AN INDEPENDENT EVALUATION OF MINDOUT The mental health project for , men, bisexual and people in & and beyond. 12 years on…

By Dr Paul Hanna, PH Independent Research Consultants, September 2011

An independent evaluation of MindOut

PREFACE FROM THE MINDOUT TRUSTEE BOARD

Preface from the MindOut Trustee Board

indOut is a key provider of services to ’s largest minority community and is one of the few LGB&T specific mental health Mservices in the country. We have pioneered suicide prevention for LGB&T communities, as well as running a unique combination of advice, information, advocacy and peer support group work.

The MindOut Trustees Board would like to express how much they welcome this very useful independent summary of MindOut’s work to date.

This evaluation is timely considering MindOut, formerly a project within Mind In Brighton & Hove, became an independent charity in 2010. MindOut has gone from strength to strength over past 12 years, and its trustees are very pleased to take over stewardship of this vital organisation. The MindOut project has always developed in response to service user consultation and increasing demand and this report is part of on-going review and development of our service delivery.

This evaluation highlights the profound impact that MindOut services can have for individuals. For the Trustees, it is heart-warming to be reminded of the very real and very valued contribution that MindOut makes to people’s recovery. It encourages us to press on with our work to improve the well-being and resilience of LGB&T people with lived experience of mental health issues .

This evaluation also confirms that MindOut services continue to be enriched by a combination of: l advice & information l casework & advocacy l peer support group work l mental health promotion l anti-stigma campaigning l LGB&T affirmative practice training

This combination remains effective, useful and very much needed. It is still what people really want and benefit from. Our central values of empowerment and self-determination run throughout all these services.

The Trustees look forward to developing our local work as well as promoting good practice at a national level. We will be considering the suggestions made in this report in terms of future strategic planning, and developing the service based on the needs of service users.

The Trustees would like to thank everyone who took part in this evaluation, particularly the author, and all the staff and service users who continue to shape the future of MindOut services.

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contents

Contents

1. Executive summary of report 4

1.1 Overview 4 1.2 Major achievements 4 1.3 Recommendations 5

Introduction: , Gay, Bisexual, and Transgender (LGBT) and Mental Health 6 2.

2.1 Current knowledge of mental health issues in LGBT communities 6 2.2 Mental health issues among Brighton and Hove’s LGBT community 7 2.3 lGBT and mental health services in the Brighton & Hove region 8

3. Historical trajectories of MindOut 9

MindOut, Lesbian, Gay, The current project: 4. Bisexual and Transgender mental health project 11

4.1 the aims of the current project 11 4.2 Advice, Information and Advocacy 12 4.3 peer Support groups 15 4.4 lGBT mental health promotion 19 4.5 Staffing 20

commending success and Concluding remarks: 5. recommending improvements 21

5.1 Highlights of MindOut as a unique service 21 5.2 independent recommendations for future improvement to the services offered by MindOut 21

6. References 22

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An independent evaluation of MindOut

executive summary of report

1. Executive summary of report

1.1 appraisal of the current services offered by MindOut. Here it is established that MindOut Overview is achieving significant success in meeting its declared aims, whilst also often offering its MindOut in Brighton and Hove is a mental service users added benefits. health service specifically helping LGBT indi- viduals with mental health issues. Previously a project working from within Mind in Brighton and Hove (1999-2011) MindOut is 1.2 now an independent organisation. MindOut predominately offers an advice, information Major and advocacy service, a peer support group service and seeks to raise awareness of the achievements issues faced by LGBT individuals with mental health problems in the local LGBT community Through the hard work and dedication of and general public. The most recent aims of MindOut’s workers, this evaluation finds that the project proposed in 2007 comprise of five MindOut meets its aim of improving access key elements to the service. to appropriate mental health services for LGBT people. In addition, the advice, The five aims are to achieve: information and advocacy service provides l Improved access to appropriate mental support and guidance on a range of health services for LGBT people. additional issues such as housing and l Reduced social isolation for LGBT people employment. This achievement is reflected with mental health problems. in the increasing demand for the service and l Improved suicide prevention for LGBT the voices of those currently using the people. service who also suggest the advice, l Increased involvement in mental health information and advocacy service empowers promotion by LGBT people with mental health them and offers hope and practical support problems. in times of adversity. l Increased awareness and support around This evaluation finds that MindOut’s mental health in the LGBT community. peer support group work provides an essential service to LGBT individuals with The current independent evaluation has been mental health issues. It offers support to conducted to explore the extent to which individuals that they cannot find elsewhere each of these aims have/have not been met due to the safe space in which such and propose recommendations for the future individuals are interacting with other people of MindOut. The evaluation was conducted in in similar situations, reducing isolation and August and September 2011 and opens with suicidal distress. a review of the need for such a specific In evaluating the recent implementation service in the Brighton and Hove region. of ‘themed’ peer support groups this report Following this, a review of MindOut’s services finds that this added addition to the services over the past twelve years is presented to offered by MindOut has been a success. document shifts in the organisations aims, Although in the early stages, the ‘themed’ structure and services. Drawing on data peer support groups enable the homogenous collected by service users for this evaluation, ‘LGBT identity’ to be understood as more

