Lesbian,gay, bisexual and transgender older people in Ireland: Mental health issues

International policy initiatives have highlighted the need to include older lesbian, gay, bisexual and transgender (LGBT) issues in the provision of appropriate health and social care. However, empirical studies in the area remain sparse. The aim of this study was to investigate the experiences and needs of LGBT people over the age of 55 years living in Ireland and this article reports on specific mental health issues. Mixed methods were used involving 144 surveys and 36 semi-structured in-depth interviews. The findings revealed that a significant number of the survey respondents had experienced a mental health problem at some point in their lives with interview participants providing further details of their concerns. It is recommended that policy makers address the mental health needs of older LGBT people in future strategic directives and develop standards of care that support the principles of equality, inclusion and respect for diversity.     

Resiliency and mental health and well-being among lesbian,gay and bisexual people

Reports concerning the mental well-being of lesbian, gay and bisexual (LGB) people mostly focus on mental health issues, negative events and stress, and very few focus on strategies LGB use to achieve well-being. To address this gap, we report on a qualitative project involving 93 LGB people who completed an online survey. Participants provided accounts of resilience, particularly in relation to the ways in which they were caring for themselves. They were engaged in a wide variety of activities that supported their well-being related to social connections, self-care, interests and hobbies, and professional help. Despite this, we argue that there is a compelling need to ensure a wider mental health promotion focus is adopted to support LGB people lead mentally healthy lives.     

Legitimate love: the meaning of civil partnership for the positioning of lesbian and gay people in society

The Civil Partnership Act (CPA) came into force in the UK on 5 December 2005, entitling same-sex relationships to formal legal recognition. It is the second piece of legislation (following the Adoption & Children Act, 2002) that begins to redress the legal inequalities between opposite-sex and same-sex couples by giving civilly partnered (CP'd) couples similar civil and financial benefits to married couples. The study was a qualitative exploration of the experiences of individuals who have registered a CP. The analysis showed that same-sex couples face many challenges living in a heteronormative society. Civil partnership led to a sense of increased social recognition of same-sex relationships and increased feelings of social support. Many participants also felt that CPs challenged negative stereotypes regarding the identity of lesbian, gay and bisexual individuals and relationships. However, difficulties were expressed in their attempts to find a coherent sense of their new positioning in society as a CP'd couple.     

Visibility management in school and beyond: a qualitative study of gay,lesbian, bisexual youth

Grounded theory was utilized to develop a theory of gay, lesbian, and bisexual (GLB) youths' interactions with and response to their environment. Data included in-depth interviews of 20 GLB youth. The central phenomenon that emerged from the qualitative data analysis was the strategy of visibility management. Visibility management refers to the dynamic, ongoing process by which GLB youth make careful, planned decisions about whether they will disclose their sexual orientation, and, if they decide to disclose, to whom and how they disclose, and how they continue to monitor the presentation of their sexual orientation in different environments. The process of visibility management is proposed as a key construct in GLB identity development. Implications are proposed for working with GLB youth and their families and for making schools safer for GLB youth.     

Concerns about aging and caregiving among middle-aged and older lesbian and gay adults

Objectives: Despite the increasing number of lesbian and gay older adults, research geared towards health and well-being of this population is limited. Many lesbian and gay seniors experience health disparities and are at risk for poor health outcomes. The aims of this study were to gather in-depth information on the concerns of lesbian and gay elders with respect to aging and care needs.

Method: The sample included 124 gay men and lesbian women aged 50+ years. Data were gathered via focus groups and questionnaires. The focus groups addressed: (1) concerns about aging in the LGBT community, (2) barriers to needed support and services, (3) concerns about caregiving and (4) needed programs for lesbian and gay seniors.

Results: Concerns expressed about aging included: lack of financial security, lack of family or social support, fears about the lack of someone to provide needed care, and discrimination in healthcare or service communities. Participants also indicated concerns about being alone and vulnerable and a need for resources and support programs, specifically for lesbian and gay older adults and for lesbian and gay caregivers.

