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See below for Jan's news and blog.
9th May 2016
average age 18.5 years;
81% white British, 9% BME/other;
23% had been in receipt of school meals but equal number of those in receipt and those not in receipt had parents who had a degree;
25% disabled (high percentage included mental health).
195 of participants identified as bisexual, 128 as gay, 118 as pan-sexual, 103 as lesbian. Five interconnecting factors:
2) sexual/gender norms;
3) managing sexual/gender identities across multiple life domains;
4) being unable to talk;
5) other life crises. 1. Homophobia, biphobia or transphobia
a. 527 (70.8%) had experienced abuse when self-harming or feeling suicidal
b. Trans/unsure and/or disabled twice as likely to experience abuse
c. Bisexual participants least likely to experience abuse
d. Those who experienced abuse 1.5 times more likely to plan or attempt suicide
e. Those who reported they were affected by abuse were twice as likely to plan or attempt suicide
f. 80% of abuse took place at school; 45% in a public place; 40% on the internet; 38% at home; 30% at social event, e.g. party; 15% at work; 13% at religious event (these percentages are guestimates from graph) 2. Sexual, gender norms related to self-harm/suicidal feelings a. 14.2% completely related; 21.4% very much; 12.9% unsure; 26.5% somewhat; 25% not at all b. More likely to effect gender diverse young people; least likely to effect bisexual participants; those who felt their sexual orientation and gender identity strongly impacted on their self-harm and suicidal feeling were more likely to plan or attempt suicide. 3. Managing sexual/gender identities across multiple life domains 83.4% found hiding their sexual orientation/gender identity distressing;
trans/unsure participants 3.63 times more likely to feel distressed;
bisexual participants were less likely to be distressed compared to all other sexuality groups;
those who were distressed were 1.72 times more likely to self-harm;
those who 'strongly' distressed were significantly more likely to attempt or plan suicide. 4. Being unable to talk: in response to the question "How much did not being able to talk about your emotions affect your self-harm and suicidal feelings?" 32.4% completely;
41.7% very much;
5.1% not at all 5. Other life crises included illness in family;
death in family;
illness of friend;
problems with friends;
death of a friend;
previous experience of abuse; own illness;
bullying. 6. The following were most likely to have planned or attempted suicide: those who had self-harmed;
affected by not talking about their emotions;
disabled/chronic illness or impairment;
effected by abuse; those with gender diverse identities Help-seeking 1. Who did participants ask for help from? 49% friends;
22.90% I did not ask for help;
22.80% NHS mental health services;
22.80%; 21.10% parent/carer; 19.30% boyfriend/girlfriend; 17% school counsellor; 13.10% teacher; others: counsellor outside school, helpline (childline), LGBT youth group (about 25% of participants attended an LGBT youth group);
ther family member, youth worker, school nurse, religious leader. 2. Why did you ask for help? 57.90% I was no longer coping;
49.40% I could not go on with how I was feeling;
43.20% I was worried about my mental health; 33.90% I felt out of control;
32.80% I was desperate;
27% I knew what I was feeling was not…;
26.70% I could not imagine my future;
20.50% I was encouraged by someone else;
18.90% I was unable to lead the life I wanted;
14.70% I was forced by someone else. 3. Those most likely to seek help: those who had self-harmed;
planned or attempted suicide;
disability, chronic illness or impairment;
trans/gender diverse. 4. Reasons for hesitancy: fear of reactions to their LGBTQ disclosure; stigma of mental health diagnosis;
feeling like their distress would not be taken seriously by adults;
feeling like they were coping. 5. How helpful was the support, advice or information? Helpful: 76.5% LGBTQ youth group;
74.6 % Friends;
47.2% NHS mental heals services (gender identity clinics). 6. Mental health services: only 22.8% accessed mental health services; 47.2% found NHS mental health services helpful while 36% found them unhelpful; cisgender participants were more likely to indicate that NHS mental health services were 'helpful' when compared to participants who were trans or unsure. 7. Mental health staff survey: small survey consisting of interviews with 27: 50% inadequate training for supporting LGBTQ youth self-harming/suicidal; almost half had inadequate support from organisation to work with LGBTQ youth; those with LGBTQ awareness training were significantly more likely to routinely discuss issues of sexuality and gender identity with patients, have access to adequate training to support LGBTQ youth, work in a supportive organisation; most stated best way to engage LGBTQ youth in service was mandatory LGBTQ awareness staff training. 8. CAMHS Poor experience with CAHMS (from those young participants interviewed): staff limited knowledge or understanding of LGBTQ issues;