attention then turns to a comprehensive diverse, offering service users to overcome t

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executive summary of report

Stamp Out Stigma: MindOut’s annual t issues specific to particular aspects of their campaign against the double stigma identity and experiences. of identifying as LGBT and living with MindOut continues to successfully raise mental health problems (above) awareness of mental health issues experienced by LGBT individuals through its Since attending the groups at promotional strategies. In addition, this evaluation commends MindOut it has helped me MindOut’s efforts to involve LGBT individuals enormously. I don’t feel so with mental health issues in the awareness raising activities and the running of MindOut isolated and alone with my as an organisation. problems. Being able to relate to other LGBT people 1.3 has really helped me Recommendations

Based on the findings of this independent l Independent research investigating the review the following recommendations issues around the benefits of group are suggested: membership in terms of recovery, factors l Expansion of both advice, information involved in group retention rates and and advocacy and peer support services, experiences of new members within the including funding sources, staffing and group service which would comprise of a full quantity or services on offer to cope evaluation of the peer support group with the increase in demand (potentially structure. due to public sector funding cuts and/or l MindOut needs to continue with the MindOut going independent), reduce development of ‘themed’ peer support waiting lists, and enable the continuation of groups and targeted groups for particularly this essential service. isolated people, eg older people. l Extend the model employed by MindOut l The promotion of MindOut within to other LGBT communities. A high number of statutory services and the further referrals from outside Brighton & Hove development of relationships between the demonstrates need across . two parties. n

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introduction: Lesbian, Gay, Bisexual, and Transgender (LGBT) and Mental Health

2. Introduction Lesbian, Gay, Bisexual, and Transgender (LGBT) and Mental Health

2.1 depression at some point, with over 60% of those interviewed attributing their Current knowledge of experiences of depression directly to their LGBT identity. They also found that 77% of mental health issues in participants surveyed online had self harmed at least once with 50% having self-harmed LGBT communities more than 6 times in their life. Further, their findings also suggest that Mental health issues are certainly nothing one-fifth of their online participants and one- new and are not isolated to LGBT third of interview participants had attempted communities. In 2008 the World Health suicide at least once in life. They argue that Organisation reported that throughout the females were more likely to have attempted world, 450 million people suffer from ‘mental suicide with a quarter of all female disorders’ with more suffering from ‘mental participants, compared to 15% of male problems’ (WHO, 2010). Of course, those participants, having attempted suicide at from a more critical orientation might suggest least once in their lifetime. In England and that this figure is merely a reflection of the Wales the situation appears similar with ever increasing number of mental health Warner and colleagues’ (2004) large scale diagnosis featured in the DSM (Diagnostic research on 1285 gays, lesbians and bisexual and Statistical Manual of Mental Disorders) people finding high rates of mental illness (e.g. Marecek and Hare-Mustin, 2009). (43%) and attempted suicide (31%) amongst However, what most will agree on are the the sampled population. situated, embodied, real and difficult The reasons for such high rates of mental experiences of individuals with mental health health issues within the LGBT community are problems. Further, what is also clear when not fully understood however issues such as examining mental health data is that certain isolation and lack of belonging have been groups in society are highly over-represented noted (e.g. McLaren, Jude and McLachlan, in experiences and diagnosis of mental health 2008). Furthermore, a growing body of issues (e.g. Fox and Prilleltensky, 2009). literature suggests that there is a direct Research conducted throughout the correlation between suffering homophobic western world has a tendency to agree that abuse, and increased likelihood of mental LGBT individuals are far more likely to health issues in LBGT individuals (e.g. Pitts et experience mental health issues at some al., 2006). In their meta-analysis and point during their life. For example, in systematic review, King and colleagues Australia McLaren, Jude and McLachlan (2008) conclude that: (2008) argue that increased rates of depression were found in gay men in “...it is likely that the social hostility, comparison to their heterosexual stigma and discrimination that most LGB counterparts. A recent large scale survey people experience is at least part of the conducted in Ireland surveyed 1100 LGBT reason for the higher rates of psychological people online (age 14-73 representative of morbidity observed” population) and conducted 40 in-depth interviews with LGBT individuals (Mayock et This stigma, discrimination and al., 2010). They found that 86% of online and harassment is experienced in high frequency

