The Wellness Qlinic: A Unique Mental Health Resource for LGBTQ+ Adults
Innovation and compassion are core values at Weill Cornell Medicine, and they’re making a difference for patients in underserved communities.
Medical training has only recently included findings regarding the needs of the LGBTQ+ population. Soon, it will be easier to find mental and physical care that’s sensitive to the needs of sexual and gender minorities.
At the Wellness Qlinic at Weill Cornell Medicine, that future has arrived. This innovative program provides free, student-run mental health services to the LGBTQ+ community in New York City and the New York Metro Area. Medical students, psychology trainees and psychiatry residents, as well as their faculty supervisors, see it as a model for affirming mental health care, as well as for education, clinical experience and research.
Certainly, says Dr. Christopher Ceccolini, when it comes to mental health, there are disparities between LGBTQ+ individuals and the heterosexual and cisgender majority. But these disparities can be traced largely to stigma, discrimination and prejudice, often starting in childhood or adolescence.
These experiences, he explains, can lead to internalized homophobia or transphobia—“the internalization of the world’s negative views of us.”
Dr. Ceccolini, who is Assistant Professor of Psychology in Clinical Psychiatry and Assistant Attending Psychologist at Weill Cornell Medicine as well as Director of Research at the Wellness Qlinic, shares the following consequences of that negative dynamic:
- Queer people are more than twice as likely to have a mental health disorder in their lifetime compared to heterosexual and cisgender individuals.
- They are 2.5 times more likely to experience depression, anxiety and substance use.
- Their rate of suicide attempts is 4 times greater.
However, when it comes to LGBTQ+ mental health, Dr. Ceccolini favors a positive psychology approach over one that stresses the kinds of disparities listed above—and so do the students he advises at the Wellness Qlinic. Rather than focusing on illness, positive psychology emphasizes the strengths and behaviors that allow people to live meaningfully and purposefully, with full acceptance of who they are.
Clinical Services
Connie Zhou, an MD/PhD student at Weill Cornell and Co-Executive Director of the Wellness Qlinic, outlined the Qlinic’s services:
- Psychopharmacology
- Medication management
- Several types of individual psychotherapy
In addition to well-known modalities such as cognitive-behavioral therapy (CBT), the volunteer students and residents at the Wellness Qlinic are also trained to provide dialectical behavior therapy (DBT). DBT is all about helping people accept the reality of their lives and their behaviors, as well as helping them change unhelpful behaviors.
Who are the Wellness Qlinic’s patients?
The Wellness Qlinic has a high retention rate, which points to a high satisfaction rate.
“Many of our patients come to us seeking mental health care for the very first time,” Zhou says. “It’s possible that they can’t find treatment elsewhere. Or they may have reservations about seeking it, given negative past experiences.
“We have an incredibly diverse and lovely patient population,” she continues. “They’re mostly in their 20s and 30s, and they’re very racially diverse. Over half identify as transgender, gender non-conforming or non-binary. About one-third are uninsured. But given that our services are free, a lack of insurance isn’t a barrier to receiving care.”
Dr. Jessica Spellun, Clinical Assistant Professor of Psychiatry and Mental Health Director of the Wellness Qlinic, is quick to point out that LGBTQ+ people seek mental health treatment for the same reasons as everyone else: distress, anxiety, depression, difficulties at work, and difficulties in relationships. Their sexual or gender identities aren’t the be-all and end-all of what’s happening in their lives.
Who are the Qlinic’s staff?
Since the Wellness Qlinic opened its doors in March 2019, more than 200 medical students have volunteered in some capacity. Through that experience, they gain exposure to psychiatry, and some may decide to pursue that specialty later as residents.
Dr. Daniel Knoepflmacher, Assistant Professor of Clinical Psychiatry, Vice Chair of Education in Psychiatry and Director of the General Psychiatry Residency Program at Weill Cornell Medicine, says the Wellness Qlinic has real educational value, infused with a humanistic focus. The residents who volunteer there are reminded every day of the common humanity at the core of the Qlinic’s mission and practice. “That’s a key part of the humility that’s so important for psychiatrists, psychologists and doctors generally to learn early on,” he says.
The Wellness Qlinic’s future
With its unique mission and modus operandi, the Wellness Qlinic is serious about the research needed to make sure it’s addressing the needs of its patients effectively. “There are ongoing studies designed to ensure that we’re actually delivering what we think we’re delivering,” Dr. Spellun says, noting that the Qlinic’s leadership and staff can make evidence-based changes to the model, should that prove necessary.
The Wellness Qlinic’s future also has to do with growth and sustainability. Dr. Ceccolini is looking toward integrating the project with digital mental health at Weill Cornell, possibly through a mental health app. “That would be a way to supplement the care we’re providing; a way to ensure that we’re doing everything we can to expand access to care to a population that often faces so many barriers,” he says.
What’s more, he stresses the importance of sharing current and future evidence for the effectiveness of the model with the wider world—especially the larger academic community.
And finally, there’s the issue of sustainability. Beyond funding, sustainability will require that a new generation can take the helm and bring in their ideas, says Zhou.
Additional resources for the LGBTQ+ community
In the New York Metro Area, several resources have been found to be “reliably affirming,” Dr. Ceccolini says. These include the Lesbian, Gay, Bisexual, and Transgender Community Center and the Callen-Lorde Community Health Center. Both provide mental health and primary care services.
On a national level, he recommends the LGBT National Help Center and the Trevor Project, especially for those in the midst of a crisis. There’s also 988, the National Suicide Hotline. And of course, in the case of a psychiatric emergency, there’s 911.
Closer to home, Weill Cornell Medicine houses its own LGBTQIA+ Trauma Treatment Program—an oupatient psychotherapy treatment program that focuses on the healing of trauma.