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Determining staff experience of lesbian, gay, bisexual and gender identity presentations in child and adolescent mental health settings

Published online by Cambridge University Press:  14 October 2022

Peter James Fitzpatrick and
Helen Keeley
Peter James Fitzpatrick*
Affiliation:
Department of Child Psychiatry, St Canice’s Psychiatric Hospital, Kilkenny, Ireland
Helen Keeley
Affiliation:
Health Service Executive, Child and Adolescent Mental Health Services, Cork, Ireland
*
Address for correspondence: P. J. Fitzpatrick, Department of Child Psychiatry, St Canice’s Psychiatric Hospital, Kilkenny, Ireland. (Email: peterj.fitzpatrick@hse.ie)
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Abstract

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Information

Type
Letter to the Editor
Information
Irish Journal of Psychological Medicine , Volume 41 , Issue 1 , March 2024, pp. 161 - 162
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of College of Psychiatrists of Ireland

Background

Previous studies have found LGBT individuals often receive poor healthcare compared to the general population (Ward et al. Reference Ward, Dahlhamer, Galinsky and Joestl2014). An American Public Health study found there was a need and interest for faculties to develop procedures, policies, and programs that improve access to LGBT competent physicians and to train physicians to be LGBT competent (Khalili et al. Reference Khalili, Leung and Diamant2015). Prior studies have researched various disciplines awareness or beliefs relating to lesbian, gay, bisexual (LGB) and gender identity patients, including nursing and occupational therapy (Manzer et al. Reference Manzer, O’Sullivan and Doucet2018).

The National Transgender Discrimination Survey found a lack of provider knowledge, with 50% having to teach their medical providers about transgender care (Grant et al. Reference Grant, Mottet, Tanis, Herman, Harrison and Keisling2010). Consideration of awareness of use of pronouns, or having gender inclusive assessment forms and records, are examples of areas where staff may not have been upskilled.

Objectives

We set out to explore staff experience, attitudes, and awareness of LGB and gender identity presentations in Irish child and adolescent mental health settings. Our objective was to explore levels of staff satisfaction with training regarding these presentations and to ascertain if there is interest in future training regarding working with these client groups. We aimed to identify if there are differences when responses are analyzed by age, gender, occupation, years of clinical practice, and prior training.

Methods

A survey was designed based on prior studies, namely the Sexual Orientations Belief Scale (SOBS) and the Gay Affirmative Practice Scale (GAP) and included the following measures: LGB and gender identity healthcare experience, attitudes, and awareness. The SOBS is a multidimensional instrument with which to assess a broad range of beliefs about sexual orientation, which evidence suggests are highly correlated with positive and negative attitudes about sexual minorities (Arseneau et al. Reference Arseneau, Grzanka, Miles and Fassinger2013).

The GAP is a self-administrated scale to assess the degree in which practitioners engage in principles consistent with gay affirmative practice (Crisp, Reference Crisp2006). It consists of 30 itemized statements that are rated on a Likert scale.

Results

Sixty people were invited, and 42 respondents consented and completed the survey in full, representing 70% uptake. Descriptive analysis of the data took place, with specific analysis under the themes of demographic, experience, training, awareness, attitudes, and beliefs.

Fifty-two percent were dissatisfied with their training on LGB presentations, and 69% were dissatisfied with training on gender identity. Those who disagreed were adequately trained on both LBG presentations (28.6%, n = 12) and gender identity presentations (47.6%, n = 20), were mostly female, aged 31–40 years, and were working as a nurse or non-trainee registrar. Overall, 90.5% indicated they would attend additional training.

Conclusions

Results indicated that CAMHs staff are dissatisfied with their current level of training in both sexual orientation and gender identity. Respondents were suggested to seek HSE online training or Gender Identity Skills Training if interested in immediate resources.

It is envisaged that gender identity services in Ireland require development, with the July 2021 announcement of the “National Gender Service,” a public service provided by the Health Service Executive and St John of God Hospital based in Dublin (National Gender Service, 2021). As service models evolve, it is important to ensure appropriate training is available so mental health staff can remain updated.

Acknowledgements

The researchers would like to thank the participants for their time and contributions.

Financial support

This research received no specific grant from any funding agency, commercial, or not-for-profit sectors.

Conflict of interest

None.

Ethical standards

Approval for the study was granted by CREC (Cork Research and Ethics Committee) in August 2020. The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committee on human experimentation with the Helsinki Declaration of 1975, as revised in 2008.

References

Arseneau, JR, Grzanka, PR, Miles, JR, Fassinger, RE (2013). Development and initial validation of the Sexual Orientation Beliefs Scale (SOBS). Journal of Counselling Psychology 60, 407–420.CrossRefGoogle ScholarPubMed
Crisp, C (2006). The gay affirmative practice scale (GAP): a new measure for assessing cultural competence with gay and lesbian clients. Social Work 51, 115–126.CrossRefGoogle Scholar
Grant, J, Mottet, L, Tanis, J, Herman, JL, Harrison, J, Keisling, M (2010). National Transgender Discrimination Survey Report on Health and Health Care, pp. 22–25. National Center for Transgender Equality: Washington, DC.Google Scholar
Khalili, J, Leung, LB, Diamant, AL (2015). Finding the perfect doctor: identifying lesbian, gay, bisexual, and transgender-competent physicians. American Journal of Public Health 105, 1114–1119.CrossRefGoogle ScholarPubMed
Manzer, D, O’Sullivan, LF, Doucet, S (2018). Myths, misunderstandings, and missing information: experiences of nurse practitioners providing primary care to lesbian, gay, bisexual, and transgender patients. The Canadian Journal of Human Sexuality 27, 157–170.CrossRefGoogle Scholar
National Gender Service (2021). (https://nationalgenderserviceireland.com/about/). Accessed 6 August 2021.Google Scholar
Ward, BW, Dahlhamer, JM, Galinsky, AM, Joestl, SS (2014). Sexual orientation and health among US adults: National Health Interview Survey, 2013. National Health Statistics Report, Centers for Disease Control and Prevention 77, 5–6.Google Scholar