Why LGBTQ-specific training is essential for mental health service providers

Because “queerness informs all parts of our psyche”, Ireland needs to improve its mental health services for LGBTQ+ folks.

This article is about mental health services for LGBTQ+ people in Ireland. In the photo, a man speaking to a psychologist.
Image: Via Pexels - Alex Green

As the weather gets colder and the days shorter, those of us with seasonal depression, anxiety and other issues are bound to notice increased symptoms. But it would be remiss not to mention that LGBTQ+ folks, in Ireland as in the rest of the world, are more likely to suffer from mental health issues than our cis-het counterparts.

A 2018 report conducted by Belong To revealed that an astounding 90% of LGBTQ+ youth in Ireland reported struggling with their mental health throughout that year, with 49% of queer Irish youth feeling reluctant to open up about their mental health issues or to seek guidance.

Mental health issues within the LGBTQ+ community in Ireland go beyond those which affect the general population. Factors such as bullying, stigma, and unaccepting families have also been shown to result in heightened levels of depression and anxiety in LGBTQ+ folks worldwide. These factors, while a struggle at any time during the year, can become increasingly difficult to manage during the winter months when sunlight and warmth are in short supply.

Similarly, the holiday season can be a source of significant stress for queer folks who are not on good terms with family after coming out, or for those who have yet to come out. In some cases, this can lead certain queer folks to decide that they are safer (both mentally and physically) to spend the holiday season away from family. While this decision, in many cases, is warranted, it doesn’t make it any easier, especially if they are already suffering with their mental health.

These situations can be somewhat alleviated when accessible and high-quality mental health services are offered at a nationwide level. However, according to new research published by Mental Health Reform, approximately 43% of LGTBQ+ folks in Ireland have reported having a negative experience when seeking and receiving mental health services with the HSE.

Further findings from the study showed that 22% of LGBTQ+ participants felt that they were “never well-supported and listened to” by their HSE-appointed psychiatrist. Meanwhile, less than one-third of participants (31%) reported feeling as if they were “always treated with dignity and respect by community mental health services”.

For a first-hand account of the current state of LGBTQ+ and GSRD (Gender, Sexual, and Relationship Diversity) mental health services in Ireland, I spoke with Anne Marie Toole. Toole, alongside Dil Wickremasinghe, founded Insight Matters—one of the largest private practices for mental health services in Ireland—in 2011. Toole is similarly an IACP accredited Psychotherapist and Counsellor, having initially trained in psychology and addiction as early as 2006. With Insight Matters, Toole works with those identifying as part of the LGBTQ+ community, as well as those in non-traditional relationships.

When asked about her thoughts on the pros and cons of current mental health services for LGBTQ+ folks in Ireland, Toole had this to say: “I think the main difficulty in finding accessible and worthwhile mental health services hinges on an acute unawareness of the particular issues facing the community. We know that this problem is systemic in nature. There’s simply not enough awareness or enough discernible content in the core training for mental health practitioners in Ireland when it comes to the very unique challenges facing our community. The training does not integrate LGBT issues and, as a result, mental health services for queer people will always be lacking.”

In order for there to be meaningful change in this regard, Toole suggests that we must alter the way we are educating the next generation of practitioners, both those who work in physical and mental health sectors.

“How students are taught is problematic,” Toole continued. “Being taught under a primarily heteronormative banner is the standard for education programs across Ireland. Anything non-heteronormative is brought in as extracurricular. In fact, a leading college in Dublin only devoted two hours of LGBTQ+ content over the course of two years’ worth of study for those training in medical fields, including mental health courses.”

According to Toole, this is particularly problematic as, in her own words, “queerness informs all parts of our psyche”. Therefore, members of the LGBTQ+ community simply cannot receive worthwhile and effective mental health care without a practitioner who understands how the nuances of their identities permeate the entirety of their lives.

As an accredited member of the IACP (Irish Association for Counselling and Psychotherapy), Toole is actively working to enact changes to college curriculums throughout the country. “There needs to be systemic change to the way our doctors are taught about GSDR, including sourcing better training to continually increase awareness,” Toole said. “It cannot and should never be up to the client to teach the practitioner about their identity. This is an undue burden on the client.”

Another issue that Toole notes is a kind of blanket-accreditation, wherein current training programs effectively allow any practitioner to work with any patient, regardless of whether or not they have received proper training to work with the LGBTQ+ community.

“Without the proper training,” Toole shared, “practitioners can and will do harm to their LGBTQ+ patients. At best, the experience for patients in these cases will be a waste of time, at worst, it could confuse the patient even more.”

The last few years, since the onset of the Covid pandemic, has seen a significant rise in mental health service requests for the LGBTQ+ community, according to Toole. “The number of clients that come to us is growing, which we know because of mental health issues increasing throughout the general population over the last two to three years.

“This winter, in particular, will be rough for our community. People are still in crisis and still only beginning to process the trauma of the last few years. The entire world is scrambling for safety after the last few years and so many people could go to the government for safety, but that’s not always been the case for members of our community. Our safety has never been a given fact. Instead, we must all practice vigilance at a higher degree.”

Despite these facts, however, Toole shares that she believes “we are going in the right direction”.

“In general, more people in Ireland today have a wider awareness of gender and sexuality than ever before.” However, Toole also noted that “Unfortunately, at the end of the day, we simply don’t have the same level of awareness and connection in our schools that is necessary to enact meaningful systemic change.”

This story originally appeared in GCN’s December 2022 issue 375. Read the full issue here.

© 2023 GCN (Gay Community News). All rights reserved.

This article was published in the print edition Issue No. 375 (December 16, 2022). Click here to read it now.

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Looking Forward

Issue 375 December 16, 2022

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This article was originally published in GCN Issue 375 (December 16, 2022).

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