Breaking Barriers: Supporting Mental Health in Stigmatised Communities
Mental health is a vital aspect of people’s lives. Access to mental health care can be challenging for everyone. Long waiting lists, unavailability of counsellors, stigma surrounding mental health treatment, time constraints, and the cost of therapy often create invisible barriers that prevent individuals from seeking therapy. However, these barriers can be even more pronounced for stigmatised minority groups such as refugees, LGBTQI+ individuals, and women. Consider the case of LGBTQI+ individuals: a recent systematic review analysing findings from 26 studies reported that the impacts of prejudice, expectations of prejudice, living a closeted life, and internalised stigma extend beyond mental health, adversely affecting physical health, immunity, risk of suicide, HIV, cardiovascular health, metabolic issues, cancer, and hormonal outcomes for over 50 per cent of the participants. (Flentje et al., 2020)
Despite the challenges, there is also evidence for effective treatment approaches for stigmatised groups. Integrated care and affirming therapy primarily provide positive mental and physical health outcomes for individuals, raising the question of what can be done when people lack access to integrated care (Hughes et al., 2017). My experience as a therapist working with sexual minorities, along with the majority of academic literature, points in the same direction: family and social support.
What about Family and Social Support?
Family and social support are some of the most important predictors of positive outcomes in the mental health of sexual minorities, particularly for youth (McConnell et al., 2016). Supportive parents and family members are a crucial first step. Open conversations about identity and validation of experiences with family members directly impact healthier mental health outcomes.
Social support and peer networks also play a crucial role. Having a strong network of friends, LGBTQ+ peers, or allies contributes to emotional well-being, alongside safe spaces where individuals can express themselves without fear or discrimination. Supportive school environments, anti-bullying policies, advocacy groups, online communities, and pride marches often serve as a shield protecting LGBTQI+ individuals, particularly those in unsupportive settings.
Another important aspect is having mentors. LGBTQI+ youth often have no one to discuss issues concerning dating, sexual health, and questions about their own identity without judgement, even in supportive family environments. Shared experiences and mentoring seem to promote a strong, positive sense of identity, helping to reduce shame while fostering higher self-esteem.
Seeing LGBTQ+ role models and allies in television, media, literature, and professional fields is crucial, especially for those without access to family, social support, and affirmative mental health care. Telling queer stories, celebrating LGBTQI+ artists, and highlighting prominent role models are essential. Such representations reduce feelings of isolation and provide the possibility of a life outside, often becoming a beacon of hope for many individuals.
In summary, mental health is crucial for everyone, yet barriers hinder access for stigmatized groups such as LGBTQI+ individuals. It is essential for individuals, institutions, and lawmakers to recognise these challenges and collaborate to dismantle such barriers.
References
Flentje, A., Heck, N. C., Brennan, J. M., & Meyer, I. H. (2020). The relationship between minority stress and biological outcomes: A systematic review. Journal of Behavioral Medicine, 43(5), 673–694. https://doi.org/10.1007/s10865-019-00120-6
Hughes, R. L., Damin, C., & Heiden-Rootes, K. (2017). Where’s the LGBT in integrated care research? A systematic review. Families, Systems, & Health, 35(3), 308–319. https://doi.org/10.1037/fsh0000290
McConnell, E. A., Birkett, M., & Mustanski, B. (2016). Families Matter: Social Support and Mental Health Trajectories Among Lesbian, Gay, Bisexual, and Transgender Youth. Journal of Adolescent Health, 59(6), 674–680. https://doi.org/10.1016/j.jadohealth.2016.07.026
