It’s time to talk about LGBT mental health in Scotland
Did you know that lesbian, gay, bisexual and transgender (LGBT) people in Scotland experience poorer than average mental health and yet are less likely to use mental health services?
Join us in developing LGBT inclusive mental health services in Scotland.
As the only charity in Scotland providing specialist services to LGBT adults, we know that LGBT people continue to experience poorer than average mental health. But we also know that we can change this, together. In our bid to improve the wellbeing of LGBT people in Scotland, we are launching a National Conversation on Mental Health to find solutions to the barriers LGBT people face when using mental health services in Scotland.
LGBT people are at higher risks of experiencing mental health problems
Research over the past years have consistently evidenced higher levels of mental health problems within the LGBT community. Stonewall Scotland’s latest report (2018-19) on the health of LGBT people in Scotland highlights a disturbing number of LGBT people experiencing depression (49%) and anxiety (60%), resulting in self-harm (16%) and thoughts of suicide (32%).
However, a common misconception is that poor mental health is an intrinsic part of being LGBT: “In my previous experiences with mental health professionals, people had often linked my sexual orientation to my mental health conditions and both had felt like labels”
After years of community work with LGBT people, we know that it is the stigmatisation of LGBT identities as well as people’s past experiences of discrimination and their anticipation of being discriminated against that profoundly impacts wellbeing.
Discrimination
Despite progress and legal changes in Scotland, for many LGBT people discrimination is still an everyday reality. In fact, hate crimes against LGBT people in Scotland have consistently increased over the past 10 years and were at their highest in the year to March 2019. It is difficult to know to what extent this rise reflects an increase in confidence around reporting hate crime, but a 2017 report from Stonewall Scotland suggests that despite the introduction of hate crime legislation, 87% of anti-LGBT hate crimes still go unreported.
Minority stress
The threat and reality of discrimination can have a devastating impact on wellbeing, pushing many LGBT people to live in a constant state of stress and fear. This is best explained by the concept of ‘minority stress’ which recognises that experiences of “stigma, prejudice and discrimination create a hostile and stressful social environment that causes mental health problems”. As a result, a majority of LGBT people in Scotland still ‘never’ or only ‘sometimes’ feel able to be open about their sexual orientation or gender identity with their own family (52%), at work (60%) or when accessing services (71%).
Stigma
Coming to terms with one’s identity becomes difficult in a social environment that is prejudiced against LGBT people. As a community organisation, we witness the impact of stigma on a daily basis and a large part of our work focuses on supporting LGBT people to accept themselves and celebrate who they are, so they can grow in resilience and happiness. Currently, trans people in Scotland are being vilified in a toxic public discourse surrounding reform to the Gender Recognition Act (GRA). The consultation has put the spotlight on trans people in an unprecedented way, challenging their fundamental rights to live in safety and access public spaces and services.
LGBT people face barriers in accessing mental health services in Scotland
And yet, despite being particularly vulnerable to poor mental health LGBT people are less likely to access key health services. In fact, many of us are reluctant to be open about our sexual orientation or gender identity when seeking medical help because of fear of being treated differently. And when we decide to ‘come out’ to healthcare providers, we often have a poor experience. A few issues include:
Irrelevant or wrong information
37% of LGBT people find that health information isn’t relevant to their sexual orientation or gender identity. For example, 60% of lesbian and bisexual women say it’s hard to find relevant information about sexual health, and 37% of them were told that they did not require cervical screening test.
Gaps in knowledge
27% of LGBT people (59% of trans people) experienced healthcare staff lacking understanding of their specific needs
Assumptions and invasive questioning
55% of LGBT people experienced healthcare staff making incorrect assumptions about their sexual orientation or gender identity. And 25% experienced inappropriate curiosity because of their sexual orientation and gender identity.
Discrimination
13% of LGBT people received unfair treatment from healthcare staff, as well as being outed without consent to other staff or patients.
Those negative experiences contribute to mainstream health services not feeling ‘safe’ for LGBT people, who all too often feel unable to access the health care that they need.
Working towards LGBT inclusive mental health services in Scotland
Healthcare and service providers play a key role in the recovery and wellbeing of the people that reach out for support. Therefore, you play a key part in ensuring LGBT people can access services that are affirmative of their identities and inclusive of their needs. Together, we can work towards a health sector that fully embraces the diversity of the LGBT community, where LGBT people feel safe and taken care of with dignity and respect.
Practical steps and resources
We have developed a range of resources to help health and social care services provide quality care and support to LGBT people.
LGBT Inclusive Mental Health Services
A guide developed in partnership with the Mental Welfare Commission for Scotland, including practical steps you can take to improve the experience of LGBT people accessing your services.
LGBT Mental Health Audit Tool
A framework to help you examine your practice and identify practical steps to ensure your services include the needs of LGBT people (including around policy, evaluation and promotion).
LGBT Helpline Scotland
We offer a helpline service on Tuesdays and Wednesdays between 12-9pm that you can use to ask for information and advice on how to best support LGBT people.
Find out about the experiences of LGBT people in Scotland
On Sunday 22nd September, we are hosting a National Conversation on Mental Health bringing the LGBT community together to talk about mental health and identify solutions to overcome barriers when we look to mainstream services for support.
The conversation will span across 3 events:
During the Community Discussion, we would like to engage organisations that want to improve mental health services for the LGBT community. This will be a great opportunity to learn about the experiences of LGBT people using mental health services in Scotland and identify solutions to overcome barriers. Join us in working towards a Scotland where LGBT people have access to services that are responsive to their needs.