YP therefore reluctant to talk;
focus on symptoms, less underlying causes;
practitioners were disinterested;
ineffective treatment e.g. CBT; YP feeling lost their agency;
treatment plans not negotiated with YP;
YP told how to 'fix' their problems. 9. Gender Identity Services: again from interviews only: services accessed at critical points for YP;
led to seeking alternatives e.g. private health care, internet, overseas health care;
stress of justifying trans status (repeatedly);
being tested and having 'pass' as trans;
difficulties fitting their gender identity within the NHS gender identity assessments. 10. Who are you most likely to ask for help? Likely: LGBTQ individuals/groups, 53.3%;
mental health professionals 47.2%;
youth group 15.9%;
school/teacher 12.2%. Unlikely LGBTQ individuals/groups, 25%;
mental health professionals 28.5%;
youth group 57%;
school/teacher 71%. 11. Preferred mode of help-seeking: 82% internet;
8th December 2015
4th December 2015
Queer Futures is holding a Conference on Friday 11th December 2015 at Lancaster University. Dr Liz McDermott will introduce the day followed by keynote speaker Professor Louis Appleby who is lead for the Suicide Prevention Strategy for England.Part I of the results, Understanding LGBTQ youth suicide and self-harm will be shared followed by four workshops on Preventing LGBTQ youth suicide and self-harm: Health, Education, Youth & Social Work, Family. The afternoon will begin with Part II of the results, Help Seeking, again followed by the four themed workshops. The aim of the workshops is to agree recommendations under each theme for parts I and II. I will be facilitating the workshop on Help Seeking, Youth and Social Work in the afternoon. I am keen to discover whether this research will encourage Professor Appleby to give LGBTQ young people a higher profile in the Suicide Prevention Strategy. To be honest (me being cynical after over 25 years campaigning for this) I am not holding my breath. Here is a link to some of the work I have done over the years: GALYIC History and before that, my work with Lesbian Information Service. It will also be interesting to see if the research, which of course I have supported as I did Youth Chances, will come up with anything new. Here is a presentation I gave on Suicide Prevention Strategy 2011: LGBTs in Rochdale in October 2012. I think many services are now aware of the high levels of suicide and self-harm amongst LGBTQ young people; the problem is how to get them to do something about it: it was difficult enough getting them to include the needs of LGBTQ young people before the drastic cut backs, it feels that, without substantial funding and specific actions supported by national strategy,nothing is going to change.
Here is a link to a document we produced at GALYIC back in 2008 LGBT Young People: Pathways to A and E which identifies the triggers for self-harm and suicide amongst LGBT young people, potential areas of intervention, how to reduce admissions and an example of a comprehensive LGBT youth service.
21st March 2015
An article in The Guardian looks more closely at what happened. There is a link to the new organisation Nazz and Matt Foundation, Nazeem's partner, Matthew Ogston has set up to help other LGBT people facing similar circumstances.
I have supported several young Asian (Muslim) LGBT people over the years. I have known an Asian Muslim family send their daughter back to Pakistan and we heard that she had died in a cooking accident.
I have known young Asian gay men get married because they want to keep the love and support of their families.
On the website there is an interview with Matthew on Sky TV. At the end of the interview the interviewer asks Matthew if he believes government should be more pro-active in the way they have done with enforced marriage. Matthew said no but that education was needed within the community.
I would disagree - having experienced the support of the police and social services in relation to a young Asian Muslim lesbian when the 'enforced marriage' rules kicked in, I would say this saved her life and, had the 'enforced marriage' procedures not been there neither the police nor social services would have acted the way they did. Nor, in fact, would the family have responded the way they did (in a positive way) because the police and social services were involved.
