A Transcultural Approach to meeting the needs of our LGBTQ+ Scots

People seeking help for their mental health from our members should know their experiences are understood. That aspiration is the fundamental end state of the equality of access that the College’s Equality Action Plan aspires to for people from all backgrounds.

As we celebrate our LGBTQ+ communities and members during Pride month, we should then reflect on their experiences when trying to access potentially life-saving mental healthcare. 

The latest research by Stonewall Scotland shows this is a community that appears to be predisposed to poor mental wellbeing and mental illness. Half of LGBT people (49%) reported that they had experienced depression in the last year, including seven in ten trans people (72%). One in twelve LGBT people (8%) said they had experienced an eating disorder in the last year, and it was the same figure for an addiction.

Not only are these communities that are potentially likelier to need mental health support and potentially specialist care, though - the report emphasises those providing healthcare can fail to understand this community's experiences. Up to 13% of LGBT people reported they had received unfair treatment by their healthcare providers, and one in four said they had experienced a lack of understanding for their healthcare needs.

Addressing this gap in understanding in mental health settings will take a collective effort from our members and the services in which they operate, with the GMC seeking to start these conversations through its own guidance. The thinking around how to address this is taking place though, as seen through the recent Scottish Transcultural Psychiatry Conference. 

Transcultural psychiatry calls on members to understand the person they are providing care to, their experiences and the particular challenges they might face as a result of these experiences. By explicitly acknowledging these, care and treatment can be optimised to meet that person’s needs and to respond to those challenges.

Across a series of presentations, we saw a range of issues and approaches covered. This included using Pakistani television dramas to communicate to ex-pat communities in Scotland about their mental health, through to disparities in detentions under the Mental Health (Care & Treatment) (Scotland) Act. The common thread across all of these was aiding members to understand and empathise their patient’s cultural experiences and background as part of providing their care. 

Greater empathy has the potential to ensure our LGBTQ+ communities, when at potentially their most vulnerable, feel the specialist mental health doctor they are engaging with is taking account of them. This includes the community they are from, which may come with a particular set of experiences that influence the kind of care and treatment they will need.

The sense among our LGBTQ+ communities is that this understanding and empathy can be lacking when they seek mental health care. We as a College will look to continue these conversations around a transcultural approach to psychiatry, and to consider how it can be used to address the disparities some of our most vulnerable Scots face.