What can be done to improve the mental health of LGBTQ+ young people in schools?

By Liam Spencer, Research Assistant and ARC NENC Mental Health Research Fellow, Fuse & NIHR School for Public Health Research, Newcastle University

Young people who identify as lesbian, gay, bisexual, transgender, or queer/questioning (LGBTQ+) experience significant mental health inequalities in comparison with their peers. School environment is a major risk factor and is consistently associated with negative mental health for LGBTQ+ young people, as shown in research here, here and here. The UN Convention for the Rights of Child Committee has also specifically emphasised the need to take effective action to protect LGBTQ+ young people from all forms of violence, discrimination or bullying, and to improve mental health.

Our research

Our Creating LGBTQ+ Affirming School Environments (CLASS) research project aimed to investigate the impact of school-based interventions (schemes or initiatives) on the mental health of LGBTQ+ young people. In the first stage of our study, we reviewed published evidence, and identified positive interventions that supported LGBTQ+ mental health in school, however the focus tended to be on the outcomes rather than detailing how they were done.

We also interviewed 10 young people aged between 13 and 18 years, nine practitioners (e.g. people working in organisations who had delivered LGBTQ+ inclusivity interventions in UK schools), and three members of school staff, and analysed the data to identify interventions that improved mental health. We used this information to develop a theory model that aimed to explain how, why, for who, and in what context school-based interventions can prevent or reduce mental health problems in LGBTQ+ young people, in collaboration with these key stakeholders.

McDermott, E. et al. Understanding How School-Based Interventions Can Tackle LGBTQ+ Youth Mental Health Inequality:
A Realist Approach. Int. J. Environ. Res. Public Health 2023, 20, 4274. https://doi.org/10.3390/ijerph20054274

Our model (diagram above) has three levels at which interventions may work, on psychological, behavioural, emotional, cultural, and social levels. It explains how school-based interventions that directly tackle dominant cisgender and heterosexual norms can improve LGBTQ+ pupils’ mental health. 

Our findings

We found that contextual factors such as a ‘whole-school approach’ and ‘collaborative leadership’ were crucial to the delivery of successful interventions. Our theory suggests three ways (causal pathways) that might improve mental health:

1. Interventions that promote LGBTQ+ visibility and ‘usualise’ the presence of LGBTQ+ identities, school belonging, and recognition.
2. Interventions for talking and support that develop safety and coping.
3. Interventions that address institutional school culture (staff training and inclusion polices) that foster school belonging, empowerment, recognition, and safety.

Our findings suggest that providing a school environment that affirms and ‘usualises’ LGBTQ+ identities, and that promotes school safety and belonging can improve mental health outcomes for LGBTQ+ pupils. The causal pathways we present are a starting point as theories, however more research to develop our understanding of how school interventions work to improve school climate and the mental health of LGBTQ+ young people is needed. We now need the UK, and other countries, to take seriously LGBTQ+ young people’s rights and ensure they are afforded equal respect and protection as their peers in schools. We may then find that the mental health of LGBTQ+ young people improves.

Read the full research paper here: Understanding How School-Based Interventions Can Tackle LGBTQ+ Youth Mental Health Inequality: A Realist Approach, 28/02/23

Funded as part of the NIHR School for Public Health Research (SPHR) Public Mental Health programme, the Creating LGBTQ+ Affirming School Environments (CLASS) research project, led by Professor Liz McDermott, aimed to investigate the mental health impact on LGBTQ+ young people of school-based interventions. Fuse is a founding member of the NIHR SPHR.

Adapted with thanks to SPHR

North East women share their experiences of inequalities in powerful poems for International Women's Day

Posted by Claire Smiles, Fuse PhD student from Newcastle University and experts by experience Marie Warby and Kayleigh Cookson

Presenters and experts by experience at the Fuse event on International Women's Day 

On International Women’s Day 2023 we at Fuse celebrated by showcasing the lived experiences of women in the North East. This event brought together experts by experience, researchers and practitioners who engaged with presentations, shared experiences and devised top priorities to tackle women’s health inequalities. 