It isn't an either or, I think we need legislative support alongside education of families and communities.
We need legislation to ensure the police, social services and other services work together to tackle this, significant, problem.
It also needs to be put into perspective that there are many white, non-religious, families in Britain who throw out their children when they learn they are LGBT.
At the same time, there are many white, Christian, families who do not accept their children being LGBT and this often ends up with the young person killing themselves (like the 14 year old young lesbian from Cheshire who hung herself recently).
We do need legislation in this country that would stop parents (whatever their background or religion) from rejecting their children simply because they are LGBT.
We need CAMHS (Child and Adolescent Mental Health Services) and Family Services (Social Services) trained up to support families to accept their children.
We need more LGBT youth support groups to help young people rejected by their families.
We need to stop brushing this under the carpet and ignoring it.
18th March 2015
This report states, under section 22. Tackling inequalities and promoting equality, "Reducing health inequalities in children and young people from vulnerable groups should be a focus both for commissioners and providers of health care."
The Task and Finish Group point out The Health and Social Care Act 2012 places a legal duty on clinical commissioning groups, NHS England and the Department of Health to have regard to tackling health inequalities and this includes children and young people vulnerable to mental health problems.
They also note the Equality Act 2010 sets out equality duties for both the public and voluntary sector in respect of protected characteristics.
So that inequalities are better addressed, the Group proposes:
Awareness is needed that those in vulnerable groups may have protected characteristics, such as disabilities caused by both physical and mental health difficulties, complex medical conditions, race, faith, sexual orientation, or gender reassignment. There may be a need for more training across all agencies working with children and young people, in recognising protected characteristics as a potential vulnerability to mental health problems. Children and young people - such as those with learning disabilities - should not be turned away from specialist services because of their disability.
The report adds:
An example of a protected characteristic that could easily be missed is LGBT children and young people who are more vulnerable to mental health difficulties, particularly those who are just coming to terms with their sexual orientation or gender identity. In addition, many LGBT young people experience homophobic bullying and the impact on their mental health is profound. This is made worse if they have not come out to family and friends and consequently feel they have no one to turn to.
I would have liked this to acknowledge some young LGBT people do not have the support of their parents, given that CAMHS usually work with families, and that parental/family support can make a huge difference.
It remains to be seen whether clinical commissioning groups, NHS England or the Department of Health take any action. I don't want to be cynical but somehow I doubt it.
16th March 2015
21st February 2015
20th Febuary 2015
20th February 2015
9th February 2015
6th February 2015
17th January 2015
14th January 2015
5th December 2014
Dear Ms Bridget,
Thank you for your correspondence of 5 November to Norman Lamb about the Children and Young People's Mental Health and Wellbeing Taskforce. I have been asked to reply.
As you will know, the Taskforce was launched in August to find ways to improve the way children and young people's mental health services are organised, commissioned and provided, and how to make it easier for all young people to access help and support. The Taskforce will consider how to reduce health inequalities and promote equality for all children and young people with mental health needs.
The Taskforce shares your concern for the mental health and wellbeing of the LGBT community, as it knows that young people who are lesbian, gay, bisexual or transgender are at a significantly higher than average risk of having mental health problems, and are more likely to have difficulty in accessing services.
To ensure that mental health services reflect the needs of the LGBT community, the Taskforce has set up a 'Task and Finish' group that looks specifically at vulnerable groups, including the LGBT community, and inequalities.
The Vulnerable Groups and Inequalities Task and Finish Group is considering how to ensure there is system that works for the most vulnerable children and young people. The group will work with other Task and Finish groups in the Taskforce to ensure that the needs of all children and young people are considered and addressed, including those from the LGBT community.
I hope this reply is helpful.
Ministerial Correspondence and Public Enquiries
Department of Health
In response to this I sent an email to the chairs of the 'Task and Finish' group to find out ways the Vulnerable Children's Group will be taking on board the needs of LGBT young people? This is the response I got:
There has been a lot of commentary saying they don't think we should identify individual groups of children and young people but should concentrate more on the needs of vulnerable groups generally which is what we are trying to do. We hope that the general proposals that will be made by the taskforce will address the needs of all children and young people. However, the overarching report is intended to be short - 30 pages or so - so will not go into much detail about specific groups, obviously a great deal of the work will come at a later stage (ie post-election depending on what incoming Ministers wish to do) and at local level.
