Gay, Lesbians, and Mental Illness - Research Paper Example

Gay, Lesbians, and Mental Illness It would seem homosexuality has come of age; it has its own plethora of mental illnesses as any other deviant group in existence. The purpose of this study is to ascertain whether homosexuals being what they are, have a tendency to suffer from mental illness of any kind. Curiously, there is an ironic twist to this enigma which in itself is a little problematic in nature. It appears that the topic in question itself is highly controversial, to say the least. It is often assumed that gay people being a deviant minority are susceptible to the aberrations, both physical and mental in nature, that are not generally prevalent in conventional relationships. There is a belief gaining momentum in certain circles that being a gay/lesbian itself is a form of mental illness. This is so because mental health personnel and society at large were given biased information to begin with. The resultant conclusions were biased too because some time ago, only those gay/lesbians undergoing medical treatment were involved in the studies. But it soon became apparent that homosexuality was not a mental syndrome when researchers studied data of those who were not undergoing therapy. It was not only the mental health professional themselves who were guilty of this belief. Until 1973, even a prestigious organization as the American Psychiatric Association was guilty of this practice for they used to include homosexuality in the official manual that listed mental and emotional disorders. And it took American Psychological Association another two years to pass the resolution supporting the action of the APA. Some people still cling to the idea that mental illness is associated with homosexual orientation. It was the new and better designed research methods that helped turn the tables in reaching this momentous decision on behalf of the gay/lesbians. Now, all concerned are in agreement that homosexuality is not an illness, mental disorder or an emotional problem. But it was not until more than three decades have passed that the situation was finally remedied. It is gratifying to note that much research has been done on the subject. Tori DeAngelis, is a writer who is based in New York. She writes prolifically on homosexuality and related issues. She unearths valuable data on the lesbian/gay and bisexual (LGB) mental health and states that new findings overturn beliefs that were held previously inviolable. She reports on some of the new ‘breakthrough studies’ that offer fresh insights into the mental state of gay/lesbians. According to her, many such studies indicate that compared to heterosexuals, gay/lesbians seem to have higher rates of mental disorders. Of course this does not rise to the levels of serious pathology. One of the factors that aggravate these higher rates is discrimination. Strangely, lesbians maintain strong levels of mental health on a par with their heterosexual counterparts and even exhibit higher levels of self-esteem. Previous research had suggested that attempts of suicide among gay/lesbian youth were much higher than heterosexuals. But new studies reveal that the incidence is only a little more likely than those with normal sex behavior patterns. Such studies suggest there is the need for a far better and ‘more tailored psychological treatment’ for LGB folk. (Tori, 2002). A series of population-based studies were conducted by Dr. Susan Cochran, an epidemiologist with the School of Public Health, UCLA and the findings were reported in the November issue of The American Psychologist. Compared to heterosexuals, gay/lesbians were found to have ‘higher rates of major, generalized anxiety disorder and substance use or dependence.’ Among gay men, higher rates of ‘recurrent major depression’ were evident. Among same-sex partners between the ages of 15-54, there was higher incidence of ‘anxiety, mood and substance use disorders, and suicidal thoughts.’ Such persons also made more extensive use of mental health services. Cochran states that sifting out this kind of data has never been possible with general surveys before. “However, because the surveys on which these studies were based, examine HIV-risk factors, including psychiatric problems and sexual behavior, they include questions on sexual orientation and sexual partners.” (Dr. Cochran) She goes on to say that such information is a breakthrough in the annals of gay/lesbian problems. This is because the LGB folk forms a marginal minority and this made gathering of large samples of them in the traditional manner an uphill task. Previous studies found that no significant discrepancies existed in the mental health of LGB folk and heterosexuals. This makes Cochran worry that such findings my help to falsely propagate the assumption that gay folk are mentally ill by nature. She says, "These are certainly not levels of morbidity consistent with models that say homosexuality is inherently pathological." Also, the available data cannot