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“No One Leaves Home Unless Home Is the Mouth of a Shark": Collaborating to Advance the Emotional Health of LGBTQ Individuals in Crisis Zones

Available: June 1, 2024 - June 1, 2027


This course is free to members for the month of June 2024. On July 1, 2024, the course will be available for purchase.


In June 2020, the death by suicide of a young Egyptian LGBTQ activist Sarah Hegazi sent shock waves throughout the world. LGBTQ communities around the world were affected by this tragic loss, experiencing feelings of sadness, anger, frustration, helplessness, and hopelessness as they mourned her death. Her death highlighted the tragic situation of the mental health of sexual and gender minorities. In the MENA region and other areas around the world, LGBTQ people face mental health disparities while dealing with repressive authorities, rejection, denial of existence and naked, blunt and culturally “justified” violence. Many LGBTQ individuals, in addition to being silenced, are continually being shamed, prosecuted, and pressured to either change their sexual orientation or gender identity or to conform with the perceived societal ‘norms’. This pressure can cause significant trauma/acute and post-traumatic stress disorders as well as anxiety, depression, substance use, and at times may lead to suicide. Moreover, living with stigma and isolation can lead to risky behaviors that increase the risk of exposure to violence and victimization. Even when LGBTQ people immigrate to or seek refuge in other countries, their struggles continue as they find themselves dealing with the exact same oppression by communities of origins abroad, along with new forms of discrimination and barriers to integration with the host culture, where local and national movements are fighting the legal, political and social discriminations in various forms, levels, and degrees. In this session, the speakers will describe some of the specific challenges and mental health consequences faced by LGBTQ refugees from around the globe, including examples, and underline the profound mental health needs of this population. We will also share the journey of starting up an online program that aims at providing emotional support and psychoeducation to LGBTQ refugees located in Afghanistan using a trauma-informed and culturally/linguistically-appropriate approach and discuss the challenges and successes of this project. We will present ways in which psychiatrists can engage in assisting these most vulnerable individuals wherever they are in the world from here in the U.S. by working remotely to provide assessment, treatment, training and supervision. The newly launched UN document known as the Istanbul Protocol-22 with its new LGBTIQ section will be introduced as well as how to access remote training.


Recorded webinar, non-interactive, self-paced distance learning activity.

This presentation was recorded at the American Psychiatric Association Annual Meeting 2023.

Learning Objectives

  • Highlight the precarious circumstances of LGBTQ refugees, including their mental health needs
  • Discuss challenges and successes of starting up a collaborative online emotional support for LGBTQ Afghani refugees
  • Understand the role of mental health professionals in the assessment of survivors of human rights abuses

Target Audience

Medical Students, Residents/Fellows, Psychiatrists

Estimated Time to Complete

Estimated Duration: 1.50 hours
Begin Date: June 1, 2024
End Date: June 1, 2027

How to Earn Credit

Participants who wish to earn AMA PRA Category 1 Credit ™ or a certificate of participation may do so by completing all sections of the course including the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the event date and hours earned.

Continuing Education Credit

In support of improving patient care, the American Psychiatric Association is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.


The APA designates this enduring activity for a maximum of 1.50 AMA PRA Category 1 Credit ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Faculty and Planner Disclosures

The American Psychiatric Association adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Medical Education. Any individuals in a position to control the content of a CME activity — including faculty, planners, reviewers or others — are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Program Presenters

  • Omar Fattal, MD, MPH.
  • Joanne Ahola, MD, DLFAPA. 
  • Graeme Reid, PhD. 

Program Planners

  • Vishal Madaan, MD. Chief of Education and Deputy Medical Director, APA.

Accessibility for Participants with Disabilities

The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. If you have trouble accessing any of APA’s online resources, please contact us at 202-559-3900 for assistance.

Technical Requirements

This internet-based CME activity is best experienced using any of the following:

  • The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari
  • Internet Explorer 11+

This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player.

Optimal System Configuration:

  • Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)
  • Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)
  • Internet Connection: 1 Mbps or higher

Minimum Requirements:

  • Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content
  • Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content

For assistance: Contact for questions about this activity | Contact for technical assistance

Availability: On-Demand
Expires on Jun 01, 2027
Cost: Member: $18.75
Non-Member: $37.50
Medical Student: $18.75
Resident Fellow Member: $18.75
Credit Offered:
1.5 CME Credits
1.5 COP Credits
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