Conclusions: These findings suggest needed areas of support and programs for older gay men and lesbian women. They also suggest that healthcare professionals might need more training regarding the particular needs and concerns of this community.     

Developmental trajectories and milestones of lesbian,gay, and bisexual young people

Abstract

Lesbian, gay, and bisexual (LGB) young people experience a variety of developmental trajectories that consist of milestones, the sequence and timing of which differ across individuals. They include early feelings of being different from peers, the onset of same-sex attraction, questioning one's sexuality, first same-sex sexual experience, recognition and self-labelling, disclosure to others, first romantic relationship, and self-acceptance. The invention of ‘gay youth’ during the 1970s and 1980s is briefly reviewed with an emphasis on the ways in which the portrait created by early research fails to capture the developmental trajectories of millennial young people. Although some young people struggle with mental health problems as they navigate these milestones, research documents the complexity, variety, and normative nature of the vast majority of LGB young people. A growing chorus of developmental, behavioural, and social scientists now emphasize that many contemporary young people forego sexual confusion, recognize the sex or gender to which they are attracted to and love, and believe they are as mentally healthy as heterosexual young people.     

Aspects of mental health among older lesbian, gay, and bisexual adults

This study examined aspects of mental health among 416 lesbian, gay, and bisexual adults aged 60 to 91 years old, attending social and recreational programs. Mental health indicators were perceived mental health status; self-esteem; internalized homophobia; loneliness; alcohol and drug abuse; and suicidality. Better mental health was correlated with higher self-esteem, less loneliness, and lower internalized homophobia. Compared to women, men reported significantly more internalized homophobia, alcohol abuse, and suicidality related to their sexual orientation. Less lifetime suicidal ideation was associated with lower internalized homophobia, less loneliness, and more people knowing about participants' sexual orientation.     

Mental health services for people with intellectual disability: a conceptual framework

The present paper discusses the application of the ‘matrix model’ to mental health services for people with intellectual disability. There is great variability between the service models in this area, which makes comparisons and conclusions difficult. The present model facilitates the breaking down of these complexities into understandable parts so that future directions for research, service planning and delivery can be logical, coherent and evidence‐based.     

Sexual satisfaction in Chinese gay and bisexual men: relationship to negative sexual minority identity and sexual role preference

The present study explored the relationships among sexual satisfaction, sexual minority identity, and sexual role preference (top, bottom, and versatile) in a sample (N = 403) of Chinese men who self-identified as either gay or bisexual. Participants completed online the New Scale of Sexual Satisfaction, Lesbian and Gay Identity Scale, and a survey of sexual role preference. The New Scale of Sexual Satisfaction comprises two factors: (1) personal experiences and sensations (ego focused), and (2) participants’ perceptions of partner reactions and sexual activity in general (partner/activity focused). The hierarchical multiple regression model revealed that internalized homonegativity (the degree of negativity the participant associates with their sexual minority identity) significantly predicted ego-focused and partner/activity-focused sexual satisfaction. There were significant differences in ego-focused sexual satisfaction among sexual role preference groups (top, bottom, and versatile). Participants in the top (preferring the insertive position) and versatile (preferring either position) groups scored higher on ego-focused sexual satisfaction compared to those in the bottom (preferring the receptive position) group (M_tops = 3.12, M_versatiles = 3.23, M_bottoms = 2.98, p < .05). These findings indicated that reducing internalized homonegativity could be a complementary treatment for sexual satisfaction in gay and bisexual men.     

