From the Outside Looking In: Depression in the LGBT Community

Sue Bergeson Health Guide
  • I’ve been doing a lot of thinking lately about depression and bipolar disorder in the LGBT community (lesbian, gay, bisexual, transgender). As is the case with other cultural minorities, there hasn’t been a lot of work done considering the impact of our illnesses in this community—for example, special treatment needs and culturally effective outreach.

    For individuals diagnosed with serious mental illness who are LGBT, homophobic attitudes among providers of mental health services, and mental health programs which are heterosexist, create barriers to recovery and detract from the effectiveness of treatment and support services. (Source: Chassman, J. “Deviance or diversity.” The Gay & Lesbian "Consumer" Newsletter. 1996;1:1-2.)
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    As with other minority communities, DBSA wants to find ways to offer hope, help and support. I am looking in from the outside here. So, in some ways, I suppose there are people on the inside who will say I shouldn’t even be taking on the topic. But it worries me. I think about the millions of people who have to overcome even higher obstacles to care because of their “sexual minority status.” And I think something has to be done.

    I’ve recently run across two interesting publications that I find helpful in thinking about these issues. One is a report written by Alicia Lucksted, PhD (Center for Mental Health Services Research, University of Maryland), “Experiences of LGBT People with Serious Mental Illnesses: Raising Issues.” In it, she outlines concerns from the community including:

    • LGBT consumers report frequent harassment and belittlement from clients attending the same programs.
    • Consumer-run self-help groups are often unwelcoming to LGBT consumers.
    • LGBT communities may be especially reluctant to embrace LGBT consumers given that, in the past, LGBT identities per se were considered mental illnesses.
    • Consumers experience many mental health workers as fearful—they don’t understand, don’t know about, don’t like LGBT identities and so don’t treat the people well and don’t want to deal with relevant issues.
    • Many mental health staff hold stereotypes that LGBT people are all HIV positive, sick or sexual predators. Or that they hate men, are swishy, butch or confused. There’s a rampant trend—ranging from subtle to blatant prejudice—of seeing LGBT identities as psychologically abnormal.
    • Knowledge of, and respect for, LGBT consumers isn’t covered in mental health staff trainings or program policies.
    One consumer reports, “Patients in the system also panic—there is LOTS of homophobia and transphobia and attacks and harassment. And the staff will usually ignore it, condone it by their inactivity.”

    The second publication is a more recent report from the Department of Behavioral Health/Mental Retardation Services, City of Philadelphia, Division of Social Services. This report, “Community Generated Recommendations to Improve the Behavioral Health Services Provided to Lesbian, Gay, Bisexual and Transgender Persons in Philadelphia,” outlines specific recommendations for changes within training, service systems and data collection.

  • “They are saying that many of the people who provide treatment for their behavioral health problems still place a stigma on LGBT persons and treat them in ways that make it a barrier to accessing and receiving appropriate treatment. Other staff may be more accepting but are not knowledgeable about LGBT issues, and hence, therapy time is wasted by not dealing appropriately with the core issues that the consumer presents. LGBT behavioral health consumers have reported that peers in treatment programs have also been a source of ridicule and harassment. Consumers say that providers do not address the sexuality of consumers in general much less than specifically the needs of LGBT consumers. They report that they feel unsafe to reveal or express their sexual orientation and/or gender identity in treatment, especially in inpatient and residential settings. They report there are certain levels of care for which there are no LGBT-affirming resources, and also, providers in general do not know what treatment or community resources are available for referrals.“
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    I am not sure where to start … what to do … how to make a difference. If this is an issue of concern to you, you may want to join me at the 2007 DBSA National Conference, Making the Recovery Connection for our session on Mood Disorders in the GLBT Community. Attendees will engage in an open discussion about mood disorders within this community and will offer opportunities to share challenges unique to this group and explore strategies to address these obstacles.

    In the meantime, I need your thoughts on what will be effective or meaningful or helpful for DBSA to do to offer hope, help and support within this community.
Published On: June 06, 2007