prove the arguments either in favor or against the LGB folk. Does the inherent biology of homosexuality causes mental illness or the social stigma attached to it does it? One cannot be certain. In his report on sexuality and health the U.S. Surgeon General has recommended better psychological treatment for LGB people and Cochran on her part fully endorses it. Is there a connection between discrimination and mental health? In a joint study with Dr. Vickie Mays of UCLA, Cochran tried to discover the likely root causes of mental illness among LGB people. They investigated whether the perpetual discrimination causes anxiety, depression and other stress-related mental health problems. Surprisingly, they found enough evidence to connect the two. Here they used the data from public health surveys conducted on large scales. They compared 74 LGB and 2844 heterosexual subjects to find out how they rated discriminatory experiences both on a macro and micro levels. They examined particular instances, like not being selected for a job or denied a bank loan. They also looked for ‘perceived discrimination’ meaning if people treated them with less respect. They also made an assessment of the degrees of mental illness in the two groups. The team found that in every ‘category related discrimination,’ LGB subjects complained of higher levels of perceived discrimination than heterosexuals. Their study does not indicate that discrimination leads to mental health problems. But it demonstrated that the social stigma attached to a homosexual has marked consequences in their mental health. This further emphasizes the need for custom planned mental health therapy which must include discussion of how experiences connected to discrimination affects mental stress levels. The findings of the study were reported in the November issue of the American Journal of Public Health (Vol. 91, No. 11). Do LGB youth have a higher incidence of suicide rates? Dr. Ritch. C. Savin-Williams of Cornell University conducted two elegant studies about the topic. The study found that LGB youth are more likely than their heterosexual counterparts to report attempts at suicide. Interestingly, nearly half of those reports were found to be false, those teenagers only thought about suicide but had not acted upon in it. Besides many of the true attempts made by those youth were not in any way ‘life-threatening.’ “When you ask in-depth questions about suicide attempts, the responses you get account for the rate differences between heterosexual and sexual minority youth suicide," Savin-Williams says. "The heterosexual youth had hardly any false attempts, while those with same-sex attractions had a lot of them." The scientist maintains that the well-meant attempts of the media and certain researchers, who depict gay/lesbians negatively as highly stressed folk heading for a collision with life, make those youth highly vulnerable. "When you ask in-depth questions about suicide attempts, the responses you get account for the rate differences between heterosexual and sexual minority youth suicide," Savin-Williams says. "The heterosexual youth had hardly any false attempts, while those with same-sex attractions had a lot of them." In another study he compared reports of suicide attempts in 126 young sexual-minority young people and 140 young heterosexual men and women. While LGB youth by far have a higher tendency to report attempts of suicide, the two groups shared the same rate of suicide attempts. "There's a script we have in our culture--a 'suffering suicidal' script--that these kids have picked up on," he says. A better approach for researchers, teachers and other youth workers, he believes, is to treat all young LGBT people as ordinary kids with great potential, unless they show research-based or visible indicators of suicide risk. He says, “There's a script we have in our culture--a 'suffering suicidal' script--that these kids have picked up on.” To arrest this trend he suggests that all those concerned should treat all young LGBT folk as ordinary youth with great potential, “unless they show research-based or visible indicators of suicide risk.” Now what about research on the topic in question? Two large-scale studies were conducted on lesbians and bisexual women by Dr. Esther. D. Rothblum and Dr. Rhonda Factor, psychologists at the Vermont University. Both of them have good news on lesbians' mental health. They found that lesbians report that they are mentally Healthy as their heterosexual sisters do; they even report higher self-esteem than the ‘normal’ folk. The findings of the study were reported in the December issue of Psychological Science (Vol. 12, No. 1). Comparisons were made about the mental health and lifestyle factors of various kinds of groups. They consisted of 184 pairs of lesbian and heterosexual sisters, 44 pairs of bisexual and heterosexual sisters, 29 pairs of lesbian and bisexual sisters, 18 pairs of bisexual sisters and 11 pairs of heterosexual sisters. They selected LGB participants through