I presented the early findings from the ‘Women’s Sexual Wellbeing’ study alongside wonderful women with lived experience. During my presentation Marie and Kayleigh shared powerful poetry they had written for our IWD Fuse event. Their poetry about womanhood and motherhood reflected on personal experiences and demonstrated the challenges and the resilience of women. A big thank you to Marie and Kayleigh for agreeing to share their poems in this blog post and to Kirsty for taking the videos below.

Catch up with all the discussion on Twitter using #FuseRE and International Women's Day using #IWD2023 and #EmbracingEquity. For more information about the event visit the Fuse website.

** Content/trigger warning: adult language and references to abuse and suicide **

Womanhood by Marie Warby

The road to womanhood wasn’t so kind to me. 

I look at infancy and I see abuse; I look at puberty and I see a noose. 

A very painful past as I recall, I didn’t allow it to stop me, I refuse to fall. 

I felt like an adolescent, stuck in a woman’s body, 

Screaming out hoping someone would hear, my body always stuck in a constant state of fear 

Very submissive that’s what I’d become, all I needed was a way to find home. 

Without a map nor a tool, just a woman to teach me from her school, 

A wealth of knowledge to show me the way, I know ill be powerful and independent one day. 

My inner child is reaching out and ready to kneel, this little girl needs to heal. 

With a blank sheet of paper where do I start, it's time to mend my broken heart. 

I look at my past with no regret, for every challenge of womanhood I’ve met. 

To say it’s been easy that would be wrong, and here I stand singing my song. 

Shining a light for others to see, some days I can’t believe it's me. 

Womanhood is such a beautiful place to be, and now finally I can nurture Marie.

Needs to be everything by Kayleigh Cookson

 

The expectations of a mother is not easy,
I need superpowers and multi-tasking skills.
I have to be a role model and provide a clean tidy house,
I have to budget and pay all the bills.

I need to be very organised,
Always plan ahead every time I go shopping.
I have to be a cook, a baker, I'm never out the kitchen,
And I am a professional at washing.

I need to be brilliant at cleaning,
Wash the dishes, hoover up, pick up mess.
I have to negotiate and play referee,
My patience constantly at test.

I need to be very responsible,
Be a doctor, nurse, councillor, therapist.
I have to be handy at odd jobs round the house,
There's no problem that I cannot fix.

I need to be an expert encyclopaedia,
To answer all the why's, how's, what's, where's and when.
I have to be fun and play lots of games,
Again and again and again.

I need to be a smart tutor,
Help with homework, teach right from wrong.
I have to be a PA, hairdresser, taxi driver,
And always put things back where they belong.

I need to make lots of dreams come true,
I am Santa, the tooth fairy, Easter bunny.
I have to cure boredom on cold and wet rainy days,
Go out and make memories when it is sunny.

I need to be rich with empathy,
Be supportive, wipe away lots of tears.
I have to be a hero and never be scared,
And chase away all the nightmares and fears.

I need to be a care giver,
A good communicator and be able to detect lies.
I have to be an agony aunt and a shoulder to lean on,
I've got to know how to save lives.

I need to be an active listener,
Good at advice and have psychic abilities.
I have to be ready and always prepared,
To provide mental and emotional stability.

I need to be loving and caring,
Tend to wounds, scars, bumps, patch up scrapes.
I have to be a healer and always the best one,
To pick up pieces every time a heart breaks.

I need to be strong, be a survivor,
Put on a brave face no matter the weather.
I have to paint on a smile, show no pain, head up high,
Always cope, always hold it all together.

I need to always have time,
There's no relax, no switch off, no escape.
I have to put everyone's needs above my own,
Oh the guilt if I make a mistake.

I need to never be ill,
Cope with bleeding monthly and raging hormones.
I have to put up with mood swings, hot flushes and cramps,
Then not to mention the menopause.

I need to be forever perfect,
Can't shout or swear coz I'll face stigma and shame.
I have to never go out coz I'll be a bad mam and a slag,
Not worthy, always judged, the one to blame.

The expectations of a mother is not easy,
I need to also then be a friend, a partner, a wife.
I have to be a daughter, a sister, an aunty, a nana,
I am never just me, a woman living my life.