The Northwest Network of Bisexual, Transgender, Lesbian and Gay Survivors of Abuse
Queer Collaborations: Full Spectrum Support for LGBTQ Youth Planning Phase Documents
Submitted By: Shannon Perez-Darby, Youth Service Program Manager, Carrie Lippy, PhD, Evaluation Consultant, Breona Mendoza, Youth Advocate, Connie Burk, Executive Director
Q-Lab Needs Assessment Report Section 1: Executive Summary Project Description Queer Collaborations (Q-Lab) is a project of the NW Network of Bisexual, Trans, Lesbian, and Gay Survivors of Abuse that will provide a full spectrum of prevention, intervention, and treatment services to LGBTQ youth experiencing dating violence, domestic violence, stalking, sexual assault and sexual exploitation in the King County, Puget Sound region. We are working with partners across the county to create a regional collaboration to increase access to services for LGBTQ youth. Purpose and Objectives of Needs Assessment We conducted the needs assessment to understand the current knowledge, services, training, and policies of organizations serving LGBTQ youth survivors of violence in King County. The assessment incorporates capacity building, professional development, and coordinated community response goals. The assessment focused on four key areas: 1) services currently available for youth 2) mandatory reporting practices 3) confidentiality policies, and 4) training and preparedness. Overall, the goal of the assessment was to learn how domestic violence agencies and youth agencies in our region are approaching these issues and where there is need for more support, advocacy, and training. Report Sections The needs assessment report is separated into six sections. Section 2 provides a brief overview of the Q-Lab partnerships and activities. Section 3 outlines the methodology of the needs assessment, including the data collection and analysis process. Section 4 provides a description of the needs assessment participants. Section 5 describes the findings from the needs assessment, and, where appropriate, additional methodological detail related to specific findings. The findings are separated into four subsections corresponding to the four key topical areas of the needs assessment. Finally Section 6 summarizes the key findings and explains how they will inform the planning priorities of the project. Assessment Tools Our team developed two separate confidential surveys for the needs assessment: one for youth serving agencies and another for domestic violence agencies. Both surveys featured open- and close-ended questions, allowing for both qualitative and quantitative analysis. The survey for youth agencies was administered by phone while the survey for the domestic violence agencies was administered online and by phone. Key Finding We found important strengths of both youth and domestic violence agencies in serving LGBTQ youth survivors of violence. The needs assessment also uncovered key gaps including a need for greater consistency of policies and practices relating to confidentiality and mandatory reporting within and across agencies in the area.
Section 2: Description of Partnership
Q-Lab or Queer Collaborations is a project of the NW Network of Bisexual, Trans, Lesbian, and Gay survivors of abuse. The Q-Lab project will provide a full spectrum of prevention, intervention, treatment and response to LGBTQ youth ages 13-24 who are experiencing dating violence, domestic violence, stalking, sexual assault or sexual exploitation in King County and the Puget Sound region. We are working with select collaborative partners across the county to create a regional and collaborative response to support and prevent LGBTQ youth victims of violence. Building on the NW Network’s record of success with multi-modal campaigns, Q-Lab will enhance protective factors for LGBTQ youth while building capacity within service systems. Local youth-serving programs will receive training and technical assistance to close skill and capacity gaps and increase access to services for LGBTQ youth. The project will launch the Teen Dating Violence Coalition and represent the needs of youth experiencing violence throughout regional service sectors. The Q-Lab Project Partners include: Seattle Counseling Services, Entre Hermanos, Mockingbird Society, Asian Counseling & Referral Services, Teen Feed, YouthCare, Seattle Public Schools and the Seattle Police Department’s Victim Services Team. The project prioritizes the expressed needs of LGBTQ youth survivors of dating and domestic violence, sexual assault, stalking and trafficking. Consequently, we chose many of the direct service project partners because they provide culturally specific services by and for the LGBTQ community. The organizations that work primarily with non-LGBTQ youth have demonstrated a commitment to the empowerment and safety of LGBTQ youth in their programming, including receiving training and technical assistance from the NW Network to increase their organizations’ cultural competency in their work with LGBTQ people. These collaborations live strongly at the intersections of our work and have been built through years of working together to promote the health and wellbeing of diverse LGBTQ communities and serve as a strong foundation from which to create a regional network of support for LGBTQ youth survivors.