90% of interview participants had suffered despite the perception that the general public t

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introduction: Lesbian, Gay, Bisexual, and Transgender (LGBT) and Mental Health

MindOut Director of Services Helen Jones: getting the anti-discrimination message out to the Brighton community

t are more aware of LGBT people (Ash and 2.2 Mackereth, 2010). In addition, the healthcare sector is not immune to forms of LGBT Mental health issues harassment and discrimination. For example, I have been living with Beehler (2001) argues that at least 25% of among Brighton and LGBT people experience negative attitudes frequent suicidal thoughts from healthcare staff. In addition, the Hove’s LGBT community and I strongly believe that Department of Health’s (2007) report suggests that LGBT individuals are often Although the above review offers us an the support that I have treated differently by healthcare insight into the relationship between being received from MindOut has professionals and face discrimination within LBGT and experiencing mental health issues the health system. it does not address the specific context of helped stop me acting on The prevalence of mental health issues Brighton and Hove. Brighton and Hove is said them!!! within LGBT communities has attracted a to represent the ‘gay capital of the UK’ with growing concern. For example the Journal of around 14% (35000 individuals) of its Child and Adolescent Psychiatric Nursing population identifying as LGBT (Browne and has recently dedicated a special edition to Lim, 2010). Therefore, with a strong LGBT and mental health (see for example representation of LGBT people within Poster and Weber, 2010). In addition, it has Brighton and Hove, alongside the ‘liberal’ and also been argued that not only do LGBT ‘bohemian’ identity the city is said to possess individuals with mental health issues suffer (e.g. VisitBrighton); it could be assumed that prejudice within the healthcare sector, but issues of discrimination might not be as they also face discriminatory practices prevalent in this area. However, the recent within the LGBT community due to the ‘Count Me In Too’ (Browne, 2011) study in stigmatisation of their mental health issues. Brighton and Hove finds that this might not This ‘double discrimination’ potentially be the case. For example, they found that leads to enhanced isolation and prejudice 73% of their research participants had within services and groups that only focus experienced some form of hate crime over on LGBT issues or mental health problems, the past five years directly related to their and thus it is suggested that services are ‘gender’ or ‘sexual’ identity. When turning to needed that take into consideration that this their data on mental health and housing their group of individuals have LGBT issues and findings are equally as troubling. For mental health problems (Johnson, 2007). It example, their research found that 80% of is at this intersection that MindOut targets LGBT people in Brighton and Hove were

its services. experiencing mental health issues and nearly t

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Introduction: Lesbian, Gay, Bisexual, and Transgender (LGBT) and Mental Health

t 25% of LGBT people had been homeless at service by LGBT counsellors and a some point in their lives. In addition, they telephone helpline. found that 23% of LGBT individuals had seriously considered taking their own lives, l Brighton Linkup provides an It was very useful being in an a figure over 50% lower than that reported alternative social group for those that do all trans space so did not by the service users of MindOut (Saw and not like the ‘scene’. - I Jones, 2007). feel I had to explain myself Therefore, despite being situated l GOAL group provides support for gay within the ‘gay capital of the UK’ these men affected by alcohol dependency. or worry about being judged . findings mirror the troubling situation Essential. The mix of mental uncovered in other areas of the UK (e.g. l Metonoya offers a private counselling Ash and Mackereth, 2010; Johnson, 2007), and psychotherapy to LGBT individuals. health and trans issues was Ireland (e.g. Mayock et al., 2010), Australia very important (e.g. Pitts et al., 2006; McLaren et al., l Outlet Accommodation offers 2008) and the USA (e.g. Mustanski et al., housing advice for gay people in Brighton Service user talking about one of 2010). However, Brighton and Hove does and East Sussex. represent a city in which a number of MindOut’s themed peer support groups charities and organisations function in an l Lucas Bright, Sprit Space and attempt to serve this population, it is these Spring to Mind all offer alternative services in Brighton and Hove that the therapy services from Andy Lucas such following section shall document. as hypnotherapy.

