Pride Month: Talking mental illness, mental health, and being part of the LGBT community.
We spoke to CPsychI REFOCUS member (Recovery Experience Forum of Carers and Users of Services) Laura Louise Condell who has been a member of the committee since 2016. She is also the the coordinator of the Dublin Lesbian Line which focuses on supporting women of the LGBT+ community. We sat down with her to talk mental illness, mental health, and being part of the LGBT community.
Can you tell us a little bit about yourself and why you are on the REFOCUS committee?
I’m on the REFOCUS Committee because I have personal experience with mental health difficulties. I’ve been treated for depression for the last sixteen years and in that time I’ve encountered a huge amount of stigma, mainly because I don’t present with the stereotype of what someone with depression would look like or act like. I find that very frustrating. I have done a lot of advocacy around mental health and have been trying to break down those stigmas. I’m an ambassador with See Change for about 5 years and then the opportunity came up to join REFOCUS and I took it because I feel like it’s a wonderful and supportive environment but also that it’s very proactive and really working toward positive changes that I’ve been wanting to see for a very long time.
The LGBT Community experience more bullying than other groups, what effect do you think this has on people’s mental health?
I think it’s pretty complex; I think it has effects, like the obvious things that come along when someone is bullied, such as affecting your self-esteem, and your confidence, making people very nervous, can lead to things like experiencing panic attacks or avoiding the workplace. But then there is a lot of internalised stigma, if you’re being bullied because of your identity people start to believe the things that they are being bullied about; things like ‘it’s wrong to be gay’ or if you’re bisexual, just all the negative things that people say when it comes to bullying about being a part of the [LGBT] community, you start to internalise them and believe them. It’s quite complex and it has a lot of different affects and this goes a lot deeper and it can be a lot harder to come back from that when you’ve been bullied.
We’re seeing a lot of this lately in the workplace. I’m not sure if it’s become more of an issue or if people are just contacting us more about it. Bullying but not like throwing things at people for shouting at them but more in a subtle way, like making comments or undermining people, excluding them from things, making jokes that aren’t funny like homophobic or transphobic jokes seems to be something that’s coming up at the moment.
For those who have yet to come out it can be quite isolating, similar to when you live with mental health difficulties in silence- it can be a vicious cycle of isolation and fear. Do you have any thoughts on this?
I used to compare coming out about my sexuality and coming out about having a mental health difficulty and how the experience was really similar, that both times I would have loads of fear and be afraid of how people would react because you can’t predict how people are going to react. When coming out or talking about either of them I would just feel really apologetic and just a lot of fear there. It can be hugely isolating if people aren’t able to come out or not in a position to come out yet especially around times like Pride when it seems like everyone’s celebrating and everyone is wearing their rainbow things and being part of the community. Even the word ‘community’ – if you’re not out, it makes you feel like you’re not part of the community and you’re excluded. It’s definitely a time of huge loneliness for people. I think loneliness is kind of a mental health difficulty that we don’t recognise so much but it is a huge issue for the community, isolation and loneliness.
Is there stigma attached to accessing help?
That’s a really good question because I have seen a huge change in the last few years both from my friends in the community and from working with the helpline. A few years ago people didn’t use the words ‘mental health’ and people wouldn’t really admit openly, at least I didn’t hear anything anyway, many people wouldn’t admit openly about going to a counsellor or going to use mental health services. Now I’ve seen a huge change in that, for example people contact us are really self-aware about their mental health, I mean they are able to talk about going to a counsellor and talk about what medication they’re on, they are very articulate. There has been a very big change about that.
I think the stigma has decreased for some people, I know not everybody, about accessing help but the biggest issue now is that more of our community feel like they can go and access help but when they get there they are encountering problems of people that are providing help, whoever they are (mental health service providers) aren’t LGBT aware, aren’t LGBT trained and have their own stigma, their own homophobia, their own transphobia and that’s affecting people – and then that compounds the difficulties they’re experiencing if you’re trying to get help and you can’t get it because of your identity. So, I think the stigma for accessing help has gone down, but people are experiencing a different stigma then when they actually go and try getting help.
Can you talk a bit about double or triple stigma; the stigma of having a mental illness; the stigma associated with being LGBT; and the stigma of these intersections?