Section 3: Methodology of the Assessment
Data Collection Our needs assessment aimed to learn about the knowledge, services, training, practices, and policies of organizations that interface with LGBTQ youth experiencing dating and domestic violence, stalking, sexual assault, and sexual exploitation. As such, our team conducted surveys with two types of agencies that often work with this population: youth-serving and domestic violence (DV) agencies. We created a separate survey for each type of agency, tailoring questions to the unique contexts and issues facing each. Both surveys addressed the key topic areas of the needs assessment, including: 1) services currently available for youth 2) mandatory reporting practices and 3) confidentiality policies. In addition, the youth services survey addressed topic 4) which pertained to staff training and preparedness.1 Secondly, we administered the survey for youth agencies as an interview over the phone whereas we conducted the survey for DV agencies using an online survey platform. We conducted the survey for DV providers online to enable its distribution through the Washington State Coalition Against Domestic Violence list serve so that we could reach a broader range of providers across the state. As a result, we included more questions on the survey for youth agencies and tried to limit the number of questions for DV agencies as a way to prevent burnout and attrition. Both surveys featured language at the beginning to provide informed consent for participants. We explained participants’ rights, emphasized that the surveys were voluntary, and that participants could stop at any time. Both surveys were confidential. We did not gather participants’ names to protect their privacy. Finally both surveys featured both close- and open-ended questions to allow for both quantitative and qualitative analysis. Data Analysis A member of the Q-Lab project team entered the data from youth agencies manually. The data from the domestic violence agencies were downloaded directly from the online system into Microsoft Excel. An evaluation and research consultant then exported the data from both youth and domestic violence agencies into SPSS 19 for analysis. The consultant ran descriptive and correlational statistics for the report. Because the two surveys featured different questions, the consultant ran the analyses using separate databases for youth and DV agencies. The NW Network has several projects specifically working with anti-violence organizations to meet the unique needs of LGBTQ communities including our National LGBT Domestic Violence Capacity Building Learning Center and the LGBTQ Access Project. The Access Project conducted an extensive needs assessment looking at services for adult LGBTQ crime victims. The Q-Lab assessment did not collect information regarding staff training and preparedness from domestic violence providers as we were able to utilize the data from the Access Project assessment to help inform the needs specific to domestic violence organizations in our region and did not find it necessary to duplicate the effort. 1
Section 4: Participant Profile
Youth Organization Staff A total of 23 staff members from 23 youth-serving agencies completed the needs assessment survey by telephone. The table below provides a description of the individuals from the youth organizations who completed the survey. Youth Survey Participants Organization Type Mental Health/Behavioral Health Community Services Homelessness Education Criminal/Legal Role in Organization* Manager Direct Service Admin
Percent 38% 29% 19% 10% 5%
70% 52% 9%
Time at Organization 0-1 year 9% 1-2 years 27% 2-4 years 23% 4-10 years 14% 10+ years 27% *Exceeds 100% because some respondents selected more than one role
Domestic Violence Organization Staff Our team collected online survey data on 31 participants from 19 domestic violence organizations. Multiple respondents from the same agency completed the survey for six of the organizations. In analyzing the data, our team discovered that participants from the same agency provided surprisingly different answers to the same questions. Since variability clearly existed both across and within agencies, our team decided to analyze the data from all participants, including those from the same agency. Thus we analyzed the data at the individual level, rather than the organizational level. The table below provides a description of the staff from the DV agencies who completed the survey.
DV Survey Participants Role in Organization Direct Service Management Administrative Other Time at Organization 0-1 year 2-4 years 5-7 years 8+ years
Percent 50% 21% 17% 13%
25% 25% 13% 38%
Section 5: Brief Report of Results A. Services for Youth The first question on the survey for staff at domestic violence (DV) organizations asked if their organization provides services for individuals under the age of 18. Although the vast majority (87%) reported yes, their responses to a subsequent question about challenges to serving youth illustrate important contexts that can affect the consistency, efficacy and availability of these services. For example, one respondent explained how service provision differs significantly based on which staff member the youth survivor is working with. "I will serve survivors, but there is no agency wide policy. I feel some of my co-workers would turn someone under the age of 18 away and/or automatically make a CPS report."
Additionally, several respondents described that although their organization is willing and able to serve youth, not many youth are coming through the doors. “[Youth survivors are] a highly undeserved population for us. We see very few of them but typically can provide all the same advocacy we would provide adult survivors. That said I don't know that someone under 18 [years old] would feel comfortable in women's support groups….” “Most of our challenges come from [our] lack of ability to do outreach for youth. We do have advocates that can assist with protection orders, provide counseling, safety planning, and shelter options. Our number[s] are low so we lack the ability to connect with youth.”
