? We have someone who’s at that organization who’s gone through this program.”
The goal is to have more well trained providers because right now, the data is showing that we don’t have enough providers who are knowledgeable about LGBTQ folks and their needs. We’re also excited to help create an infrastructure for these newly trained providers so that they can all communicate when they have a client who is struggling and can reach out to each other for support. We really want to develop a network that ensures fewer folks fall through the cracks.
A couple follow-up questions – first, tell me about the grant that’s funding this amazing work.
Absolutely. So the grant comes from the Mental Health Services Act and the county oversees those funds. This particular project was awarded an innovation grant, being something that is brand new and never been done anywhere else before in the way that we’re doing it. We had to pitch this idea and say, “nobody’s ever done a nine month training program to train LGBT affirming mental health therapists.” So that was the frame – this is something we can test with research to see if it works. If it does and we have the pieces that work, then we can send it out into other counties that could emulate our process. These participants who will go through the training, we’ll be doing a lot of data and digging to see if they are truly learning what we want them to learn and acquiring the skills we want them to have. Then we’ll hopefully be able to see how that’s affecting their LGBTQ clients and affecting the broader LGBTQ community here.
How soon will the first training start and is there an application process?
We’re hoping to do the first training in fall. So we’re currently looking for therapists and are committed to securing a good, representative sample of 25 folks for this first incoming class – we want people from SLO, North County, South County, people who take insurance, people who don’t. In terms of the application process and criteria, the participants have to be therapists, but they can also be psychologists. They can be a master’s level, so LMFT, social work, any of those areas. We’ll have a basic application just to see where people are coming from. We want to make sure that the 25 people we pick are representing most of San Luis Obispo County.
You alluded to this already, but will you talk about the importance of queer mental health research in general and why it’s so important to improve mental health services for the LGBTQ community, specifically within a county scope?
Yeah, so part of the beginning of this project was that we had this data from the California Healthy Kids survey. They broke it down by county and then pulled out how many people identify as LGBT during that period of time when they were conducting the survey. So this is from 2015 data – what we knew about youth was that in SLO County in particular, looking at middle school and high school students, we had almost a thousand who identified as LGB and almost 200 who identified as transgender. Some of the data stemmed from questions about mental health. For example, “did you miss school because you felt sad, hopeless, anxious, stressed, angry during the past 30 days?” Almost 40% of LGB respondents said yes compared to 10% of their heterosexual peers. I think that the striking one that everyone kind of latched onto was when students were asked, “did you seriously consider attempting suicide in the past 12 months?” Almost 50% of LGB youth reported that they had considered attempting suicide and 46% of trans youth said that they had seriously considered suicide in the last 12 months. So, I mean, if you extrapolate that out from what that means for our numbers here, that in one year in SLO County, approximately 570 middle school and high school LGBT youth seriously considered suicide.
570 middle school and high school LGBT youth in SLO County seriously considered suicide. That’s astonishing.
Yeah. Right? That’s nearly 600 of our youth who identify as queer saying, “yes, I’ve seriously considered suicide.” So that was one that obviously stood out and was part of the catalyst for understanding what’s going on. The other part was that because of stigma, whether it’s prejudice and discrimination that people are experiencing on the outside or internalized stigma, being connected to the community can be harder in more rural or conservative areas where it can be harder to come out. So all of these factors lead to poor mental health – higher anxiety, higher depression, higher suicide rates and attempts. So given all of these factors, it makes it challenging to pinpoint causes. We know that people are struggling here based on this data. Let’s see what else is happening here. When we’re thinking about what services to provide and how to use our money, we know that our queer youth in particular are struggling. We also know, and I think this data will help us better understand, there are other segments of the population who are struggling. We want to identify who those people and what they need so we can best help them.
That’s a perfect segue. So QCARES has been doing some research with the survey and focus groups around LGBTQ+ mental health. Can you share about the initial research effort and some preliminary findings?
What we’re seeing so far in terms of demographics and where we were pulling data from, we’ve got a good number of folks from age 13 all the way up to 89. So we’ve got a pretty awesome range. We have 10% under 18, which is fantastic. We have another 15% that are college age-Ish, like 18 to 22. At least 5-6% that are over 60. So it’s quite a good range in terms of age, which is great.
In terms of some of the findings, some of it’s anecdotal at this point because we haven’t actually run the statistics. But some of what people are saying in the focus groups or some of what they’re writing on the survey is this: they’re either aren’t enough services in terms of mental health support, and for those who do find a service or a therapist that’s queer friendly or trans friendly or knowledgeable, they’re either already full or they don’t take insurance. So there’s multiple barriers. That was one of our big questions. If people are seeking support, what are their barriers to getting care? Another question was if they’re not seeking support, why not? And so for some people, they don’t need it, they’re fine. For others, they’re not seeking support because they heard that somebody else had a bad experience. And so that becomes another barrier even if they’ve never actually tried to get help. So that’s some of what we’re seeing initially – that they’re just aren’t enough therapist or not enough therapists who are well trained or who take insurance.
