Even as many addiction treatment centers have begun marketing treatment tracks established for members of the lesbian, gay, bisexual and transgender (LGBT) community, the Minnesota-based PRIDE Institute still holds its standing as an innovator in its exclusive focus on the addiction and related health care needs of LGBT clients.

Now in its 26th year of operation, PRIDE often finds itself assisting individuals who previously attended treatment in programs that called themselves “LGBT-affirming” but that in reality fell short of that ideal.

“We have clients who come to us who came from a program that they were told was LGBT-specific but where they experienced harassment,” Nicky Simon-Burton, PRIDE’s director of community relations and marketing, told ADAW. With PRIDE’s LGBT-exclusive environment, “this is a place where someone can go and not fear whether their roommate is going to be homophobic,” Simon-Burton said.

PRIDE also has remained strikingly consistent in its business operations since its 1986 founding. While in recent years it has expanded from its addiction services base somewhat to incorporate more services in mental health, sexual health and sexual compulsivity, it does not envision major service or capacity expansions going forward.

For example, Simon-Burton said that the organization has no plans to establish its own recovery housing, preferring to refer its clients to recovery homes with a sound reputation in the local community — including some that were established by former PRIDE clients or staff.

What might be most noteworthy about PRIDE is the surprising thought that with so much current attention to the addiction and recovery needs of the LGBT community, so few organizations have tried to replicate PRIDE’s LGBT-exclusive model elsewhere in the country. Simon-Burton has one possible explanation for this.

“This is a complex community, and staying abreast of its changing needs can be intense,” she said. “I’ve encountered programs that couldn’t sustain a census.”

High demand

Keeping beds full doesn’t pose a challenge for PRIDE administrators, even though their target market represents only about 10 percent of the nation’s population. Simon-Burton says PRIDE is routinely maintaining waiting lists for both its 42-bed residential treatment facility and its intensive outpatient (IOP) tracks; she says the organization serves about 400 IOP clients in a typical month. She said admissions staff members maintain daily contact with individuals as they wait for a treatment slot to open.

Simon-Burton said PRIDE’s most common referral bases are the Internet and clinical settings such as other IOP programs and counseling centers. Outside of Minnesota, the states from which the next highest number of PRIDE clients reside are New York and Illinois. A good number of individuals who arrive from another state end up staying in Minnesota post-treatment, taking advantage of the opportunities available via the state’s strong recovery community.

Simon-Burton in fact credits a number of characteristics of Minnesota, from its gay-friendly policies to the Minnesota model of treatment, for creating a confluence of factors that made it easy for PRIDE to be established there in the 1980s, long before “LGBT-affirming” became part of the treatment vocabulary.

Targeted marketing to individuals covered by private insurance has resulted in more than half of the organization’s revenue coming from the insurance market, but that also has created frustration as of late. Simon-Burton said that CEO Rick Pliszka’s greatest concern at present is that residential stays for insured patients continue to be pushed downward, with little apparent impact from the federal parity law.

“The concern is that parity has not had enough of an impact on the quality of care,” Simon-Burton said. “As a result, we have to work harder, faster with our clients. And not everybody is ready to work that fast.”

Other trends

Simon-Burton said that any additions PRIDE has made to its programming have been based on identifying emerging needs in the LGBT community. It is offering more mental health services to address issues such as depression and anxiety, and it also has moved into areas such as sexual health and Internet addiction. Admission to PRIDE’s residential treatment and IOP programs still requires a substance abuse diagnosis.

As it looks to the future, PRIDE will closely monitor how the greater cultural acceptance of LGBT individuals in many communities could affect patterns of substance use and why clients are using. Simon-Burton said that drug-use patterns in the client population have remained relatively stable, with crystal meth use still high and prescription drug and cocaine use also prevalent.

PRIDE also has the knowledge base to understand how key events in the LGBT community, such as June’s traditional Pride Month celebrations, can affect recovery and relapse risk in the community. This is likely not common knowledge in programs that might have one LGBT therapist or a small LGBT treatment track.

Another factor that Simon-Burton cites as contributing to PRIDE’s stability is its ownership by large hospital company Universal Health Services (UHS); PRIDE was part of Psychiatric Solutions, Inc., before UHS acquired Psychiatric Solutions in 2010. Simon-Burton says many people ask her about the effects of being owned by a major hospital chain, but she says it has been a source of stability because “they are about client outcomes.”

While PRIDE certainly monitors trends in other treatment programs, such as the establishment of LGBT tracks and the hiring of LGBT staff, its officials still believe in most cases that their LGBT-exclusive environment differs greatly from a program that might conduct an LGBT-specific group once a week. And Simon-Burton points out that even in centers where staff members are sufficiently trained to work with LGBT clients, other patients might still pose a problem for the LGBT client.

PRIDE Institute

  • Location: Eden Prairie, Minn.
  • Founded: 1986
  • Services: Residential treatment, intensive outpatient treatment and mental health services for lesbian, gay, bisexual and transgender clients
  • Employees: 75 full- and part-time
  • Payer mix: About 55 percent private insurance, 5 percent self-pay, 40 percent Medicaid