Pike, Brigid (2009) Mental health and well-being of LGBT people the role of alcohol and drugs. Drugnet Ireland, Issue 30, Summer 2009, p. 20.
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On 2 February 2009an exploratory study of the mental health and well-being of lesbian, gay, bisexual and transgender (LGBT) people in Ireland was published. Commissioned by the Gay and Lesbian Equality Network (GLEN) and BeLonG To Youth Services, and funded by the Health Service Executive's National Office for Suicide Prevention, the research was undertaken by a team of researchers from TCD, UCD and UCC.1
The purpose of the study was to examine mental health and well-being, including an investigation of suicide vulnerability (risk) and resilience, among LGBT people in Ireland, and to make recommendations on policy, service delivery and practice related to mental health promotion and suicide prevention.
The researchers used the 'minority stress model' to aid their understanding of the negative impacts on health and well-being caused by a stigmatising social context. External stressors were found to include presumed heterosexuality, homophobia, prejudice and victimisation; internal stressors related to the anxiety of coming out. Negative reactions from others when an individual 'came out' to them also featured, as did the stress of self-concealment.
The findings on mental health indicators suggested that the stigma and discrimination encountered by LGBT people can result in an extremely negative experience of being LGBT. Many participants in the study described having experienced depression, and a significant minority reported engaging in self-injurious behaviour, including hazardous drinking or problem alcohol use, and suicidal thoughts.
The 'resilience narratives' of LGBT individuals were explored, with special reference to self and others, and also in relation to the social environments or contexts where LGBT people interact. Four key sources of social resilience were discerned - friends, family, the LGBT community, school and the work place.
With regard to 'self-resilience', the researchers found evidence to suggest that resilience is an ongoing and emerging process rather than simply a trait possessed by some LGBT individuals and not by others. Positive life experiences and turning points were observed to have led to greater self-esteem and self-efficacy among participants. Many also identified 'coping strategies' that they used to alleviate stress. Six of the 20 coping strategies listed in the survey instrument related to the use of licit and illicit substances, and participants (N=1,110) identified using these strategies as follows:
- drink alcohol to get drunk 28.2% (n=313)
- drink alcohol (not to get drunk) 25.5% (n=283)
- smoke cigarettes 24.5% (n=272)
- take medication prescribed by a doctor/psychiatrist (e.g. anti-depressants) 17.3% (n=192)
- take prescription drugs (without advice of a doctor or medical worker) 12.3% (n=136)
- take illegal drugs 10.0% (n=111)
The researchers concluded that social and structural factors play a significant role in determining the mental health of LGBT people. Their recommendations therefore focused on measures to achieve institutional and social change. For example:
- the needs of LGBT people should be integrated into all health policies and strategies, including policies and strategies on alcohol and drug (mis)use;
- health, mental health and social services should be provided in a way that is accessible and appropriate to LGBT people;
- specific attention should be paid to the needs of transgender people within health policy;
- health professionals should be trained both to understand how an LGBT identity is a potential risk factor for self-harm, suicidal behaviour and depression, and to have cultural competency specific to the LGBT population;
- LGBT-specific groups and organisations nationally, and front-line responses such as the voluntary LGBT helplines throughout the country, should be resourced to engage in mental health promotion and suicide prevention work.
The researchers identified opportunities for positive intervention and change at the personal and interpersonal levels in the education and youth-work sectors, and within families. They recommended, for example, increasing the recognition of LGBT needs and issues in the SPHE (Social, Personal and Health Education) curriculum and in early-school-leaving policies and programmes, and increasing awareness, training and resourcing of teachers, youth workers and family members who work with LGBT young people, in order to ensure they can support them in developing confidence and self-esteem.
With regard to research, the authors recommended that, in future, all national administrative databases, general population surveys, and longitudinal and other large-scale survey research on children, young people and families should, as a matter of course, include items that can capture, or questions on, sexual orientation, gender identity and same-sex partnership and cohabitation.
1. Mayock P, Bryan A, Carr N and Kitching K(2009) Supporting LGBT lives: a study of the mental health and well-being of lesbian, gay, bisexual and transgender people. Dublin: National Office for Suicide Prevention. Retrieved on 25 April 2009 at www.tcd.ie/childrensresearchcentre. The research adopted a multi-modal approach, including the administration of a primarily quantitative on-line survey, and the conduct of a community assessment process and of in-depth individual interviews with 40 individuals who identified as LGBT.
Item Type
Article
Publication Type
Irish-related, Open Access, Article
Drug Type
All substances
Intervention Type
Harm reduction
Issue Title
Issue 30, Summer 2009
Date
2009
Page Range
p. 20
Publisher
Health Research Board
Volume
Issue 30, Summer 2009
EndNote
Accession Number
HRB (Available)
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