Report on a service in Brighton that has, for the last 10 years, bridged the gap between the gay community and professionals
Despite the high prevalence of mental health issues among the lesbian, gay, bisexual and transgender (LGBT) community there are relatively few services across the country addressing their needs.
The most recent national statistics date back to 2003 and show that while only 33% of heterosexual men had seen a mental health practitioner about emotional difficulties 53% of gay men had done so. The gap between straight and lesbian was 24 percentage points. Further, 33% of gay men reported negative reactions when they disclosed their sexuality to a health professional. Despite this there are few dedicated services for this group outside major population centres such as London, Brighton and Manchester.
Mind Out in Brighton, a city known for its large LGBT community, is a project that has been filling the gap for over a decade.
It started as an advocacy service in 1999. A collaboration between Brighton and Hove LGBT Switchboard, a helpline which also provides face-to-face counselling, and mental health charity Mind, it was formed because of the number of inquiries they were receiving from their respective client groups.
Today the service encompasses peers support groups, which aim to help clients through shared experiences, activities groups, which help to tackle social isolation, and awareness raising campaigns.
Service manager Helen Jones says most issues are rooted in professionals’ heterosexist attitudes which see homosexuality as unusual and sometimes part of the problem.
Jones points out that it was only removed from the World Health Organisation’s list of mental disorders in 1992. She believes there are some mental health professionals who still see it as a developmental problem and fear of this stops many people coming forward to seek help.
However, there are instances where prejudices, discrimination and harassment suffered by LGBT people contribute to their mental ill-health. Mind Out client and disabled person Alison Grey needs a care worker to help her out of bed but has found staff to be uncomfortable with her girlfriend’s presence and to often refuse to help until she had left the room. “You are made to feel worthless and have no dignity,” she says.
Striking the balance between taking sexuality and gender identity into account and not attributing problems to it unnecessarily is difficult. Jones advocates training as a place for staff to reflect on their own attitudes. “It has made me more confident about discussing LGBT issues in an open way,” says approved mental health practitioner Nerina Parr, who has attended one of Mind Out’s training sessions. She says awareness of the pressures LGBT face and their consequences has helped her direct clients to targeted services.
Some people don’t request help at all. “LGBT people have an expectation of discrimination on some level,” states Jones. In order to combat this she says it’s important that services are vocal about being welcoming. Simple actions such as LGBT positive images on posters or welcoming statements create an expectation which even if not delivered on can empower service users to speak out against bad practice, she says.
Jones is keen to expand Mind Out’s services into brokerage, helping people access services, as part of personalisation agenda. With a client base of around 300 people a year there would appear to be ample demand to support this. Jones is confident all authorities can improve in this area if the city with one of the country’s biggest LGBT populations has room for improvement. “LGBT people want mainstream services to be more appropriate but they also want specialist services in their own communities,” she says.
Ralf Harrison’s * depression and anger was originally triggered by homophobic bullying at work. “I had been ill for many years on and off but I had fought it off,” he says. He eventually checked himself into hospital, but says he rarely reveals his sexuality to professionals when he sees them because he believes they will make judgements about him and his illness because of it. He says this problem is exasperated for trans-gendered people he has spoken to as they find it harder to hide this aspect of themselves.
Harrison confirms he isn’t open about his sexuality even though he feels people have a more rounded view of the reasons for his illness when he is out to them. “They don’t understand my history so they don’t understand my outbursts,” he says. He says it’s easy to feel isolated when you are hiding an element of your identity.
However, at Mind Out he feels comfortable and accepted; a situation helped by many of the staff being openly gay themselves. Revealing his sexuality has led to improved advice. Support workers have advised him about risky areas of the city for gay people which he says is helpful because those with mental health issues are sometimes more vulnerable to exploitation. “It’s a holistic approach to mental health,” he says.
*not his real name
Top tips for services
- Create an LGBT positive environment with images and messages.
- Monitor your service’s success in reaching the LGBT community as part of standard registration processes.
- Don’t be afraid to challenge behaviour, it is everyone’s responsibility.
- Reflect on your own attitudes regularly, it’s an ongoing process.
This article is published in the 25 February 2010 edition of Community Care magazine under the headline Keeping Gay Issues in Mind