LGBTQ+ support groups provide community care for substance abuse

This article is part of the Mental Health Collaborative, a project completed by nine North Carolina college newsrooms to cover mental health issues in their communities. To read more stories about mental health, explore the interactive project developed specifically for this collaborative.

When Jemm Merritt-Feder and their ex-partner moved to North Carolina in 2020, they felt isolated in their recovery from substance dependence and afraid to ask for outside help.

Eventually, Merritt-Feder began to look for a therapist who would understand their experiences with both substance abuse and gender identity issues.

"There was nothing direct toward queer people, particularly queer people of color as well, who were looking for support," they said.

Over the next year, Merritt-Feder became a certified peer support specialist and founded One Day at a Time, a peer support group for gender-diverse individuals to discuss their experiences with gender transition, mental health and substance abuse in a nonjudgmental space. The group, which currently has about 15 members, meets monthly in person and via Zoom.

Despite having a clinical background, Merritt-Feder said their biggest role at peer support meetings is to humanize people's experiences.

"This is a human issue," they said. "And people dealing with substance abuse and all these mental illnesses, like, it comes from something else."

According to the Substance Abuse and Mental Health Services Administration's 2021 and 2022 National Surveys on Drug Use and Health, adults in the LGBTQ+ community were over twice as likely to have a serious mental illness than straight adults.

Members of the LGBTQ+ community were also more likely than straight adults to have had a substance use disorder in the past year, according to the same survey.

Merritt-Feder said that members of the LGBTQ+ community may turn to substances because they don't have support systems or don't know that there are other options to work through what they are going through.

Since 2011, the North Carolina Harm Reduction Coalition has hosted a peer-based discussion group for transgender and gender-nonconforming people in the Triangle through a harm reduction lens. It is a statewide nonprofit founded in 2004 providing grassroots services and advocating for the dignity, autonomy and self-determination of people who use drugs. The group currently meets twice a month — once virtual, and once at the LGBTQ Center of Durham. 

Loftin Wilson, the harm reduction programs manager at NCHRC, founded the group after noticing a lack of community resources for trans and gender-questioning people in the area. He said that his inspiration for the group was a mixture of his passion for harm reduction and his own desire for community support during his transition.

The group is open to people experiencing any of the stages of drug use, from those actively using to those in recovery, Wilson said, as well as people of all ages.

"Less and less these days, it seems like there are fewer and fewer real intergenerational community spaces where people can learn from people who have some sort of core shared experience that we all share, but we also are coming from different places in life and different perspectives and different cultures and all of that," he said. "So being able to have that space to learn from each other is really incredible."

At One Step at a Time, community building goes beyond the monthly meetings — the group goes on outings to bowling alleys and the zoo, and members affirm one another outside of sessions. 

"I'm thinking that we're just here talking, and then there are people who are getting to know each other and really making connections beyond this," Merritt-Feder said.

They said everybody heals differently, and there are people that need community-based support and education to meet them where they are, rather than going to hospitals or rehabilitation centers.

Peer support is not a replacement for traditional mental health care, they said, but it can provide the space for people to talk about things they wouldn't bring up to a therapist or doctor.

"Historically, most mental health service providers have been cisgender white women — and that's changing and improving," William Hall, an associate professor at UNC's School of Social Work, said. "But I think it's really important that I think the professionals providing these services to these communities have lived experience with the communities they're trying to help."

Hall, who researches mental health disparities among LGBTQ+ populations, said that much of the existing mental health care interventions and services for the LGBTQ+ community are not currently tailored to specific populations within the community.

Both health care providers and community members are interested in increasing training and representation within mental health care — which includes representation for immigrants, people of color and people with disabilities — but many of them are not trained to address LGBTQ+ specific issues in their care.

A few years after founding the peer support group, Wilson and other trans community members began offering training about how to care for trans and gender-nonconforming people to health care providers.

"I feel like the level of education and knowledge has really increased over the past 15 years, and it's nowhere near as dire of a situation as it was," he said. "Although there's still, obviously, room to grow."

@eliza_benbow

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