Lesbian, gay, bisexual and trans individuals, like anyone, will experience mental health challenges and distress during their lifetime.
However the evidence both from the UK and internationally highlights increased levels of common mental health problems, such as depression, anxiety and stress among people from these groups.
The negative impacts of experiences of discrimination and marginalisation, both direct and indirect, on LGBT individuals and groups are well established.
Research also suggests that there may be additional inequalities affecting LGBT people from ethnic minority communities or those living with disabilities.
Addressing these impacts and preventing them in the first place must be part of our approach to protecting and improving the public’s mental health at both national and local level.
Promoting the health and wellbeing of gay and bisexual men and other men who have sex with men (2014) highlights the link between mental health, sexual health and issues of substance misuse, within the wider social and legislative context.
This pattern is expected to be similar for trans individuals and lesbian and bisexual women, although there may be different interactions around physical health which may be stronger, for example issues of cervical and breast cancer for women and issues relating to access to gender identity services for trans people.
In addition, the available data on suicide and self-harm among young LGBT people is stark, and highlights the need for local and national suicide prevention strategies and action plans to consider LGBT issues in their approaches.
Some statistics that highlight the reality of the issue include:
- 52% of young LGBT people reported self-harm either recently or in the past compared to 25% of heterosexual non-trans young people and 44% of young LGBT people have considered suicide compared to 26% of heterosexual non-trans young people.
- The Gay Men’s Health Survey (2013) found that in the last year, 3% of gay men have attempted to take their own life. This increases to 5% of black and minority ethnic men, 5% of bisexual men and 7% of gay and bisexual men with a disability. In the same period, 0.4% of all men attempted to take their own life
- Prescription for Change (2008) found that In the last year, 5% of lesbians and bisexual women say they have attempted to take their own life. This increases to 7% of bisexual women, 7% of black and minority ethnic women and 10% of lesbians and bisexual women with a disability.
- The Trans Mental Health Study (2012) found that 11% of trans people had thought about ending their lives at some point in the last year and 33% had attempted to take their life more than once in their lifetime, 3% attempting suicide more than 10 times.
Developing an LGBT inclusive approach to protecting and improving mental health and to prevent suicide should be done alongside LGBT community organisations and members.
Many local areas are already demonstrating promising practice in this space, highlighting mental health issues through the local LGBT needs assessments.
Although there has been significant legislative reform and constructive statements from professionals bodies, issues remain for LGBT people when accessing inclusive and supportive mental health services.
Diagnosis Homophobic (1995) set out a variety of harrowing narratives from lesbian, gay and bisexual mental health services users about their experiences of NHS services.
Sadly Stonewall’s Unhealthy Attitudes highlight recent experiences of discrimination in the NHS, suggesting that although progress has been made, many LGBT NHS staff and patients still experience and perceive discrimination in NHS settings.
In partnership with the Royal College of Nursing, PHE published two toolkits to support front line healthcare professionals to help them prevent suicide amongst LGBT young people.
The introduction of the NHS sexual orientation monitoring information standard builds on the existing collection of data through IAPT talking therapies services.
It will increase our understanding at a national and local level about inequalities in service uptake and potential barriers when accessing healthcare services for LGBT clients.
The Mental Health Intelligence Network is actively looking at how this data can be visualised as it becomes available.
Responding to mental health challenges is not something that can be achieved by any specific part of the system in isolation. Working together at both national and local level between the public, private, the third sector and most importantly the LGBT community itself, there is potential to support better mental health and wellbeing improve the lives of all lesbian, gay, bisexual and trans people of all ages.
Interested in LGBT health? Read our blog on the health needs of LGBT women.