Mental Welfare Commission publishes good practice guide on designing LGBTQ+ inclusive services

In August, the Mental Welfare Commission for Scotland published an updated LGBTQ+ good practice guide for staff working in mental health wards, community services, and primary care services. The report aims to raise awareness of good practice regarding the complexity of individual relationships to sexuality, gender, and sex, as well as highlight the subjective experiences of LGBTQ+ people and how this may present in clinical spaces and their community services.

Previous research by the Mental Welfare Commission has replicated numerous other research papers showing that LGBTQ+ people are considerably more likely to experience mental health challenges, especially severe anxiety, depression, and eating disorders, compared to the general population. For instance, it was found that people from these communities are much more likely to have suicidal ideation and rates of self-harm: 20-25% compared with 2.4%. Additionally, further analysis established that almost 60% of trans people and 27% of LGB people reported that they have experienced a lack of understanding of their needs through their experience of healthcare services.

In directly addressing the latter point on the accessibility of services and aiming to ameliorate the former conclusions concerning the rates of mental health conditions, the Mental Welfare Commission co-produced the updated guide with the Scottish ‘LGBT Health and Wellbeing’ charity. The document includes practical recommendations for making services more reflective of LGBTQ+ experiences and, therefore, more multidimensional in how it understands the needs, supports, and communicates with specific individuals.

Promoting straightforward dialogue in clinical settings and developing an inclusive framework of support in Scotland – what can the rest of the UK learn from the guide?

The guide details how simple discursive and practical changes to how professionals in mental health and social care engage with individuals have the potential to create an overall more inclusive environment for LGBTQ+ people. For instance:

• Not assuming that a patient is heterosexual or cisgender (identify with the gender assigned to them at birth).
• The use of gender-neutral language in initial questions, such as “do you have a partner?”.
• Not presupposing someone’s gender or use of pronouns – if appropriate, feel confident in asking what pronouns the person prefers.
• Be aware that sharing a person’s transgender status without their permission is an offence under the Gender Recognition Act 2004.

Suzanne McGuinness, executive director of social work at the Mental Welfare Commission, summarised the content of the guide and its utility for practitioners. She said:

“While giving practical advice on real-life situations, the guide recognises that LGBT people are a diverse community who at times experience prejudice, whether intentional or not, and inequalities […] We hope this guide will help equip mental health and social care professionals with the information they need to provide the best possible care and support to LGBT people.”

“Key points are to focus on the individual who is in our care, taking their lead from how they describe themselves and their identity, and to make sure the environment is supportive.”