Policies and Practices for LGBT Clients: Perspectives of Mental Health Services Administrators

Nine administrators of mental health agencies were interviewed by phone about policies, practices, and experiences they perceived to be helpful and unhelpful for LGBT clients in their agencies. A holistic case study approach was used to analyze the interview transcripts. Five salient factors that reflected the themes present across multiple cases were identified: responding to transgender clients, coordination of services within and outside the agency, connection with other LGBT individuals, availability and visibility of openly gay staff, and power and position of LGBT-affirming and LGBT-nonaffirming staff. Each salient factor is described and illustrated by casematerial. Implications for practice, training, and research are discussed.