I am curious to know who is making the 'commentary' given that none of the oral submissions to the House of Commons Inquiry mentioned LGBT young people and only five of the 163 written submissions included them (three of these were references to the vulnerability of LGBT young people, two, my own and one from the Metro Centre, looked at LGBT young people specifically); and given that the Taskforce does not appear to have any input from an expert on LGBT young people?
The Children and young people's mental health and well-being taskforce are now consulting professionals who work with children and young people: Professionals' Survey for Children and Young People's Mental Health and Wellbeing Taskforce. I only heard about this yesterday and have completed the survey. The deadline was today but it has been extended to 12th December. It is not known whether any other professionals who work with (or have worked with like me) young LGBT people have completed the survey but I suspect not.
It is worth noting that although the above response says individual groups of children and young people should not be identified, there is a section of the survey which states:
We know that there are some groups of children and young people who are particularly vulnerable and find it harder to access mental health services (e.g. victims of sexual exploitation, learning disabled children, looked after/adopted children, young offenders).
Pardon me for being confused! And pardon me if I don't believe that the needs of LGBT young people will be addressed or included in the needs of vulnerable groups generally.
20th November 2014
12th November 2014
6th November 2014
6th November 2014
5th November 2014
The recommendations are that the new Department of Health/NHS England taskforce, whose task is to overhaul the way CAMHS is commissioned and to ensure young people are offered the most appropriate care both in the community and hospital, "takes full account of the submissions we have received, and the wealth of information they contain." This is specifically mentioned with regard to vulnerable groups.
It remains to be seen whether this taskforce, which does not appear to have representation from a specialist LGBT expert, will take on board the issues raised in the two submissions.
5th June 2014
We know that lesbian, gay, bisexual, transgender and questioning (LGBTQ) young people are highly vulnerable to a range of issues including mental health (self-harm and suicide), substance misuse, sexual health issues, homelessness, and this is usually the result of bullying, abuse, isolation, parental rejection.I believe that, in order to reduce this vulnerability, when a young LGBTQ person accesses a service, the providers have a duty to comprehensively assess their needs in a holistic and empowering way. I realised how important it was to develop a screening tool back in 2000 when one of the first members of my youth group died from a heroin overdose. As result I developed the Needs Assessment Tool (or NAT), which I used, developed and improved, over the 13 years I ran Gay and Lesbian Youth in Calderdale (1999-2012). The NAT is wide-ranging and covers everything from coming out, bullying, substance misuse, sexual health, mental health, homelessness, to emotional abuse, etc. Working with the young person, using the results of the NAT, together we would develop an action plan. This could include, for example, referral for counselling, a sexual health check-up, access to housing, and so on. This method enabled young people to understand whether and how they were vulnerable, why they were vulnerable and have control over what to do about it. After six months an Impact Assessment (IMP) would take place to review progress. The report would enable me, and the young person, to see the journey the young person had taken and identify improvements made and any further action needed. This method of comprehensively assessing the needs of LGBTQ young people was identified as an example of good practice in research by the London-based, LGBT mental health organisation, PACE (Where to Turn, 2010). Just in itself, the NATnIMP can be a life saver. But there are significant added benefits, not least that after, say, 20 NATs, a consolidated report can be requested to show what percentage of young people have, for example, attempted suicide, smoke, misuse alcohol, etc. This data can then be used to access funding (we were successful in a BBC Children in Need funding bid using this method). The combined NATnIMP also provide hard evidence of the success of interventions, again extremely useful when reporting back to funders. I will be discussing the NATnIMP at the WorldPride Human Rights Conference in Toronto on 27th June 2014 and encouraging other agencies world-wide to utilise this, or other similar screening methods, when working with LGBTQ young people. I am delighted to have been chosen to make a presentation as nearly 400 applicants from almost 60 countries applied for such a privilege. Here is a link to my presentation: "Assessing the Needs of LGBTQ Youth" Jan Bridget