Blog: LGBTQ inequality in mental health
Published: 5 Feb 2019
Discrimination and inequality in health and social care settings have been revealed in a recent government survey of LGBTQ people.
In a recent official survey of Lesbian, Gay, Bisexual, Trans and Queer people, 16% of respondents said their experiences of health services had been negative because of their sexual orientation, and this rose to 38% for transgender people*. Inevitability this will result in poorer health outcomes, and these are especially pronounced in mental health.
As the Director of Advocacy Centre North, a charity representing the needs of vulnerable people in Newcastle-Upon-Tyne, I’m naturally concerned by this situation. Doubly so because LGBTQ people are already at an increased risk of mental health problems. The survey identified that two thirds of LGBTQ people are afraid to hold hands in public for fear of discrimination. This type of anxiety, not to mention physical violence and hate crimes they may also be the victim of, can eventually lead to a person experiencing PTSD-like symptoms.
Below: a march during Toronto Pride Month
I visited Canada in 2017 and Australia in 2018 on a Churchill Fellowship to look at how third sector leaders are addressing this issue through ‘independent advocacy’. Independent advocacy is about standing alongside disadvantaged people and supporting them to uphold their rights. It is a practice that is ideally placed to move from its traditional role of working with disabled people and older people in health and social care settings, to working with LGBTQ people who also experience disadvantage in these settings.
During my travels, I came across the idea of ‘cultural competency’. This approach gives providers a clear responsibility for meeting the specific needs of different groups. Meeting the needs of diverse individuals is therefore framed as an issue of basic competence.
In both Australia and Canada, I observed important work aimed at raising mental health professionals’ awareness of the issues faced by LGBTQ people. In Sydney, LGBTI Health Alliance run an intensive course for counsellors and produce training packs for mental health professionals. In Ontario, Rainbow Health host group sessions to inform and support GPs who are working with trans people.
Below: Jacqui, second from right, with LGBTI Health Alliance team, Sydney, Australia
Now I’m back in the UK, I‘m focusing on sharing and discussing my findings and recommendations, not only within the advocacy sector, but also within the wider voluntary, community and public sectors, and with policy-makers.
LGBTQ people are often wary of seeking help about their mental health needs, in case it is blamed on their sexuality. It is important that mental health professionals not only become culturally competent, but also develop an awareness that LGBTQ people’s mental distress is often caused by societal discrimination. I want LGBTQ people to feel confident in a competent mental health service that can meet their needs - and I hope that my Fellowship will contribute to achieving this.
* LGBT Action Plan, Government Equalities Office, July 2018