Respondents offered several potential reasons for the limited number of youth utilizing their services. For example, youth may not feel comfortable seeking services at organizations that primarily serve adults. Receiving services with individuals many years older was posed as a potential source of discomfort for youth. One respondent also described how this discomfort may be magnified if the organization also lacks younger people on staff. Furthermore, respondents reported that requiring youth to obtain parental consent in order to access services poses a significant barrier is getting youth in the door. Another potential reason for the underutilization of services by youth is the lack of or limited success of outreach efforts. Respondents described a need to “get the word out” and increase the visibility and awareness of their organization’s services. For some, this issue stems from a loss of funding and time for outreach efforts.
We asked both DV and youth organizations what services they provide for youth. For the DV organizations, the question used a close-ended format whereby respondents selected all the relevant services that they provide. Since many of the participating youth agencies provide especially wide-ranging services, this question used an openended answer format for these agencies. For this reason, percentages will only be provided for the DV organization respondents while the more qualitative data from youth organizations will be summarized thematically. Figure 1 below illustrates the percentage of respondents from DV organizations that report that their organization provides services for youth. As evident in the graph, the most commonly reported services were advocacy, safety planning, prevention, and legal services. The least common were shelter, housing, employment, and mental and medical health services. Figure 1. Services for Youth Provided by DV organizations Advocacy
93.5%
Safety Plan
80.6%
Prevention
74.2%
Legal services
71.0%
Case management
51.6%
Family services
48.4%
Emegency financial‌
45.2%
Support group
41.9%
Immigration services
38.7%
Emergency Shelter
35.5%
Shelter Mental health
32.3% 19.4%
Transitional housing
12.9%
Employment services
12.9%
Medical
9.7% % of respondents reporting their organization provides service
This, however, stands in stark contrast with the services reported by respondents from youth organizations. The most commonly reported services for these organizations include mental health and counseling services, case management, support groups and safety planning. Many youth organizations did, however, state that they regularly referred and connected youth with DV-specific services that they do not provide inhouse.
B. Mandated Reporting A primary goal of the assessment was to understand mandated reporting practices of DV and youth agencies. To assess this, the surveys posed a series of hypothetical scenarios involving a 16-year old client disclosing a variety of experiences around engaging in sex or experiencing sexual or physical violence. For each scenario, we asked respondents if they would be mandated to report this information, to whom, and why. We asked staff from youth organizations about six hypothetical scenarios and staff from DV organizations about two scenarios. Respondents from DV organizations received fewer scenarios for a couple of reasons. First, they completed the survey online, so we limited the number of questions to reduce the risk of burnout and attrition. Second, youth serving organizations often have less support and training on issues such as confidentiality and mandated reporting. For this reason we saw it as important to delve deeper to learn more about existing policies and practices of these agencies. Below is the list of the hypothetical scenarios: Imagine a 16- year old client told you: 1. Their same age partner slapped them 2. They had sex with another 16-year old while severely intoxicated 3. They had sex with someone 4 years older 4. Their partner threatened their life 5. They were sexually assaulted by a same-age acquaintance 6. They are being stalked by an abusive ex-partner
Figures 2 and 3 below show the percentage of respondents from youth and DV organizations that would file a report in each of the hypothetical situations. As seen in Figure 2, the majority of youth agency staff would file a mandated report when a client’s life is threatened or if they have been sexually assaulted. Interestingly, far fewer staff at DV organizations would report if a client had been sexually assaulted. Few staff at either youth or DV organizations would file a mandated report if a client had been slapped by their partner. Finally, it is clear that a large percentage of staff at both youth and DV organizations are not sure if they would have to file a report for each of the scenarios. This seems to be especially true for DV organizations.2 The differences between youth and DV organizations on mandated reporting practices may be due in part to the vastly different histories of these fields. Many individuals and organizations in the DV field have spent considerable time and energy developing and fortifying confidentiality laws. This may explain why DV agencies may be more likely to be cautious about breaking confidentiality, including by making mandated reports against the wishes of a young person.
