Addressing disparities in healthcare has been a growing concern of service providers, administrators, policy makers, and researchers for over 50 years. This dissertation is the first academic inquiry into what a particular type of organization, the LGBT community center, is doing to meet the mental health and social support needs of lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) people. The minority stress model was used to explain why higher levels of distress and mental health consumer usage are found when comparing LGBTQ populations to the general population (Meyer, 2003). Goddard and Smith's (2001) framework of equity in access to healthcare, with components of availability, cost, quality, and information was used as a central framework in design, results, and discussion.

In collaboration with CenterLink, Inc. (the national association for LGBT community centers), and LGBT Movement Advancement Project, the primary investigator and his research team analyzed archival data of 69 centers from the 2010 LGBT Community Center Survey and conducted a follow-up survey with a sub-set of 37 centers. Statistical analysis was used to test hypotheses and answer exploratory questions related to mental health and social service provision.

There were four main findings. First, LGBT community centers contribute to the emotional health of LGBT people in multiple ways, both direct (provision of mental health and social support services) and indirect (referral to affirmative providers, training service providers and providing supervised clinical experience with LGBT populations to graduate students). Second, the mental health and social support services at LGBT community centers are not equally available to all LGBTQ individuals in the United States. LGBT community centers that provide in-depth and specialized services tend to be clustered within major metropolitan areas. Third, when LGBT community centers have more financial resources, they tend to provide a wider variety of services (therapy, psychiatry, support groups, hotlines, etc.) and more services designed for specific sub-populations (youth, transgender, people of color, etc.). Finally, LGBT community centers seem to be practicing within their scope of competence by utilizing providers with the appropriate level of schooling, supervision, and training to provide mental health and/or social support services.