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Research in Action: Striving for equity – mental health support for young LGBTQ+ people

Around one in eight children and young people in the UK have a clinically diagnosable mental health disorder.

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Around one in eight children and young people in the UK have a clinically diagnosable mental health disorder. This means that in the average classroom three children will be struggling with their mental health. Untreated, mental health problems in children can alter the course of their entire lives. Symptoms often persist into adult life with long term effects including reduced education and employment opportunities, relationship problems and poorer overall health.

Problems such as self-harm and anxiety were already on the rise before the pandemic and a study in The Lancet Psychiatry found children and young people’s mental health deteriorated most during lockdown compared with other age groups.

Every young person deserves easy access to support that could improve their mental wellbeing – and not just in times of crisis. But the reality is that this is not the case. Opportunities for help are not equal and this needs to change.

Breaking down barriers and reaching those in most need of support is vital if we are to change the situation. To do this, research needs to involve meaningful collaboration with those communities who are being under-served. King’s research programmes are purposefully shifting power into the hands of those who are best placed to highlight the key challenges faced by their peers and communities, including welcoming ‘peer researchers’ into our research teams. Our ambition is to transform unequal access to vital mental health education and support, bringing life-changing benefits to more young people.

Schools Training to Enhance support for LGBTQ+ young People Study (STEPS)

All aspects of a young person’s social identity, intersect to influence not only who they are and how they experience the world, but also their mental health. This includes their race or ethnicity, sexual orientation, gender identity, geography, culture, faith, and socio-economic circumstances.

At King’s College London’s Institute of Psychiatry, Psychology and Neuroscience (IoPPN), Dr Charlotte Woodhead, Amy Morgan and the STEP study team are leading a pioneering study that takes into account these intersecting social identities and aims to improve support for young LGBTQ+ people in schools.

Evidence indicates that young LGBTQ+ people are more at risk of challenges with their mental health. They can often fear stigma, prejudice or being misunderstood in healthcare settings, and healthcare staff may not be confident or aware of how best to support LGBTQ+ young people. This means these young people experience barriers to accessing and feeling supported in mental health services.

Young LGBTQ+ people are two- to three-times more likely to experience anxiety, depression, suicidal behaviours, substance use and eating disorders. Schools and other community-based organisations are crucial routes to reaching these young people. As spaces where young people may spend a huge amount of time and where they are heavily influenced by their experiences and their peers, these places should offer effective, tailored mental health support for young LGBTQ+ people.

While school staff in the UK may have access to professional development training in LGBTQ+ issues via several consultancy organisations, there is limited ethnic minority representation among training providers and the programmes themselves may not consider young people’s multi-faceted and intersectional social identities. This significantly limits the relevance and practical value of training, as different groups experience differing rates of difficulties within the LGBTQ+ population. For example, greater mental health challenges are reported for; bisexual and transgender young people, LGBTQ+ young people who are using free school meals, those with a disability and those who identify as a racial or ethnic minority.  

Young Black LGBTQ+ people face particularly significant difficulties; they are twice as likely as their white peers to say they have ‘never’ felt safe in school, and 89% of Black LGBTQ+ young people have experienced suicidal thoughts and feelings compared to 67% of white LGBTQ+ young people.

STEPS is the first study of its kind to have an explicit focus on intersectionality, and the impact of multiple forms of marginalisation (e.g. racism, homo- and trans-phobia, religious discrimination) on young people. It aims to optimise school staff training by evaluating existing LGBTQ+ resources and comparing this to the training needs identified by young people themselves.

A crucial part of STEPS is the involvement of young people themselves in the research. Co-leading the study, young peer researchers have facilitated group discussions with pupils aged 13-19, fed into the study design and worked on applications for research funding. This not only helps the rest of the team make better sense of any findings, but also ensures that young people’s voices are heard throughout and that the research outcomes are meaningful and address the issues that matter most to young LGBTQ+ people.

Once ongoing data collection is complete, the team will use their findings to develop better training materials for school staff. This tailored guidance and practice will then be shared with current training providers and teacher-training organisations.

Our guiding philosophy is that no young person should have to hide who they are, and that they should feel able to be seen and respected for the whole of themselves – that is, everything that makes them, them, from their sexual orientation or gender identity to their race, ethnicity or family background.– Dr Charlotte Woodhead, Lead Researcher for STEPS & Lecturer in Society and Mental Health at King’s College London

This project aims to give young people access to better support within their local community – support that recognises and responds to the interconnected aspects of their social identity, and that has the best possible chance of keeping them in good mental health. By publishing and sharing their findings, the STEPS team could also help to improve other channels of mental health support for LGBTQ+ young people in SE London, across the UK and around the world.

King’s is committed to directly involving communities and individuals to explore how their unique characteristics, culture and circumstances combine to impact their mental health experiences, allowing us to conduct research that will improve support for generations to come. To read/hear more about this project, please visit the STEPS website, or contact the STEPS Study Team at steps@kcl.ac.uk