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JOINT COMMITTEE ON HEALTH AND CHILDREN (Sub-Committee on the High Level of Suicide in Ireland) díospóireacht -
Wednesday, 1 Apr 2009

Suicide in Gay and Lesbian Community: Discussion.

I welcome Mr. Odhrán Allen, director of mental health at the Gay and Lesbian Equality Network, and Mr. Michael Barron, director of youth services, BeLonG To Youth Service. Before we begin, I draw attention to the fact that while members of the sub-committee have absolute privilege, the same privilege does not apply to witnesses appearing before the sub-committee. Members are reminded of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside the Houses or an official by name or in such a way as to make him or her identifiable. They may ask questions after the briefing.

We look forward to the presentation. I have been aware for some time from international research, mostly in the United States, of the higher levels of suicide among the people Mr. Allen represents. Unfortunately, there is a dearth of research in this country on the level of suicide in the gay and lesbian community. We have been asking for a number of years for such research to be initiated here. Even since the days when I was a Member of the Seanad, dating back ten years, Senator Norris has been discussing this issue. However, I am not hopeful there will be investment in research in Ireland but we must continue to campaign for it. I invite Mr. Allen to make his presentation.

Mr. Odhrán Allen

On my own behalf and that of Mr. Barron and our respective organisations, the Gay and Lesbian Equality Network and BeLonG To Youth Service, I thank the sub-committee for the invitation to speak to it. We are delighted to have the opportunity to address the issue of the high level of suicide among a minority of lesbian, gay, bisexual and transgender, LGBT, people in Ireland. We will focus on what is called LGBT minority stress and present the findings of the research funded by the National Office for Suicide Prevention which was launched by the Minister for Health and Children in February. That study was entitled, Supporting LGBT Lives.

It would be incorrect to state that being gay or lesbian per se is indicative of or has a correlation with having mental health difficulties but, because of the stresses associated with stigmatisation, discrimination and marginalisation, there is an increased risk associated with being gay, lesbian or bisexual which some LGBT people can experience. There is a great deal of evidence internationally to support this. The emerging concept in the research and national and international literature is that of LGBT minority stress, which is a useful term, because it helps us to understand that stigma, discrimination and harassment have an impact on the mental health of minorities, including LGBT people. Such stress can increase their vulnerability to developing mental health problems.

One of the recommendations of the Supporting LGBT Lives research was that it would be inappropriate to categorise all LGBTs as being at risk of mental health problems or suicide and the findings were that the majority of such people in Ireland have learned to cope well with the stresses they encounter and they are resilient. Where one experiences a lack of support or lack of inclusion or inequality that any minority such as LGBT people face, the risk of minority stress increases and the increased experience of such stress places an increased risk on mental health. Broadly, the effects of minority stress on LGBT people are an increased risk of psychological distress such as depression and anxiety, increased levels of suicidal behaviour and self-harm, and increased levels of substance misuse and eating disorders. However, much resilience is also demonstrated among gay and lesbian people in Ireland.

The Supporting LGBT Lives study was launched by the Minister for Health and Children in February. There was special emphasis in this research on young people in Ireland. It constituted an on-line survey with 1,110 surveys, in-depth qualitative interviews with 40 LGBT people and a community assessment process where the researchers met key personnel in the Departments of Health and Children, and Education and Science and service providers in the LGBT sector to inform the research process. Mr. Barron will present the main findings. It is important for us to emphasise the study was funded by the National Office for Suicide Prevention because action 15.1 called for increased evidence and research of the issues facing marginalised groups in society, including LGBT people.

The key finding of the Supporting LGBT Lives study is that minority stress has a significant impact on the mental health and well-being of LGBT people in Ireland. The specific stresses people face include the fear of coming out, the fear of being rejected when coming out, negative experiences in school such as homophobic bullying, experiences of victimisation and harassment on a day-to-day basis and the impact of the above on people's mental health. Mr. Barron will refer to the findings.

Mr. Michael Barron

I thank the sub-committee for inviting us. We had contact with the sub-committee when we made a submission in 2006, elements of which were included in a report that came out then. I thank the sub-committee for that.

What emerged from the Supporting LGBT Lives report was that the most vulnerable time in LGBT people's lives is predominantly the teenage period. On average, LGBT people realise their identity at 14 years of age but do not come out to anybody else until they are 21. Therefore, there is a seven-year gap between personal identification as LGBT and telling anybody else about it. This period coincides with puberty and school and it is a critical period in the social, emotional and vocational development of a young person. Prior to coming out, some of the stresses involve fear of rejection and isolation. As we have worked with young LGBT people for a long time, we are particularly concerned about this period.

School emerged as a key site where young LGBT people experience harassment or isolation. A total of 58% of respondents reported experiencing homophobic bullying in school and more than half were called abusive names relating to their sexual orientation or gender identity. Some 40% were verbally threatened by fellow students while one quarter of the overall sample were physically threatened by their school peers. An important statistic is that one in five disclosed they missed or skipped school as they felt threatened that they would be hurt if they went to school. That is particularly important in the context of educational attainment. One in three reported homophobic comments by teachers or other staff in school.

I refer to broader victimisation among the entire people and not only young people. A total of 80% of on-line respondents had been verbally abused because of their identity while 40% had been threatened with physical violence, and one in four had been violently assaulted, that is, punched, kicked or beaten because of their identity.