l The Sussex Beacon which offers a care service for individuals suffering 2.3 from HIV and AIDS. LGBT and mental l Disabled lesbians – GEMMA provides a self-help group for disabled lesbians health service in the through befriending and support Brighton and Hove services. l Lezgetactive offers a social group for region lesbians and their families organising a range of events such as BBQ’s, nights Brighton is fortunate to boast a number of out, etc. charities and organisations which cater for LGBT individuals or individuals with mental l Threshold is a mental health service health needs. Some of the more prominent provider specifically for women which include: aims to facilitate appropriate responses for women’s mental health needs. l Allsorts Youth Project in Brighton and Hove offers support for under 26 year olds l Broken Rainbow offers support for who identify as lesbian, gay, bisexual, trans LGBT people suffering domestic or unsure. violence.

l The Terrence Higgins Trust which l The Richmond Fellowship for offers advice, guidance and support for Community Mental Health based in individuals living with HIV. Brighton and Hove offering one of the largest voluntary mental health services l Gender Trust is a national charity based but not specific to LGBT needs. in Brighton which provides support and information for individuals who consider This evaluation does not wish to speculate themselves transsexual, gender dysphoric on the successfulness or need of these or transgenderist, their partners, families organisations but rather has presented and professionals. this list in order to highlight one fundamental factor – that none of the l Brighton Lesbian and Gay above offer services specifically for LGBT Switchboard offering a counselling individuals with mental health issues. n

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Historical trajectories of MindOut

3. Historical trajectories of MindOut

The idea of having a mental health service and twelve as ‘lesbians’(1), at this stage there specifically for LGBT individuals in Brighton were no transgender or bisexual individuals and Hove came to the fore in 1998 when using the service. However, 95% of those Brighton and Hove LGBT Switchboard individuals seen in the first year of service I’m proud to represent approached Mind with the idea of providing a declared that they were experiencing mental service that addresses the specific mental health issues. MindOut, an amazing health needs of LGBT individuals. In the same year, the group work had organisation, without whom I From the initial idea, a number of one closed group with eight regular meetings were held between Mind, Brighton attendees of whom five were gay men and probably wouldn’t be alive and Hove LBGT Switchboard, local three lesbians. By the end of the first year even today, let alone feeling community groups, service providers and the group service had an additional four activists. From these meetings and lesbian and fourteen gay men on its waiting able to take part in pride negotiations it was decided that it would be list and the recommendation was made that beneficial for Mind to provide advocacy and an additional sessional worker should be Service user talking about going on the group work services for lesbian and gay appointed to facilitate another group. MindOut bus at Brighton Pride (below) individuals with mental health issues, and training for service providers working with Expanding service lesbian and gay individuals experiencing Of course, over the subsequent twelve years mental health problems. MindOut has grown, developed and evolved Following the decision to incorporate a almost beyond recognition. In 2003 mental health service specifically for lesbian MindOut’s project experienced one of its and gay individuals within Mind, an greatest shifts in vision and user population application was made to Comic Relief to with the inclusion of bisexual and fund the project. The funding bid was a transgender individuals to its service (these success and in February 1999 MindOut was individuals were not actively rejected during launched as a project within Mind in the three years of Comic Relief funding, Brighton and Hove offering mental health rather just not explicitly targeted). support and advice to LGBT individuals in the The start of 2003 also marked the end of Brighton and Hove region. the Comic Relief funding with new funds In its first year MindOut’s key aims were coming from the local Social Services to: A) establish a steering group for the slippage, a substantial donation from a project; B) establish a case work advocacy grateful client, and The Lankelly Foundation. service, C) facilitate group advocacy; D) During 2003 the advocacy service offered by promote and commission homophobia MindOut worked with a total of one hundred awareness training for mental health service and three people, a significant increase on providers; and E) publicise and promote previous years which also included fifteen the service. individuals whom identified as transgender. In both the ‘Report on the first year of operation’ (Jones and Worker, 2000) and the Group work service and suicide ‘Independent evaluation of the first year of prevention operation’ (Platzer, 2000) there is an Group work also experienced a shift in overwhelming sense that these aims were emphasis from advocacy to support and two sufficiently met. groups (one for men and one mixed LGBT) In its first year MindOut’s advocacy ran throughout the year. Forty two group service saw thirty eight people through its sessions were held in total with regular 1) However there was not the option to identify as ‘bisexual’ or

‘transgender’ on the monitoring form. doors, twenty six of these identified as ‘gay’ attendance of twelve members in the men’s t

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Historical trajectories of MindOut