Multiple-intersections; stigma is something we encounter a lot with people because for example we work with a lot of women in direct provision so they encounter stigma because of where they are from and because of the colour of their skin. In a lot of the countries where these people are coming from mental health is not something that is ever mentioned or discussed – it’s seen as something really wrong with you, it’s not seen as an illness, depending where you’re from and what you religious association is. And then to identify as LGBT where in lots of countries it’s illegal or culturally forbidden so people would be killed or [exiled] from their community and bring shame on their family.
There are so many multiple stigmas there and people experience them either in the place in they are living, from their own community , in the mental health services or trying to access health in general not just mental health services such as the local doctor or a community support environment. Because the more ways you are marginalised the more chances are that people can, not have something against you, but have some stigma there. When people have double or triple stigma it’s really difficult to access help because sometimes you don’t know which one you’re being stigmatised for but also within yourself as well. It starts to build up [within] a person and makes it harder to even try and access help or think that you’re worth accessing help for. It can really impact your self-worth when people are kind of coming at you from all corners. Either your mental health is wrong, your identity is wrong, your nationality is wrong and it can weigh very heavily on a person then.
What advice would you give to members of the LGBT community who have the additional stress of living with mental health difficulties?
I would say access help! That might sound like it’s going against everything else that I’ve said but there is help out there and sometimes it takes a few goes to find appropriate support, like the one that’s right for you. If you’re not sure where to start or afraid of being stigmatised for your gender/ sexual identity, start off with a LGBT focused support. Call a help line and let them signpost you or if you’re going to a counselling service you can always change counsellor. Just know that there is help out there even if it’s hard to find and make sure that you engage in support somewhere, whether it’s a social community based group whether it’s an anonymous support like a helpline, or whether it’s a state provided service or your GP or something.
But just know there is help out there and just because it’s difficult to find doesn’t mean that you won’t find the perfect thing for you. And it’s ok to get support while you’re trying to get support. So if it’s taking you a while to find the right counsellor or something, (I keep saying counsellor, I know there are other mental health supports people need) but if it’s taking you a while to find the right one, call a helpline each week while you’re trying to do that. You don’t have to just use one thing at a time, if you need support – try and get it everywhere, and get as much support as you can. Then your chances get higher of finding the right one.
What do you think clinicians could learn that would encourage LGBT people to feel more comfortable, especially during vulnerable periods?
A lot of the times, say for example, when I’ve tried to access mental health support when I haven’t been well, there is either too much of a focus on my sexuality – like is that the reason for anything that’s going wrong? Or it seems the clinician is afraid to go near it and it’s like completely skirted around and you can see that they are getting nervous. They ask ‘do I have a boyfriend?’ and I say ‘no, I have a girlfriend’ and they drop their pen and then struggle to pick it up and then they can’t refer to ‘her’ then saying ‘you’re…eh…partner’.
So, even just the basic things if you don’t have the capacity to go for LGBT awareness training, even just things like ‘normalising’ the fact that not everyone has an opposite sex partner and maybe asking the question ‘do you have a partner / or are you in a relationship?’, like general questions [are good]. If you say ‘do you have a boyfriend?’ then the person has to come out as having a girlfriend. That already makes the person feel like I’m not the most ‘normal’ for want of a better word. You already have to go against something in the beginning and it sets you up on an uncomfortable position.
Not every time a LGBT community person is accessing mental health support is because of their gender or sexual identity, so yes experiences of homophobia or struggling to accept yourself, they can definitely make it more difficult, but lots of us have mental health difficulties that are completely unrelated – like myself for example. I’ve always had depression long before I knew I was a lesbian and coming out over those years was difficult but that’s not the reason and my mental health difficulties now are definitely not related to that in any way. So I guess just asking open questions, not skirting around it too much, like if you ask ‘do you feel your mental health difficulties are related to your gender or sexual identity’, then if the person says yes or no, take it from there rather than trying to assume that it is and focusing only on that or being afraid to go near the subject at all. It’s something really simple. It doesn’t involve hours of training or learning it’s just about letting the person set the pace themselves.
If you want to look up Dublin Lesbians Line. We support everybody. I know the name says ‘Dublin’ and ‘Lesbian’ and ‘Line’ but we’re not just for Dublin, not just for Lesbians, and not only a helpline. It’s www. dublinlesbianline.ie and on that website from July, there will be an updated database of LGBT friendly accredited counsellors, psychologists and psychotherapists around Ireland, so if people want to have a look at that, and if they want support from the people who have identified themselves as LGBT friendly, you can look there.