ads placed in LGB periodicals which did not mention that it was a study of lesbian mental health but as one of sisters. It was not apparent why lesbians possessed higher self-esteem, the authors could only speculate. It may be that lesbians are better educated and mobile than their heterosexual sisters. From this the authors hypothesized that lesbian sisters are more likely to be members of supportive communities which lets them strengthen their self-worth. Consistent with other studies on bisexuals, this study also found that bisexual women had comparatively poorer mental health than lesbians and heterosexual women. This may be due to the fact that bisexuals have a tendency to suffer rejection at the hands of straight and gay communities. The authors also speculate that “their mixed sexual orientation is more difficult to integrate psychologically than homosexuals' single-sex orientation.” The authors made a second study to test on 2401 lesbian and bisexual women to test ‘a structural equation model related to “outness” which is “measured by self-identification as a gay or lesbian, number of years out and level of involvement in the lesbian or bisexual community.” The authors found that the more the subjects were ‘out’, the less mental distress they reported. These findings were found to be true when applied to a wide range of racial and ethnic communities of USA. These findings could be found in the January 2001 issue American Journal of Orthopsychiatry (Vol. 71, No. 1). According to Rothblum this study is “the largest on lesbian mental health to date and is one of the only to look at the relationship of being out to lesbians' mental health.” The researchers also included Dr. Jessica Morris, a private practitioner in Northampton, Mass., and Dr. Craig R. Waldo of the University of California, San Francisco Center for AIDS Prevention Studies and AIDS Research Institute. They are in favor of any therapy that makes it easier for ‘coming out’, is good for mental health. The authors state, "Such affirmative psychotherapy, provided during the coming out process, may prevent or buffer against subsequent mental health problems." Another large survey was conducted in the UK on the psychological well-being among LGB people. Compared with the surveys held previously of mainly heterosexual folk, this survey found “high rates of planned and actual deliberate self-harm and high levels of psychiatric morbidity as defined by CIS–R score among gay men (42%), lesbians (43%) and bisexual men and women (49%).” Researchers Meltzer and Singleton found a 12% rate mental disorder in men and 20% in women as defined by CIS-R score. The disparity in the present study as compared to previous studies suggests the prevalence of higher levels of ‘psychiatric morbidity’ among LGB folk. This may also be alluded to the differences in recruitment methods or the inherent biases in ‘snowball sampling.’ In previous studies women were found to be more at risk. But the findings of this study suggest that gay males and lesbians are equally prone to psychiatric morbidity than women. There is also the possibility that gender differences are submerged due to other factors like discrimination which caused the mental distress in the first place. From the survey, the authors conclude that people under 40 years old seem to run a higher risk of psychological disorder and harmful drinking because this group exhibits greater frankness about sexuality. This might make them experience more ‘assaults and insults’ resulting in a worsening of mental well-being. Also younger people being more aggressive are more likely to reveal these facts about themselves. People get sad or depressed due to a number of reasons. Even something good can make a person depressed and sometimes it may happen without any obvious reason. As mentioned earlier, GLBT identity (gay, lesbian, bisexual and transgender) is not mental illness in itself. But depression can result by society's negative messages, condemnation, and violence in these persons. It is a medical illness that affects mentally and physically and may be far more complex than people allow. It makes chemical changes in the brain and compels those are affected to seek professional help. It is not just feeling sad which is a quite normal state in day to day life. Clinical depression is a prolonged state lasting weeks or even months. Those who suffer from its effects cannot concentrate, cannot manage their negative emotions or just have no energy left in their systems. With professional counseling and medication it can be effectively treatable. Some feel that it is a personal weakness and try to treat the symptoms themselves. GLBT persons can seek out a gay-positive counselor or ask friends to refer them to a GLBT-friendly clinical agency. Such persons may also suffer from mental illnesses besides clinical depression. There is also the likelihood of schizophrenia which disrupts cognitive activity that include hearing voices and seeing things that are not present. In our society