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Stonewall's LGBT in Britain – Health Report

Report by Stonewall into mental health, accessing treatment and smoking, alcohol and drugs among LGBT people.

LGBT charity Stonewall has just published a report drawing from the results of a survey carried out by Yougov into the mental health and wellbeing of LGBT people across England, Scotland and Wales and their experiences in accessing healthcare services. There are 3 sections to the report – mental health, discrimination in healthcare and smoking, alcohol and drug use – bookended by key findings and a section on methodology.

The Mental Health section shows some alarming statistics. 52% of LGBT people said they had experienced depression in the last year. The report disaggregates information further and sets out that rates for depression for non-binary people (7 in 10), trans people (67%) are higher still. Rates for depression were high for LGBT people who have experienced hate crime based on their sexual orientation or gender identity (69%), young LGBT people (aged 18-24 68%), black, Asian and minority ethnic LGBT people (62%) and those in lower income households (64%). For the sake of comparison the rates for common mental health problems such as anxiety and depression in the general population are one in six adults in any given week.

Figures for anxiety among the LGBT community are also significantly higher than the general population - 61% of the LGBT community generally, 79% for non-binary people, 65% for LGBT women and 54% for GBT men. Again, higher rates of anxiety can be seen in lower income households, and those who have experienced hate crime.

Without going into the detail which can be seen in the report, rates for addiction, eating disorders, suicide and self-harm are worryingly high in the LGBT community.

In some ways more concerning than the numbers of LGBT people who experience mental health problems is the barriers that many have faced when attempting to access healthcare. The numbers are interspersed with quotations from respondents to the survey which reveal some shocking discriminatory attitudes among healthcare workers.

13% of LGBT people have experienced some form of unequal treatment from healthcare staff because they are LGBT and 23% have witnessed it. This includes 32% of trans people and 24% of Asian LGBT people who have experienced unequal treatment. One particularly disgraceful set of statistics is that 5% of LGBT people and 20% of trans people have been pressurised to access services to question or change their sexual orientation or gender identity when accessing health services. One 19 year old man recalls "I got sectioned after a suicide attempt and the nurse said that my mental health problems were due to allowing Satan in my soul. If I just accepted my true gender then God could forgive me".

The final substantive section of the report looks at smoking, alcohol and drug use. While overall smoking seems to be the same in the LGBT community as in the general population, 16% of LGBT people said they drank alcohol almost every day over the last year compared to 10% of the overall population. Interestingly the levels of drinking increases the older people get, and the highest levels are seen among older (65+) LGBT people with 33% drinking almost every day. This age profile is more or less reversed when it comes to drug taking, with 13% of young LGBT people taking drugs at least once a month (compared to 9% of young people in the general population).

In the broadest brush terms, people from the LGBT community have poorer mental health, face more barriers accessing treatment and have higher levels of drug and alcohol use than the general population. Stonewall therefore makes a series of recommendations to the Department of Health and Social Care, NHS England, NHS Digital, professional bodies and the NHS Mental Health Services to address these figures. Many of these involve guidance and/or training staff on meeting the needs of this community. It also suggests supporting the widespread implementation of the Sexual Orientation Monitoring Information Standard and consistently monitoring patients' sexual orientation and gender identity. One recommendation is to "bring forward and implement comprehensive proposals to end the practice of conversion therapy. This includes any form of treatment or psychotherapy that aims to change a person's sexual orientation or to suppress a person's gender identity". On this point we are pleased to note that the Counsellors and Psychotherapists (Regulation) and Conversion Therapy Bill 2017-19, which includes provision to outlaw conversion therapy, is due for its second reading in January 2019.

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