New figures show 43% of LGBTI+ people are dissatisfied with mental health services

Mental Health Reform launch ‘My LGBTI+ Voice Matters’ report in partnership with LGBT Ireland to mark Pride Month

New research published by Mental Health Reform in partnership with LGBT Ireland reveals that nearly half (43%) of LGBTI+ people have had a poor experience of HSE mental health services.

‘My LGBTI+ Voice Matters: A Mixed Methods Exploration of the Views and Experiences of LGBTI+ Mental Health Services Users’ aims to explore the views and experiences of LGBTI+ people who use mental health services in an effort to provide insight into how mental health services and supports can better meet their needs.

The study draws on survey data from almost 1,200 mental health service users. Approximately one in every five participants identified as members of the LGBTI+ community, one of the largest samples of LGBTI+ mental health service users to share their views and experiences of the mental health services in Ireland. The study was also informed by focus groups with people from the LGBTI+ community.

22% of LGBTI+ participants said they were never well-supported and listened to by their current psychiatrist, while less than one in three (31%) felt that they were always treated with dignity and respect by community mental health services. 30% of LGBTI+ participants reported low levels of satisfaction with the mental health specific treatment received from their GP and more than one quarter (26%) disagreed that their GP gave them enough time to speak about their mental health difficulty and listened to what they had to say.

By contrast, the majority of LGBTI+ participants (58%) said they felt well-supported by their key worker. The study indicates that LGBTI+ participants are less likely to be satisfied with mental health services when compared to non-LGBTI+ participants.

Negative experiences shared by participants were characterised by a lack of LGBTI+ competence and sensitivity among mental health professionals. This manifested as inappropriate questions and comments by some mental health professionals, as well as apprehension and even fear among LGBTI+ service users.

Having to explain one’s gender or sexual identities to mental health service providers, to teach mental health service providers about LGBTI+ issues and terminology, and to self-censor when engaging with mental health service providers were common experiences. Stigma relating to, and pathologising of, LGBTI+ identification were also identified as challenges by LGBTI+ mental health service users.

Participants in the transgender community raised concerns about the diagnostic model of transition care. Currently, members of the transgender community are required to access the mental health services to receive a referral or a diagnosis of gender dysphoria to access gender affirmation services. The diagnostic approach to transition care was described as problematic by participants and perceived by some to be an infringement on their personal autonomy.

Speaking at the launch of the report, Róisín Clarke, Interim CEO, Mental Health Reform said: “Despite the development of progressive LGBTI+ policies and guidance in recent years, this research shows that many LGBTI+ people continue to have negative experiences of the mental health services. Stigma and a lack of LGBTI+ competence and sensitivity can have an adverse effect on LGBTI+ individuals who are experiencing mental health difficulties. These challenges are compounded by long waiting lists, staffing shortages and a lack of therapeutic supports in our mental health system.

LGBTI+ people are at a higher risk of experiencing mental health issues than heterosexual cisgender people. It is therefore crucial that individuals in the LGBTI+ community have access to inclusive and appropriate mental health supports that respect their rights and needs. Findings demonstrate a clear need for LGBTI+ training and education for mental health service providers. Increased investment in our mental health services must also be prioritised to improve the quality of treatment and care for people in the LGBTI+ community.”

Paula Fagan, CEO, LGBT Ireland, said: “We greatly welcome this research which provides important evidence of LGBTI+ people’s recent experiences of mental health services. This report clearly shows that much more work is needed to ensure that LGBTI+ people have access to mental health services that can meet their needs and that affirms their identities.

The research found that the knowledge, competence and sensitivity of mental health professionals was a significant moderating factor in the quality of the LGBTI+ people’s experiences of mental health services – where this was positive it was a lifeline – where this was negative it caused additional strain and led some participants to self-censor what they shared with their mental health professional. In light of these findings, it is imperative that mental health professional bodies and service providers urgently prioritise the rollout of LGBTI+ inclusion measures, including LGBTI+ awareness training, so that mental health treatment and care promotes recovery and positive outcomes for LGBTI+ people engaging with services.”


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