there is a stigma associated with mental illness. Often this can lead people to hide a mental illness thus preventing them from seeking professional help. For GLBT folk, the case is fraught with dangers. They have to suffer the multiple stigmas of homosexuality as well as suffering from a mental illness. This may be insufferably challenging and make life extremely hard to cope. So it always good to be open with a doctor or mental health counselor and discuss it as if it is not at all different from any other type of illness. What are the issues involved in the treatment of gay/lesbians with chronic mental illness? Dr.RE.Hellman of South Beach Psychiatric Center, New York sheds further light on this aspect of the problem through a paper he written on the subject. According to him, “A growing theoretical and practical body of knowledge recognizes the common clinical concerns of chronic psychiatric patients who are homosexuals and promotes their affirmative inclusion in psychiatric programs for other persons with chronic mental illness.” For gay/lesbians who happen to be chronic psychiatric patients this provides a clinical context for treatment in the inpatient and outpatient departments. In long term psychiatric programs as well as in the GLB community, such patients are ignored to a considerable extent or remain as an invisible sub-group. They are wholly dependent on heterosexually oriented communities, homes or healing centers that are unaware of their needs. As mentioned before, most of them are under the double stigma of mental illness as well as being homosexuals. Positive models of treatment can be designed to meet the needs of this group but they must be ‘modified to accommodate their psychiatric deficits.’ To destigmatize mental illness and homosexuality increased efforts should me made. An interesting editorial by P.McColl in the British Medical Journal dated 26 February 1994 treats this problem in detail. The piece was written at the invitation of the Health of the Nation Key Areas Handbook on Mental Illness to "identify the particular needs of lesbians and gay men.” In this homophobic society, gay/lesbians face prejudice from all quarters and even death. Not only strangers but their own families assault them. Some of this pervasive discrimination is derived from the law of the land. Even an organization like the British Medical Association in its BMA News Review published an article by a doctor stating, "Only a society flirting with self-destruction encourages such perversity and ruination. Under no circumstances ought homosexuality to be regarded as anything other than a destructive habit system." Such prejudicial remarks were found their echo in the British Parliament also. Strangely, the editorial such prejudice does not in itself produce an adverse impact on the mental health of gay/lesbians. In a historical context, both medicine and psychiatry defined homosexuality as a disease or homosexuals as mentally disturbed. But dedicated research found that homosexual and heterosexual populations are not at all at variance on the basis of ‘personality or psychopathology.’ To use an expression that has Kennedian overtones “Ask not why homosexuals are unstable, but why they are not.” Psychological research in the context of HIV and AIDS has no bearing on why homosexuals are unstable because it does not take into consideration the emotional needs of the LGB people with particular reference to women. All the same, these studies have shown that distress may be caused by life events, social support or lack of it and self-esteem. However prejudice and stigmatization too worsen the effects of adverse events. But when the medical profession itself proves to be homophobic where a gay/lesbian does go from there? In a survey of attitudes conducted in 1989, nearly 33% of the general practioners felt uncomfortable in the presence of male homosexuals. They even considered them undesirable and a danger to children and it is better if they are not employed in schools. Roughly 10% of them believed it is an illness. A similar study conducted in Canada in 1991, 25% members of a psychiatric faculty described themselves as prejudiced against homosexuals. In recent British survey 50% of the medical students found homosexual activity an unacceptable lifestyle. In a 1980 American survey, 25% of gay/lesbians felt that health professionals were prejudiced against them. McColl comments with a keen sense of irony that “The perception of prejudice, of course, is not proof of its existence.” Another researcher Lynn Rose has shown that these two issues ‘tend to coexist and each is disabling.’ The editorial calls for a change in attitudes and practice. It expresses the need for undergraduate and postgraduate medical education tailored to the needs of gay/lesbians. As models for such education already exist, the specific training is worth its while. Secondly, the editorial wants the establishment of points of contact between the medical health providers and gay/lesbians. It calls for the review of the Government’s own agenda as sexual orientation was found to be a risk factor for suicide among teenagers. According to a recent Department of Health booklet. Finally the editorial exhorts the Royal College of Psychiatrists to respond positively to the 1933 statement of the APA: “Whereas homosexuality per se implies no impairment in judgment, stability, reliability, or general social or vocational capabilities, the APA calls on all international health organizations, psychiatric organizations, and individual psychiatrists in other countries, to do all that is possible to decrease the stigma related to homosexuality wherever and whenever it may occur." In a report in the 15th November 2002 issue of The Washington Blade, Kathi Wolfe reports on the first-ever meeting on Gay Mental Health at which nearly 150 people from the U.S. and Canada gathered at the New Shiloh Baptist Church in Baltimore, the first ever meeting on the mental health of gay/lesbian community. In it many persons recounted their personal experiences to the meeting at large. While she was a teenager, Paula Lafferty, then37 wanted to achieve good grades and get selected in sports teams. But bisexuality and the accompanying depression set her apart from her peers. At 19 she was under treatment to her ‘bipolar disorder’ known otherwise as manic-depression. Her mental illness had made her ‘disruptive.’ She could hardly sleep at nights. All her dreams were shattered.  She also said class is an issue. Later in life, people thought she was okay in spite of her mental illness. If she is upbeat about her illness people are fine but the moment she mentions her illness or medication they “turnaway” because she had a car and middle class job. But this acceptance does not go far. Alicia Lucksted, a member of the conference planning committee opined that gays with severe mental disorders have virtually no say in the mental health system. She goes on to say that they are silent in the GLBT community also and that leaves them in an isolated place, some of them with serious illnesses like schizophrenia, bipolar disorder, and clinical depression. The illnesses are debilitating and disruptive of life for long periods to come. Steve Holochuck, an activist from Boston said jokingly that all gay/lesbians being labeled mentally ill are under treatment. According to him even a certain amount of eccentricity among gay/lesbians are labeled ‘psycho’ meaning crazy. Bert Coffman founder of the Zappalorti Society, a New York support group for gays with mental illness says the gay/lesbians are wary of the mentally because the mental health system considers homosexuality a mental illness. Then 53, he began consulting a psychologist at the tender age of 7 and his first mental breakdown occurred when he was still in his adolescence. He described himself a gay with a capital G. He was ostracized from participating in a youth rebellion because he had gone with gay groups. Cookie Gant, 50, president of Psychiatric Alternatives Alliance in Okemos, Mich., stated that she had a multiple personality disorder and her own peers considered her illness were contagious.  Mark A Davis, 46, a gay man he had been HIV-positive for 14 years and a manic depressive too. Ironically his HIV status is accepted but considered a pariah because of the mental trouble. Although gays have become more visible and accepted they still have to face homophobia when seeking medical help. He said he might trust one person among the medical staff but not the whole staff. The stigma and the difficulties do not discourage some but inspires them to extra effort. Gay consumers and mental health professionals are on the offensive for change. Another activist Southerland who happens to be a lesbian goes to her social work students every year to give them an opportunity to discuss clinical issues concerned with sexual diversity. Holochuck is also hopeful and feels that change will come “through people working with the psychiatric survivors and gay liberation movements." Oddly enough another factor also crops up in gay/lesbian mental health viz., marriage. An article appeared in the March 15 issue of last year entitled New Study Explores Impact of Marriage Discrimination on Mental Health by Anthony Baldman goes in detail about this aspect. The National Sexuality Resource Center conducted a study to explore how marriage discrimination affects the mental health of gay/lesbians. It found that if denied the right to marry they experience psychological and social harm. Dr.Gilbert Herdt who is the director of NRSC and also anthropologist and writer echoes the same sentiment. He is of the opinion that “There is a consistent negative impact on the mental health of gay men, lesbians, their families and children resulting from same-sex couples being denied access to marriage.” The study also included Robert Kertzner, an assistant clinical professor at Columbia University and appeared in the NSRC journal Sexuality Research and Social Policy: the fact that there is