I think the other piece is that people are asking for more social support. So like, sure, I need a therapist, but even before that, I need community support and there aren’t any places to go and congregate. One of the first things that lots of people say is, “we don’t have a place.” Whether it’s a coffee shop, a gay bar, there isn’t a place to go to just be. That’s especially coming out in the focus groups when people have a little bit more space to explain how it feels to be in San Luis Obispo – there’s no place where people feel like they can just pop in and know that it’s going to be a safe place. That’s just coming out again and again – “we need a place, we need a place to go, a place to hang out, a place to just feel okay being me.”
Support groups are another thing that people are asking for. Sometimes it’s that they don’t know about it, but more often it’s, “oh yeah, I know about that one, but there’s only one and it doesn’t fit.” Or, “that’s not actually my identity group” or “I went once.” And so we’re hearing that having more support groups across north and south county and SLO, but for different groups, is a need. For example, I was talking to some gay men and they said, “there’s no gay men’s group. I would love to come to a gay men’s group. I don’t care if it’s led by a therapist or just by another gay man. I just want to go to a place where I can get some support.” And it doesn’t rise to the level of one-on-one therapy but more like what are the pieces in between, in terms of community connectedness, support and wellbeing, before getting to the point of needing some kind of professional service.
Mental health and mental wellness rely a lot on connecting to a community, connectedness to family and friends and supportive environments. When people feel like they’re walking around town and they can’t hold their partner’s hand, that’s going to affect their mental health. Whether or not they actually need to go see a therapist or not, that’s going to be one of those things that impacts their wellbeing. Like we hear people saying, “I don’t feel like I can walk around with my partner and hold their hand” or “I’m careful, I’m looking over my back more often” or “it depends on what area of the county I’m in – I feel safer in some areas of the county than others.” How do we change at the community level people’s experience of feeling safe and feeling welcome and feeling that they’re not going to be a target? This is a more basic need then needing a therapist – how do we change a culture here in San Luis that doesn’t always feel welcoming for folks?
So with all of this research that you’re doing, you take all the findings, you draw some conclusions – how do we put that into action as a community and who is tasked with that?
That’s fantastic. So the best part of community based action research is the action piece. We’re doing the community based research piece – when we developed the survey, we had community members weighing in on what questions should be on there, how do we ask these questions and how do we get the survey out to the right people and to enough people to get a good sample? Now that we’re collecting the data, the idea is that we take it back to the community and say, “hey community, hey stakeholders, hey people who are curious, who are in positions of power, who are interested and want to help – how do we interpret this data?”
We have this hashtag, #out4mentalhealth, a group that’s kind of a task force here in the area. It’s led by Michelle Call, the Executive Director at GALA, and Elissa Feld at Transitions Mental Health Association. And so the two of them, along with a bunch of stakeholders from across the county, come together to figure out issues around LGBT mental health. They’re asking questions like how do we change policies, how do we change things around mental health for LGBT folks? Since I’m part of that group, we’re going to go present our findings to them first and say, “here are some of the findings that we have so far; help us understand it, help us put it in context. Does this looks similar to what you’ve been hearing? Is it, is it not? Are we missing something?” So really taking it back to the community and saying, “here’s some data; help us understand what’s going on.”
From there we’ll generate two reports, one more full length report that’s pretty intensive and another one that’s a one to two-page fact sheet. Then the idea is to be able to distribute those far and wide. We’ll probably get connected with one of the community forums, like through Sierra Vista.
We’ll get it out in various ways. If people want a presentation, I can come present at the GALA board, we can give this information out and spread it around.
And then the idea is that the community now is in charge of really figuring out what each agency can do with that data. If GALA wants to do something because they say, “hey look, this piece of the data came out that really is kind of what we do. We should create some more support groups.” Awesome GALA, go for it. If Transitions Mental Health Association says, “hey, we’re looking at this data and this is the piece that we really do, let’s create a program around it.” Awesome. And so the goal is to give it back to the community and say, “hey community, whether you are part of the mental health services area or part of an LGBT organization, here’s what we’re seeing. What are you going do about it?” And then I think it is back on folks who are doing this work to do something about it, to create another program, to create more services, to ask for money, to have grants, to do some of these programs if they need it, to make sure that our gender and sexuality alliances – the GSA’s at the high schools – are all getting what they need and the support that they need to really support our youth.