DV organizations have spent a considerable amount of time fortifying privacy laws. The Violence Against Women Act has created stringent regulations with regards to confidentiality in order to protect survivors. Thus, DV organizations are more cautious to break confidentiality in any way, including making mandated reports against the wishes of a young person. 2
Figure 2. Whether youth agency staff would report hypothetical scenarios (n= 21) Yes No Don't Know/ It Depends Partner threatened their life
61%
Sexually assaulted
52%
Sex with 20 yr old
26%
Stalked by ex-partner
26%
Sex while severely intoxicated Slapped
9%
30%
26%
22%
39%
35%
43%
17%
30%
43%
13%
39%
52%
35%
Figure 3. Whether DV agency staff would report hypothetical scenarios (n= 26) Yes No Don't Know/ It Depends Sexually assaulted Slapped by partner
27% 8%
15% 38%
58% 54%
The qualitative data about the mandated reporting practices of DV organizations help explain the lack of consistency and knowledge about agencies’ reporting practices. When asked to explain why they would or would not report each scenario, DV agency staff often cited their understanding of mandatory reporting laws. Of particular interest for this project, the understanding of these laws differed starkly across staff and organizations. Below is a small snapshot of how organizations and staff understand these laws differently. “For us - a mandatory report could not be triggered if the 16 year old didn't give us names.” “I thought it was only a mandated report if someone in authority was abusing the child, like parent, teacher or other adult.” “It depends on whether they live together or if this is a dating relationship.” “My understanding is that any physical violence toward a minor is a mandated report.” “Depends on the nature and severity of the injury. If this is a transitory injury I probably would not report this.” “We would not report a child unless they were being abused or neglected by a family member as CPS has no jurisdiction over non-family perpetrators”
Finally, we asked respondents to whom they would report the information from the hypothetical situations. As demonstrated in Figures 4 and 5, organizations varied considerably in their responses. For all scenarios, both youth and DV agency staff were more likely to report the information to the police. However, some respondents would report the information to child protective services. And again, a sizable percentage of staff did not know where they would report the information. It should be noted that only youth organization staff received an answer choice option of “parents.” We deemed this answer choice less relevant for staff at DV organizations, which was confirmed by the fact that no DV organization respondent included parent in the openended option of “other.” Figure 4. Where youth organization staff would report
Figure 5. Where DV organization staff would report
C. Confidentiality Another goal of the needs assessment was to learn about the confidentiality procedures of youth and DV organizations when it comes to addressing youth experiencing dating/domestic violence. Through the course of working with youth survivors of dating/domestic violence over the years, the Q-Lab project team has built substantial experiential evidence about wide-ranging confidentiality practices across organizations. The needs assessment allowed us to explore these organizational differences more systematically. Based on the existing experiential evidence, the Q-Lab project team posed different survey questions to the youth and DV organizations to reflect the different confidentiality issues these two types of organizations typically face. Specifically, we asked youth organization staff about what they consider confidential information and with whom they would share a hypothetical piece of confidential information about a youth in their program. For staff of DV organizations, we asked about whether existing organizational confidentiality policies pertain to youth and what those policies are. Youth Organization Practices When asked about what types of information their organization considered confidential, roughly a third of youth organization staff (30%) described broadly that their organization considers “everything” to be confidential. Interestingly, in the subsequent questions about whether their organization would share information about a hypothetical youth’s attendance with different stakeholders, these same staff had mixed responses. That is, even though they report that all information is confidential, some staff would share attendance information, and others were not sure if they would. This indicates potentially varying definitions of confidentiality among youth organizations in the region. The remaining youth organization respondents went into more detail, describing specific types of information their organization considers confidential and specific limitations to confidentiality. Types of confidential information included things like “anything that is individually-specific,” “demographic information,” “anything related to medical information or sexual assault,” and “anything that happens while the youth is participating in the program.” Limits to confidentiality varied widely across organizations. Some focused on potential or actual threats to self or others, including if youth “threaten another youth or staff member,” “[are] sexually aggressive or registered sex offender,” “have history of violent behavior towards self or others,” “[has a] safety or serious legal issue,” or “lives are in danger.” Others described being required to provide confidential information to specific people or institutions. For example, one organization described that “[youth] under 18 are either a ward of the state or parents so those parties could file a suit to get this information.” Figure 6 below shows youth organization responses to the hypothetical questions about with whom their organization would share information about a youth’s attendance in their program. The graph demonstrates that staff at youth organizations are more likely to share this information with parents and police. One area of strength is that the