little research available on the topic made the researchers to conduct the study. Herdt and colleagues reviewed about 150 other studies that were conducted over the last 20 years that “examined a variety of relationships between mental health, social support, partner formations, parenting and citizenship among gays and lesbians in the U.S.” They went to all these lengths because there was a dearth of research available on the subject. They found a strong correlation between marriage and a sense of well-being. Many gay/lesbians are interested in getting married because it would bring about an enhanced sense of well-being, the study concluded. We have already found that gay/lesbians exhibits increased stress related problems. Herdt calls this Minority Stress which is defined as “the concept that has emerged from mental health research to explain the impact of simple discrimination in a huge range of areas for people.” In USA the same-sex couples were denied the right to marry. The study claims that “assumptions concerning the immorality and sexual promiscuity of gay men and lesbians” are responsible for this act. This by the way is also the most virulent form of homophobia. In the minds of critics gay/lesbians are not eligible to marry or become parents. Herdt is of the opinion that this denial will ultimately harm all of us because it is unjust. It has no sense of fair play; it denies a portion of our society to imagine a better future. In conclusion the studies and surveys described above were chosen because they exhibit a fair amount of brevity, validity, reliability and objectivity and enhanced the understanding the role of research in understanding human behavior. The pieces of research are important in removing certain fallacies concerning the topic in question. Ethical problems of any importance are not involved here. The types of research designs that were mainly involved here are studies using statistical methods and personal surveys. The descriptive items of research consisted of correlations, observations, interviews and survey research. No experiment worth anything is apparent here. Qualitatively there were case study, and content analysis. Historical aspects of the problem were mentioned only in passing. The null hypothesis that homosexuality is a mental disease was rejected. Matters like sampling, methods and sizes were mentioned while describing the studies and surveys as also the various statistical methods used. The results can be generalized up to a large extent. By collecting the necessary data and interpreting them objectively using scientific methods helped further one’s knowledge of the topic under discussion. Historically homosexuality was defined as a disease. Minority stress is defined as “the impact of simple discrimination in a huge range of areas for people.” Homophobia is defined as “prejudice based on the belief that lesbian, gay and bisexual people are sinful, immoral, sick, inferior to heterosexuals or incomplete men and women.”  Works Cited DeAngelis, Tori. (2002). New Data on Lesbian, Gay and Bisexual Metal Health. No 2, Vol 33. Monitor on Psychology. Retrieved June 10, 2007, from http://www.apa.org/monitor/feb02/newdata.html Homosexuality. (2007). Wikipedia. Retrieved June 10, 2007, from http://en.wikipedia.org/wiki/Homosexuality#Mental_health_issues Warner, J., McKeown, E., Griffin, M., Johnson, K., Ramsay, A., Cort, C., King, M. (2004). Rates and Predictors of Mental Illness in Gay Men, Lesbians and Bisexual Men and Women: Results from a Survey Based in England and Wales. Retrieved June 10, 2007, from http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15572738 Sexuality. (2007). APA Online. Retrieved June 10, 2007, from http://www.apa.org/topics/orientation.html#mentalillness Gay, Lesbian, Bisexual and Transgender Health: Depression and Mental Health. (4 Aug. 2004). Magellan Health Service. Retrieved June 10, 2007, from http://www.magellanassist.com/mem/library/default.asp?TopicId=70&CategoryId=0&ArticleId=51 Wolfe, Kathi. (15 Nov. 2002). First-Ever Meeting Focuses on Gay Metal Health. News and Publications. The Carter Center. Retrieved June 10, 2007, from http://www.cartercenter.org/news/documents/doc1434.html Howard, H., Goldman, M. D. (2007). Psychiatric Services. P.S Psychiatryonline.ORG. Retrieved June 10, 2007, from http://www.psychservices.psychiatryonline.org/cgi/content/abstract/47/10/1093sdagang@thecentersd.orghttp://www.alliant.edu/wps/wcm/connect/website/Home/Research,+Consulting+&+Public+Resources/Research+Institutes/Rockway+Institute/For+the+Media/Rockway+in+the+News/San+Diego+Gay+Lesbian+Times,+3-06 Homosexuality and Mental Health Services. (1994). BMJ. Vol 308. p. 550-551. Retrieved June 10, 2007, from http://www.bmj.com/cgi/content/full/308/6928/550 Dunn, Sue., Magee, Andy. (6 Mar. 2006). Core Council for Gay and Lesbian Students. Homosexuality and Sexual Orientation: Common Questions. University of Notre Dame. Retrieved June 10, 2007, from http://corecouncil.nd.edu/questions/orientation.shtml Read More