Home > LGBT service users and mental health risks.

Lyons, Suzi (2016) LGBT service users and mental health risks. Drugnet Ireland, Issue 59, Autumn 2016, pp. 22-23.

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Irish research has shown that lesbian, gay, bisexual and transgender (LGBT) people, particularly younger people, are at greater risk of experiencing mental health problems than the general population. In order to increase awareness of these risks among mental health staff, the Gay and Lesbian Equality Network (GLEN) in consultation with the Mental Health Commission (MHC) has developed a guidance document.1 It aims to help mental health staff provide more inclusive services to LGBT service users. While not specifically addressing addiction issues, the guide is very relevant to staff working in addiction services.


The various steps needed to provide inclusive services to LGBT service users and their partners and families or chosen advocates are outlined in the document, which is available to download. Key considerations include the following: 

  • Most services have LGBT clients but their LGBT identity may or may not be related to the reason they are presenting to a service. Staff should not presume heterosexuality or predetermine a person’s gender, and the language used and questions asked by staff should reflect this.
  •  Staff need to be familiar with the specific stressors and needs of LGBT clients, e.g. fear of coming out, isolation, lack of family support, homophobic bullying. Staff also need to be aware of the range of LGBT organisations that can support the specific needs of LGBT clients. Training can be provided for staff by LGBT organisations to facilitate this.
  •  To create a welcoming and inclusive environment, services should display LGBT posters where possible. LGBT issues should be included in the service ethos statement or equality policy, and in any service plans or evaluations.
  •  Partners and spouses of LGBT people should be included where possible and given the same consideration and rights as heterosexual partners or spouses.
  •  Service providers have a responsibility to ensure equal access to their service regardless of gender, sexual orientation, civil status, family status, age, disability, ethnicity, social class or religion. In order to measure equity of access, services need to monitor the ethnicity and sexual orientation of their clients. Guidance is available with regard to ethnic data collection, for example, from Pavee Point,2 and examples of how to frame questions regarding self-defined gender identity and sexual orientation are contained in the questionnaire used by the National Drug Treatment Reporting System (NDTRS).3


1 Gay and Lesbian Equality Network (GLEN) (2013) Lesbian, gay, bisexual and transgender service users: guidance for staff working in mental health services. Dublin: GLEN. http://www.mhcirl.ie/File/LGBT_SU_Guide_for_staff.pdf

2 Pavee Point Traveller and Roma Centre (2016) Policy and practice in ethnic data collection and monitoring: counting us in – human rights count! Dublin: Pavee Point Traveller and Roma Centre. http://www.paveepoint.ie/wp-content/uploads/2016/04/Counting-Us-In-A4_WEB.pdf

3 Health Research Board (2016) National Drug Treatment Reporting System Form. For more information, visit http://www.hrb.ie/health-information-in-house-research/alcohol-drugs/ndtrs/information-collected/


Some key terms regarding LGBT service users


Sexual orientation refers to an enduring pattern of emotional, romantic and/or sexual attractions to men, women or both sexes. Sexual orientation also refers to a person’s sense of identity based on those attractions, related behaviours and membership in a community of others who share those attractions. Three sexual orientations are commonly recognised – heterosexual, homosexual (gay and lesbian) and bisexual.


Gender identity refers to whether one feels male or female regardless of sex assigned at birth. Gender expression refers to outwardly expressing one’s gender identity through mannerisms, grooming, physical characteristics, social interactions and speech.


Transgender is a term used to describe people whose gender identity or gender expression differ from the sex assigned to them at birth. Not everyone whose feelings, appearance or behaviour is gender-atypical will identify as a transgender person. Many transgender people live full-time or part-time in their preferred gender.


Transsexual refers to people whose gender identity is opposite to the sex assigned to them at birth. Transsexual people may seek medical interventions, such as hormones and surgery, to make their bodies fit as much as possible with their preferred gender. The process of changing from one gender to another is called transitioning. Biological females who wish to live and be recognised as men are called female-to-male (FTM) transsexuals or trans men. Biological males who wish to live and be recognised as women are called male-to-female (MTF) transsexuals or trans women. DSM-5 uses the term gender dysphoria instead of transsexual and this replaces the term gender identity disorder which was used in DSM-IV.


Disclosure: In Ireland the most common age at which LGBT people discover their LGBT identity is 12, and the most common age at which they first disclose this to anyone is 17. This indicates that for most there is a five-year period where LGBT young people conceal their identity from family and friends and this period coincides with puberty, school and a critical period of social, emotional and vocational development in their lives.


Source: Extracted from Gay and Lesbian Equality Network (2013) Lesbian, gay, bisexual and transgender service users: guidance for staff working in mental health services. Dublin: GLEN.

Item Type
Publication Type
Irish-related, Open Access, Article
Drug Type
All substances
Intervention Type
Treatment method, Harm reduction
Issue Title
Issue 59, Autumn 2016
October 2016
Page Range
pp. 22-23
Health Research Board
Issue 59, Autumn 2016

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