I think there are some bigger, programmatic changes and policy changes that can happen on a wider scale. The efforts can be small and really honed in on one area or it can be kind of big policy style, county level changes. But that’s the goal – give it back to the community and say, “community, what do you want to do?” And I think there’s a lot of things that can be done.
So it is up to all of us. I love that.
Yeah, maybe there are just different things that can happen in and around town. Everything doesn’t just have to live within one organization because I think that’s a really dangerous way to go about things. If that organization goes under or changes their scope or doesn’t want to fund something anymore, hopefully that’s just one project, one program. The idea is if we can spread it out and have it kind of all over the place, then it can’t really die because it doesn’t live in just one spot. It’s not just QCARES, right? If I leave tomorrow, I want to know that this data is in everyone’s hands and it’s up to them to do something with it. Not just me. Yeah, definitely not just me.
I’d love to hear about your favorite queer supportive / friendly spots in SLO County.
Ooh, that’s a good question. I feel like there are lots of places that I don’t know whether they’re queer friendly, but they feel fine, you know? We love Taco Tuesdays at Luna Red. Our daughter loves it. She knows when we pick her up and it’s a Tuesday, and she’s heard somewhere that it’s a Tuesday (‘cause she doesn’t actually know what day of the week it is usually), she’ll say “it’s Tuesday! Are we going to Taco Tuesday?” And even sometimes on a Friday she’ll ask, “ is it Taco Tuesday? Is it Taco Tuesday?” So we love going there.
I don’t actually know whether they’re queer friendly, but we love going to that place over by the train station, Sally Loo’s. That was one of our favorite places to go with our daughter. They always felt open and welcoming and warm and inviting. I don’t know if the same person still owns it or not, but they were super friendly.
Ellen and I, when we were developing all of this, every one of our meetings was at SLO Provisions. Every time we’d go in, they’d say, “Oh, Ellen’s at her table. That’s her table right there. Does Ellen have a meeting today?” They were fantastic. We did so much of this work at SLO Provisions. So yeah, definitely a big shout out to them. They were so awesome about letting us just use that corner all the time. So much of this work was really born there.
I get our daughter chocolate croissants sometimes at Ascendo. They run out super early, so if you’re not there like before, you know, 10, 11 or noon, they’re gone. But we love going there. She learned how to play chess there. She doesn’t actually know how, I help her, but we’d sit at the little community table and play.
Yeah, I feel like there’s so many places, and I think what’s missing for the community is that we don’t know which ones are actually queer friendly. We just happen to go back to some more than others I guess over time. But just a sticker or some emblem would be helpful. I mean, I know not everyone wants to hang a big rainbow flag outside of their business. I get that. But I think that’s part of what the community is after when they’re saying we want somewhere that feels safe is to know where to go. Whether it’s a list or a sticker in a corner or a big flag, like just some way to know that this place is going to be somewhere that I want to support, that’s going to be friendly, open and whose employees are going to be nice to me.
What can we do to help you and support what you’re doing?
For a while we were like, “just take the survey!” You can still sign up to participate in a focus group through our website, queercares.com. The other piece is to find an organization that you’re really passionate about and get involved. It can be through GALA, the #out4mentalhealth task force, the Pride Center, 5 Cities Hope, the Queer Crowd – however you want to get involved, get involved. The more people interfacing with one of these organizations or multiple organizations, the easier it is to then make some change and create community.
If people are interested in K-12 education and being more inclusive, we have the Central Coast Coalition for Inclusive Schools, an awesome organization whose mission is to be more LGBTQ inclusive at the K-12 level. They’re doing lots of trainings and policy work and making sure that we have GSA’s. If you’re interested in the philanthropy side and people who are giving out grants to do all these projects, we have the Growing Together Initiative through the Community Foundation. I think that sometimes people don’t realize that there’s so many great things happening. Just plug in to one or two and roll with it.
The other thing is sometimes we don’t see folks who are as activist minded, so how do we create space for advocacy beyond the social aspect of building community? Hanging out because we’re queer and we want to have fun – whether it’s playing dungeons and dragons or going out drinking or whatever makes sense for people – is awesome. But we also need folks who are willing to do the hard work of activism, pushing the boundaries and moving things forward in terms of policy and changes at all levels. It could be at the schools, the county, the business level – we need folks who are movers and shakers on the ground, who are wanting to create some change because there’s so much room for change. Pick something and do it. I bet you there are others who are wanting to do the same. Find community there.
This has been amazing. Thank you so much, Jay. Keep us posted on the QCARES research findings and anything we can do to help.
Thank you. I’m so glad you’re doing this. It’s fantastic.