The key mental health findings were that 86.3% had disclosed they felt or experienced depression, 46% disclosed hazardous drinking and 27% had self-harmed. In the context of this being a youth issue, 15.5 was the average age at which a person would begin to self-harm and 85% of people who had self-harmed had done so on more than one occasion. Another key finding was that female respondents were more than twice as likely to have self-harmed than male respondents. Some 17.7% of respondents had attempted suicide and 17 was the average age at which they first attempted suicide. In the context of younger people being particularly vulnerable, more than 50% of under 25s disclosed they had seriously contemplated suicide in the past year.

I refer to the risk factors relating to suicide. For those who had attempted suicide, the identified contributing factors included experience of homophobic bullying in school, feeling of fear or rejection by family, friends and school peers, experience of being verbally or physically threatened or physically hurt because of their gay identity and experience of alienation or being regarded as different.

Mr. Allen mentioned resilience, a key factor that emerges from the report. It is not the case that all LGBT people are particulary at risk of suicide or mental health difficulties and most people are quite resilient. With regard to resilience and how it emerges in people, positive turnabouts in life, particularly the transition out of school, which is a key finding, were linked to a young person building resilience around his or her mental health. Young people's individual abilities to manage their psychological distress were also key and contact with the LGBT community, a sense of being involved with or belonging to a minority community, came out as a key protective factor. That reinforces the point about young people having access to designated support services. The final point is positive school and work experiences.

To summarise, among the most at-risk young people surveyed, 12 was the average age at which people realised they were LGBT and they began self-harming at 15.5 years and first attempted suicide at 17. On average, there is a five year gap in which they conceal their identity out of fear. At age 17, they begin to come out to others and at 21 or older social supports and resilience in mental health begin.

Mr. Odhrán Allen

People may feel that there is a discrepancy in some of this information. Mr. Barron said that people identify as LGBT on average at the age of 14 and disclose this on average at 21. The final figures refer to the most common age reported which was 12 years and the most common age of disclosure was 17. The most common gap between knowing and disclosing is five years but the average is seven years.

I sincerely thank the delegation for its presentation. The mental health findings in the on-line responses were that 86.3% had a depressive experience, 46% reported hazardous drinking and 18% attempted suicide. Can the witnesses say how that relates to the total population? Do they have any idea whether these people decided to respond on-line because of their experience and how does that represent the total gay community?

Mr. Michael Barron

There are two points. First, the on-line survey was a way of getting to the highest number of people possible because the infrastructure for the LGBT communities is weak outside Dublin. We used the on-line survey to get responses from people outside Dublin.

It is not random selection?

Mr. Michael Barron

No, but there was an attempt to reach as many people as possible. In respect of random selection whether by telephone or any other means——

One would not want to extrapolate from the figures that 86% of people who are LGBT suffer from depression.

Mr. Odhrán Allen

No standardised measure of depression was used in the survey, so it would be incorrect to say that people were diagnosed with clinical depression. This was reporting of having felt down or depressed. If one asked the general population whether they had ever felt down or depressed the result might be higher than 86.3%. In respect of the other findings of the audit, 46% reporting hazardous drinking is in keeping with the figures for the general population.

It is important to state that this is not representative of all LBGT people in Ireland but, given the significant number who participated in the on-line survey and the supportive evidence from the detailed qualitative interviews, there is good evidence to indicate that this is a significant problem for a minority of LGBT people.

One of the findings of particular concern to the National Office for Suicide Prevention was that approximately 23% of those in the general population who self-harm do so two or more times. In our study, of the sample of the 27% who had self-harmed, 85% had done so more than once. That figure is particularly worrying. Repeated self-harm is a significant risk factor. The survey is not representative of all LGBT people but it is the most significant evidence we have gathered to date and it indicates that LGBT suicide is a cause for concern.

I thank the delegation for the presentation. During my training as a midwife, for whatever reason, we were told that approximately one in ten people were LGBT. Now I am involved in the sexual health programme in schools, including mixed gender schools, and I touch fleetingly on this as one of the difficulties among the other challenges for young people at puberty. Have we any idea what percentage of the population is LGBT?

Mr. Michael Barron

Generally that is set at between 5% and 10% of the population. We do not have an actual figure because it is impossible to gather that data. Traditionally it was set at one in ten based on work in the United States many years ago. We may be somewhat conservative but both of our organisations use the figure of 5%.

I thank the witnesses for their presentation which was of great relevance to our work.

Mr. Odhrán Allen

May I make a few short concluding points?

Yes, bearing in mind that this meeting is public and recorded and all the witnesses' presentations are in the public domain.

Mr. Odhrán Allen

We believe that LGBT suicide is an urgent issue. There is clear evidence of this from the LGBT Lives study. We are grateful that the National Office for Suicide Prevention has engaged with us and continues to support our work in this area. Both our organisations work with the office to address the issue. The research calls for a cross-sectoral approach, broader than the work of the National Office for Suicide Prevention and the mental health services. There is a need to engage the Departments of Education and Science, Health and Children, Social and Family Affairs and Community, Rural and Gaeltacht Affairs and the Office of the Minister of State with responsibility for children and the youth sector, to name but a few, to ensure that the policies in the State are LGBT-inclusive, where appropriate, and that dedicated services initiatives are established.

An overarching requirement is the need to address the status and visibility of lesbian, gay, bisexual and transgender people in our society. A practical example would be tackling homophobia because it is clear from the research that there is a high level of victimisation of LGBT people. I thank the sub-committee.

I congratulate the delegation on this report and its contribution. I am sure it contains a great deal of factual and useful information that may positively inform our policy.

I thank the delegation for its presentation and for answering our questions. It has been a very informative discussion. We will examine the report of the proceedings to see how the sub-committee should respond.

The sub-committee adjourned at 4 p.m. sine die.
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