New Italian lesbian,gay and bisexual psychotherapy guidelines: A review

Although homosexuality was depathologized in the last century and the majority of mental health professionals consider it to be a normal variant of human sexuality, some psychologists and psychiatrists still have negative attitudes toward lesbian, gay and bisexual (LGB) clients. Sometimes they provide interventions aimed at changing sexual orientation through ‘reparative’ or ‘conversion’ therapies. At other times their interventions are influenced by anti-gay prejudices or simply by lack of knowledge about sexual minorities. This paper argues for the need for appropriate treatment guidelines aimed at providing bias-free, respectful, and effective interventions given that Italian health associations have delayed providing them. Some of the main guidelines recently approved by the Consiglio Nazionale dell’Ordine degli Psicologi (National Council of the Italian Association of Psychologists) are presented. Issues addressed include differences between gender and sexual orientation, minority stress, including perceived stigma and internalized stigma, homophobic bullying, coming out, and resilience. Respectful listening to LGB and questioning clients, affirming their identities and fostering a sense of resilience are essential requirements for all mental health professionals wishing to provide effective interventions in a society where sexual minorities are subjected to discrimination throughout their entire life cycle.     

Mental health literacy among young people in a small US town: recognition of disorders and hypothetical helping responses

Aim: Mental health literacy may be a factor in early detection and prompt treatment for mental, emotional and behavioural disorders among young people. Building on previous research in Australia, this study assessed aspects of mental health literacy among adolescents in classrooms in a small town in the eastern USA. Methods: The students were provided brief, hypothetical, gender-matched scenarios about adolescents experiencing negative emotions and exhibiting related behaviours; some scenarios depicted diagnosable disorders. The respondents were asked to characterize each scenario as describing a mental health problem or other teen problem and indicate how they would respond to a peer who had such a problem. Results: Overall levels of recognition of mental disorders were low (27.5% identified anxiety and 42.4% identified depression as ‘a mental health problem or illness’). However, the respondents who recognized a disorder were three to four times more likely than those who did not to say they would take some helping action, such as telling an adult about the problem (depression: odds ratio 3.27; CI 1.43–7.46, anxiety: OR 4.43; CI 2.23–8.79). Few students (27.7%) remembered in-class discussions of mental health, a mandated health topic for schools in their area. Conclusions: There appears to be substantial room for improvement in mental health literacy among young people, and the development of interventions to enhance mental health literacy among students may be justified.     

Suicide and gay/lesbian/bisexual youth: implications for clinicians

The research indicating the incidence rates and specific risks for suicide in the gay, lesbian, bisexual, and questioning (GLBQ) adolescent population is reviewed. An ecological model of suicide risk assessment for GLBQ youth is presented based on Bronfenbrenner's model of human development. The model argues for individual, micro, and macro levels of assessment to increase clinical judgement and accuracy in determining high risk GLBQ adolescents. The model also delineates both primary and secondary intervention strategies which could be utilized to prevent GLBQ youth suicide.     

Mental health first aid for the elderly: A pilot study of a training program adapted for helping elderly people

Objectives: Epidemiological studies have shown a high prevalence of mental illness among the elderly. Clinical data however indicate both insufficient detection and treatment of illnesses. Suggested barriers to treatment include conceptions that mental health symptoms belong to normal aging and lack of competence among staff in elderly care in detecting mental illness. A Mental Health First Aid (MHFA) training program for the elderly was developed and provided to staff in elderly care. The aim of this study was to investigate changes in knowledge in mental illness, confidence in helping a person, readiness to give help and attitudes towards persons with mental illness.

Method: Single group pre-test–post-test design.

Results: The study group included staff in elderly care from different places in Sweden (n = 139). Significant improvements in knowledge, confidence in helping an elderly person with mental illness and attitudes towards persons with mental illness are shown. Skills acquired during the course have been practiced during the follow-up.

Conclusions: The adaption of MHFA training for staff working in elderly care gives promising results. Improvements in self-reported confidence in giving help, attitudes towards persons with mental illness and actual help given to persons with mental illness are shown. However, the study design allows no firm conclusions and a randomized controlled trail is needed to investigate the effectiveness of the program. Outcomes should include if the detection and treatment of mental illness among the elderly actually improved.