overwhelming majority of staff reported that they would not share this information with a case manager or healthcare worker. Finally, many staff are unsure about whether they would share this information with police or a legal or court representative. Figure 6. Whether youth organizations would share attendance information with different stakeholders. Yes No Don't Know/ Mixed Parent Police
21%
63%
13%
46%
Legal 5% Representative
17%
42%
55%
41%
Casemanager 4%
83%
13%
Healthcare 5%
82%
14%
DV Organization Practices With regards to confidentiality, 73% of staff from DV organizations reported that their organization had a specific confidentiality policy about serving youth. Figure 7 below shows the type of confidentiality policy at organizations. Although the majority of staff describe that their organization can provide confidential services for 13-18 year olds, many respondents cite complications and potential breaches of confidentiality posed by mandatory reporting law, parental consent laws, and inconsistencies in confidentiality policies and practices between providers. These laws add a layer of complexity for organizations to confidentially serve youth. Figure 7. Confidentiality policies at DV organizations for youth 13-18 years old No policy 11%
Some but not all services are confidential 22%
All services are confidential 67%
D. Training & Preparedness In the last section of the needs assessment, we asked youth agency staff about whether they received training on topics relevant for this project and to rate the preparedness of their organization’s staff to work with different populations of youth. As illustrated in Figure 8, with the exception of training on LGBTQ youth, the majority of respondents have not received training on relevant topics. It is particularly worth noting that 87% of respondents have not received training on LGBTQ youth experiencing dating violence. There is a clear need for future training on this topic for youth providers in the region. Figure 8. Training received by youth agency staff (n= 23) LGBTQ youth
Yes, 68%
Dating/intimate partner violence
48%
Youth in the sex trades
52%
43%
Sexual violence LGBTQ youth experiencing dating violence
No, 32%
57%
39%
61%
13%
87%
Similar to the findings on training, Figure 9 shows that staff identify that their agency is most prepared to serve LGBTQ youth. Fewer staff rate their agency as well prepared to serve youth in the sex trades or youth experiencing DV/IPV. Although somewhat counterintuitive, the finding that 13% of staff report that their agency is not at all prepared to serve youth in the sex trades may actually be a positive sign. It illustrates that staff identify this as a unique population and recognize the need for greater training and resources to prepare them to serve this group effectively.
Figure 9. Preparedness of staff to work with unique youth populations (n= 22) Completely
Very much
Youth in the sex trades 4% 9%
LGBTQ youth
Youth experiencing DV/IPV
39%
13%
4%
Somewhat
30%
26%
22%
A little
Not at all 13%
48%
52%
9%
22%
Section 6: Analysis of Key Findings Our region has the will to serve LGBTQ youth experiencing violence, but needs support to expand the infrastructure, policies, and training opportunities to do this effectively. It is important to note that the two main doors of entry into care for youth who are experiencing dating violence are youth serving organizations and domestic violence organizations. Youth are coming into these agencies needing a combination of supports. However, if these two systems send mixed messages regarding what harms are mandated reports, how will youth know if they can expect confidential support? How can a young person feel safe disclosing that they are experiencing violence when they can’t be sure what will happen to them? When asked both the domestic violence and youth providers said they didn’t often see youth who were experiencing peer to peer sexual or dating violence. The lack of consistency around reporting and general misunderstanding about what teen dating violence is and how it works creates barriers for young people to find safety and maintain their self-determination, thereby reducing their willingness to seek services. Based on these finding and in connection with the activities outlined in our Queer Collaborations Logic Model, Q-lab hopes to:
3
Provide specific training for service providers in our region on LGBTQ youth dating violence issues3 Support our region to strengthen and clarify confidentiality policy and practice with particular regard to supporting youth ages 13-18 Administer training and technical assistance to organizations working with young people in providing confidential services to youth experiencing domestic and sexual violence Work through our Q-lab Teen Dating Violence Coalition to develop best practices for our region regarding mandatory reporting issues o Even when comprehensive confidentiality policies are in place direct service workers need support in practical on the ground training regarding implementation of these policies and understanding when it is and is not required of them to make mandated reports Support our region’s youth serving organizations in better understanding patterns of power and control and the need for confidential supports for survivors of domestic/dating violence, sexual assault, stalking and sexual exploitation Provide training and technical assistance to organizations working with youth under the age of 18 experiencing sexual violence4
87% of respondents have not received training on supporting LGBTQ youth experiencing dating violence 4 Based on our findings, when youth under the age of 18 did report experiences of peer to peer sexual violence 52% of youth service workers said that they would make a report of some kind while only 27% of domestic violence agency staff said they would make a report. When asked,

Support organizations in our region to not only competently serve youth experiencing violence but to proactively design programs and services that can meet the unique needs of youth survivors of violence
58% of domestic violence agency staff said they either didn’t know if they would make a report or that it depended on a number of factors.