A Blog from SAYiT CEO Steve Slack for Mental Health Awareness week.
On May 17th many of us celebrated IDAHOBIT (International Day Against Homophobia, Biphobia, Interphobia and Transphobia). The date commemorates the day thirty years ago when the World Health Organisation removed homosexuality from the classification of diseases and related health problems. There are numerous accounts of how homosexuality was previously treated as a mental health disorder in this country. I have spoken to many LGBT+ people who have told me heart breaking stories of how they were subjected to appallingly barbaric psychiatric treatments. ‘Treatments’ for homosexuality included electro convulsive therapy (ECT) and aversion therapies – where ‘patients’ were given drugs to make them vomit whilst being simultaneously shown naked homoerotic images. Thankfully such practices no longer take place in the UK. But there is currently no legislation outlawing conversion therapy. Conversion therapy refers to any form of treatment or psychotherapy which aims to change a person’s sexual orientation or gender identity, based on the assumption that being LGBT+ is a mental illness. Most counselling bodies and psychotherapy organisations in the UK and the NHS have condemned the practice of conversion therapy as dangerous. The government is being called upon to outlaw the practice.
In the UK being LGBT+ may no longer be considered a psychiatric illness but we do know that LGBT+ people are still disproportionately impacted upon by mental health problems. LGBT+ people are more likely to self-harm and to die from suicide than the general population. Transgender people are even more at risk than other members of the LGBT+ community. What many LGBT+ people do suffer from is prejudice, discrimination, isolation and family and peer rejection which all do contribute to poorer mental health outcomes. Moreover, navigating a world which is predicated upon the assumption of heterosexuality as the norm places added pressure on all LGBT+ people. This is something which has been recognised as ‘minority stress’ and is experienced by other minority groups.
Following the outbreak of coronavirus and the need for most people to remain at home we have heard disturbing accounts of LGBT+ people being forced to conceal their sexual orientation or gender identity from families. Effectively many LGBT+ people have had to go back into the closet to protect themselves. We have heard, too, that there has been an increase in domestic violence since lockdown and we know only too well that for LGBT+ people domestic violence can be ignored by some services who have a rigid and stereotyped image of victims and perpetrators. A number of our young people have told us how isolated and lonely they feel being cut off from their friends and peers and missing their support networks. For those who have access to social media or video messaging –and have the privacy to use them – these forms of communication are no replacement for actual face to face human contact.
Since the outbreak of Covid 19, and the social and physical restrictions imposed, we have heard much from politicians and their advisors about the need to protect our physical health and well-being. Significantly less has been said about protecting our mental health and well-being. Enforced restrictions on movement and withdrawal from our social circles are likely to impact emotionally on all of us in so many ways. Much as I love Radio 2 presenter Sarah Cox, no upbeat presenter playing inspirational dance tunes or some celebrity fitness guru is going to be an antidote for the isolation felt by many or the associated anxiety. It is simply not good enough to ignore the mental health implications of this pandemic. Like all good public health initiatives we need to look at people holistically, acknowledging their emotional needs as well as their physical needs. Lessons learned during the HIV epidemic seem to be lessons forgotten. Those living with HIV with poorer mental health had poorer outcomes generally. Moreover, those most at risk of acquiring HIV with mental health problems were less likely to protect themselves.
We are not just physical beings who need protecting solely from physical ailments. We need to recognise the complex interplay between physical health and mental health and the social and environmental circumstances in which people find themselves. This pandemic has highlighted the huge social and health inequalities in this country and around the globe. Moreover, many of our government’s messages have been contradictory, unclear and wavered in response to media pressure, leaving many feeling unsure and frightened. Such ambiguity has created the perfect environment for shaming and judging and exacerbated feelings of anxiety for many.
We need to begin to plan now for meeting the mental health needs of all of our population but not least the mental health needs of our young people. Mental health provision has for the past decade or more been woefully underfunded. I fear that in the wake of this pandemic mental health provision will face more financial constraints with an even greater emphasis on physical problems. This all at a time when early and effective mental health interventions are most needed. For our young LGBT+ people, some of whom may have been in hostile environments, they are more likely to have felt a greater sense of isolation and separation from their usual support networks. The need to repair their sense of self and nourish their emotional health will be greater still. As an organisation we have provided continued support for our young people online but it does not adequately replace direct youth work and actual group interaction.
Summer is a time of Pride celebrations. Normally, during the run up to Pride, our young people would be making banners, preparing their glittery and bejeweled costumes and looking forward excitedly to such celebrations, but sadly these events have all been cancelled. Many of our young people tell us that Pride is the one day in which they can truly be themselves and come together to celebrate their differences. Many young LGBT+ people will feel even more isolated and starved of a rare opportunity to express their identities.
Staff at SAYiT are continuing to support the mental health of our young people and we recognise, too, that we need to plan for the longer term. The consequences of this pandemic will, to a greater or lesser extent, have impacted on all of us – but for some the impact may be much more fundamental and more enduring.
During mental health awareness week we have the opportunity to begin a conversation about the need to acknowledge the mental health implications of this pandemic. We were once promised parity between mental health services and physical health services now is not the time to break that promise.