What good practice with LGBT people looks like in mental health services

The Mental Welfare Commission has published new guidance to assist professionals working in mental health to be inclusive of LGBT people in community and hospital settings.

The guide is for staff working in mental health wards, community services and primary care services, with elements that may be helpful for people who identify as LGBT and their families and friends.

Studies show that LGBT people have higher rates of mental ill health, particularly anxiety, depression and eating disorders, than the general population. They are also much more likely to think about suicide or self-harm: 20-25% compared with 2.4% in the general population.

When people's experience of health care has been examined, almost 60% of trans people and 27% of LGB people reported that they have experienced a lack of understanding of their needs through their experience of healthcare.

The new guide aims to raise awareness in relation to LGBT rights and promote positive and equitable experiences for people identifying as LGBT who access mental health services, health and social care services and community services.

Suzanne McGuinness, Executive Director (Social Work), Mental Welfare Commission, said the Commission hopes that this guidance will support mental health and health and social care services to provide high quality care and support to everyone with a mental illness.

"While giving practical advice on real life situations, the guide recognises that LGBT people are a diverse community who at times experience prejudice, whether intentional or not, and inequalities.

"Key points are to focus on the individual who is in our care, taking their lead from how they describe themselves and their identity, and to make sure the environment is supportive.

"We hope this guide will help equip mental health and social care professionals with the information they need to provide the best possible care and support to LGBT people.”

The updated guide, which was co-produced with the charity LGBT Health and Wellbeing, includes practical recommendations for making services more accessible and LGBT-friendly, plus real-life case studies and advice on terminology and the law.

The guide encourages practitioners to ‘avoid assumptions’ (such as assuming that a patient is heterosexual or cisgender) and to use gender neutral language where possible. It also advises not assuming that an LGBT patient is out to all their family, and to treat this as confidential information unless you have asked if it is OK to mention it.

The guide also contains details for helping people who have experienced conversion therapy. A 2018 UK National LGBT Survey found that 7% of LGBT people, of which 10% were trans people, have been offered conversion therapy; 2% reported that they had undergone conversion therapy. There is no medical or scientific evidence that conversion therapy can change person’s sexual orientation or gender identity, and such practices are harmful, discriminatory and degrading and based on the incorrect and harmful notion that sexual and gender diversity are disorders to be corrected.

“Conversion practices can result in psychological and physical damage, which contributes to mental health problems and creates barriers to accessing help,” the guide said.

The guide will be shared with health boards, health and social care partnerships and other services across Scotland.