During the Covid-19 pandemic, mental health re-emerged as a neglected global crisis. Somewhere in the midst of these urgent discussions, critical gaps in queer mental health or well-being for LGBTQI++ communities who are historically excluded and stigmatized, languish.
This is not surprising since a large part of these discussions are led by heteronormative think tanks whose approach to mental health is one-sided.
In regions like South Asia, where mental health issues exist on an epic scale, the request to focus specifically on queer mental health is often seen as an overreach and a privilege. It is displaced in the discussion and in the programs.
Good mental health and well-being are essential for everyone, but for some vulnerable communities, such as LGBTQI++ people, the dangers are immediate and pressing. At first glance, the crisis is much more severe in these communities.
in the margins
In India, for example, despite progressive queer rights movements, mental health remains a critical challenge that has not been addressed. By some measures, 17% of India’s population identifies as non-heterosexual. Yet access to mental health information, support and services in these communities is virtually negligible.
These communities may not differ in terms of access to services from the rest of the population, but the health system is openly discriminatory and they are much more vulnerable.
Despite having legal rights, they still struggle to be accepted and often to accept themselves. The public discourse and the social environment in general is oppressive, patriarchal and encourages discrimination with the imminent fear of violence within social environments and also in homes.
To systematically counteract the legacy of violence and #discrimination HM practices must be informed and focused on the needs of #queertrans folx. The biases and inequality built into the psychic discipline must be dismantled.#PrideMonth #PRIDE #Pride2022 #qacp pic.twitter.com/aXByYXZB4A
— Mhealthinitiative (@mariwalahealth) June 1, 2022
In such settings, even coming out can be traumatic and an invitation for physical and sexual abuse, corrective conversion therapy, and abandonment. Naturally, in these circumstances, mental health and well-being deteriorate and queer communities live on the margins of society, trying to form their own support networks.
This is even worse if they are economically and socially disadvantaged, unable to build communities, without economic independence and/or access to social support networks.
High risk
What is the impact? It means that communities continue to be at much higher risk for mental health problems, suicidal ideation and substance use. Their lived experiences are often filled with dissonance and dislocation leading to fragmented and often difficult lives. They struggle every day and often suffer from severe to moderate mental health issues.
This remains a lifelong struggle as discrimination, stigma and lack of social acceptance further exacerbate mental health issues. In addition, cases of LGBTQI++ people who are sexually assaulted continue to be frequent.
While mental health statistics on the LGBTQI++ community in India are hard to come by, US numbers show that issues like depression and anxiety are the most common. LGBTQI++ youth are likely to experience 1.75 times more anxiety and depression. The transgender community, on the other hand, is said to be even more vulnerable as they suffer 2.4 times more anxiety and depression.
What’s worse, queer affirmative mental health services are hard to find. A large majority of psychiatrists in India still regard homosexuality and other sexual orientations and gender identities as a disorder and practice “correctional therapy”. Only a few psychiatrists and therapists have recognized the sexual and gender diversity of homosexuality as acceptable.
CW/TW: What is #ConversionTherapy And what does the law say about it?
East #PrideMonthsharing our videos on malpractice – There is NOTHING TO CURE!#Pride2022 #QueerMentalHealth pic.twitter.com/g9X5WFMzSR
— Center for Mental Health Law and Policy, ILS, Pune (@CMHLPIndia) June 7, 2022
The pandemic has further widened inequalities in access to mental health support for India’s LGBTQ community. Several helplines during the few months of the first wave of the pandemic in India in 2020 received thousands of distress calls on their LGBTQI++ helpline number. A similar pattern was visible during the second wave between April and May 2021.
acting early
How can this be addressed? India needs a defined and specific strategy to address the mental health needs of the LGBTQI++ communities.
You need a national plan that works at multiple levels with educational institutions, communities, health care providers, mental health professionals, law enforcement personnel, and even the judiciary to build an understanding of the need for acceptance, non-discrimination, and mental health issues queer as well as structural challenges facing these communities.
In any case, India urgently needs a mental health program for young people, especially in schools, to de-stigmatize mental health and address the mental health challenge early.
An integrated plan, specifically targeting LGBTQI++ youth and adolescents from the outset, could work in concert with such a program and work to build inclusion, de-stigmatization, mental health awareness, and self-care skills among its adolescents and youths.
These programs could include strong capacity-building components of awareness-raising for self-care and help-seeking.
Community building, both by community members themselves and in conjunction with service providers, is an important part of improving the mental health of LGBTQI++ people. They act as supportive, safe and educational spaces, points of access to health and information on healthy living.
One such project that we have been working on through a participatory methodology has opened up a series of issues that LGBTQI++ communities at major universities face on an ongoing basis. It is essential that these issues are addressed comprehensively and in an ongoing and sustainable manner.
Such programs have the revolutionary power to build understanding, address social discrimination, destigmatize mental health, and build self-care capacity within these groups. Information is key, but capacity building and early recognition of mental health problems are crucial.
These efforts and resources, if started early, can normalize sexual and gender diversity and improve mental health not only in these communities but also in society at large, thereby reducing discrimination, violence, and stigma.
The challenge, however, is that such programs are likely to meet strong opposition. This is because we live in an inherently heteronormative society that is determined not to change the status quo. They do not want to allow future generations to accept themselves, build their own identity and make life decisions.
So the question before us is whether the lives of LGBTQI++ people matter. Because if they do, their well-being, their safety and their freedom matter too. As is your mental health.
Chapal Mehra is director, The Rahat Projectand a specialist in Public Health.
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