San Luis Obispo

Increasing LGBTQ+ Affirming Mental Health Care Services in San Luis Obispo County

Gender Studies


​​​Dr. Jay Bettergarcia (they/them/their) is an assistant professor in the Psychology and Child Development Department at Cal Poly, San Luis Obispo, and a licensed psychologist whose work supports the mental health and wellness of transgender, nonbinary and gender-diverse individuals and communities. As a nonbinary person and Cal Poly alum, Dr. Bettergarcia recognized, personally and professionally, the need for more affirming mental health care services for the lesbian, gay, bisexual, transgender and queer (LGBTQ+) community in San Luis Obispo County. Now, as a Cal Poly professor and local therapist, Bettergarcia is working to increase access to affordable, culturally competent and affirming care for these communities.

As part of this work, Bettergarcia runs the Queer Community Action, Research, Education and Support (QCARES) program that involves students, community members and leaders in developing, conducting and disseminating research for policy change and social justice action. QCARES started on campus in 2017 by conducting an LGBTQ+ mental health needs assessment to explore barriers to accessing care, their experiences with providers, and the local services needed to support mental health and wellness. The San Luis Obispo County Behavioral Health Department funded this project; more than 500 LGBTQ+ youth, adults and elders shared their experiences through an extensive online survey and several focus groups. The results pointed to the need for more well-trained and affirming providers, suicidal prevention efforts targeted to LGBTQ+ youth, affirming services for transgender and gender-diverse people and LGBTQ+ community spaces that help increase their feelings of safety and connectedness, which can help to buffer the negative effects of stigma and discrimination on mental health. The results and recommendations are being used to develop affirming programs and initiatives that support LGBTQ+ mental health across San Luis Obispo County.

Bettergarcia then set out to create more local training opportunities to help increase providers’ cultural competence and to collect data about the effectiveness of such trainings. With a campus Research, Scholarly and Creative Activities grant, they conducted a series of one-day trainings for medical and mental health providers on transgender affirming care. This study assesses the changes in providers’ knowledge, attitudes and interpersonal comfort from pretest to posttest. With this coastal county being semirural, accessibility to affirming care providers can mean the difference between people getting the care they need or none at all.

Bettergarcia also developed the Affirming Cultural Competence Education and Provider Training (SLO ACCEPTance) project, a four-year program funded by the Mental Health Services Act, through SLO County Behavioral Health. This innovative program tests a nine-month training model to increase the cultural competence (including knowledge, awareness and skills) of therapists, and the feasibility of specific training activities. Through this research, Bettergarcia and their collaborators hope to better understand and study various methods of conducting diversity-related training. Additionally, approximately 60 local therapists will be trained further to provide affirming mental health care and support for LGBTQ+ people, thereby expanding access to quality care.

Bettergarcia hopes these various projects will increase access to LGBTQ+ affirming care and to reduce barriers to accessing services. Having more well-trained therapists available is one step in that direction. Research shows that prejudice, discrimination and stigma can have extensive deleterious effects on the mental health of queer and transgender people. Bettergarcia hopes that through their work, LGBTQ+ people will not have to face bias and discrimination from their doctors, nurses, and therapists as well.