MindOut wins the Community Group of the Year Award: (left to right) MindOut client Rowan Reid, TV celebrity Sue Perkins, Stonewall chief executive Ben Summerskill, MindOut Director Helen Jones, MindOut Senior Practitioner Jason Saw, rugby player for Wales Gareth Thomas

t group and seventeen in the mixed. In the promotion of ‘acceptance and support’ addition, a ‘social space’ was facilitated by for LGBT people with mental health the group workers at the end of the closed problems. For example, in June 2006 group session whereby individuals from both MindOut featured on the front cover of the groups (men and mixed LGBT) and local magazine ‘G-Scene’ and has a three- ex-members could meet in an informal but page spread covering mental health issues safe space. In the evaluation report for the in the LBGT community. MindOut, in period 2003-2004 (Jones, 2004) it was collaboration with Brighton and Hove LGBT noted that the combination of the structured Switchboard, also hosted an LGBT mental group sessions in conjunction with the social health promotion event called ‘Let’s Get space was a great success providing a Better Together’. service for users which many suggested was the highlight of their week. Annual vigil for those lost to suicide Following the end of The Lankelly In December 2006 a suicide memorial tree Foundation funding in 2005 MindOut was planted in St. Anne’s Well Gardens, successfully secured three years funding Hove, with a vigil held the following February from the Big Lottery. During this three year for LGBT people, friends and family to period of Big Lottery funding, MindOut once remember those that have been lost again tailored and developed its services. to suicide. Acknowledging emerging research The year 2007 saw the inauguration of suggesting high levels of suicide risk in LGBT ‘Mind Out for the Laughs’, a comedy night communities MindOut developed a peer hosted at the Komedia in Brighton with LGBT support group specifically for LGBT performers, to raise awareness of the individuals that had, or were experiencing mental health needs of LGBT people. At the suicidal distress. ‘Out of the Blue’ had same time, MindOut saw 216 people using sixteen individuals participating in the group their advocacy service (April 2006 - March sessions during 2006 and was a well 2007) and continued their peer support received addition to MindOut’s services in its groups with 78 individuals attending over the six month evaluation. MindOut also same period. Both of these aspects were addressed the prevalence of suicidal distress seen to be complimentary to each other and amongst the LGBT community through a essential to the Brighton and Hove area in an research project they conducted in independent evaluation carried out by Hazel partnership with the University of Brighton Platzer (2006). and Allsorts Youth Project. This research A renewed funding agreement with the sought to establish how discrimination and Big Lottery marked the start of 2007 and the prejudice affects LGBT people’s experience current MindOut project entitled ‘MindOut, of suicidal distress and explore those Lesbian, Gay, Bisexual and Transgender individuals’ survival strategies. mental health project’. It is this current In addition to the integration of suicidal project and the developments of MindOut’s distress in the remit of MindOut, the 2005- services over the past five years that our 2007 period also witnessed an increase in attention now turns. n

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4. The current project MindOut – Lesbian, Gay, Bisexual and Transgender mental health project

4.1 example: ‘improved access to appropriate mental health services for LGBT people’ is The aims of the directly addressed through the advocacy work; ‘reduced social isolation for LGBT Helping me with getting the current project people with mental health problems’ is mental health support I achieved through peer support groups; In 2007 MindOut successfully renewed its ‘improved suicide prevention for LGBT needed, helping me with my funding agreement with the Big Lottery for people’ is predominantly established via the housing. Without the help of an additional five years’ financial support. ‘Out of the Blue’ group work with its specific Along with the PCT, the Big Lottery has focus on suicide; ‘improved involvement in my advocate I believe I would enabled the continuation of MindOut’s mental health promotion by LGBT people be dead services in the Brighton and Hove region with mental health problems’ is undertaken during times of austerity. through the promotional work at Pride for example; and finally, ‘increased awareness The main aims of this project were to and support around mental health in the achieve: LGBT community’ is achieved through promotional events such as ‘Mind Out l Improved access to appropriate mental for the Laughs’. health services for LGBT people. Therefore, on the surface it appears that l Reduced social isolation for LGBT people MindOut has the sufficient infrastructure to with mental health problems. successfully meet its aims with particular l Improved suicide prevention for LGBT aspects addressing particular aims. people. However, I would argue that having l Increased involvement in mental health reviewed MindOut as an LGBT mental health promotion by LGBT people with mental service, each aspect of the service meets health problems. much more than just one aim. l Increased awareness and support around I am also of the opinion that overall mental health in the LGBT community. MindOut achieved success beyond its stated aims. Drawing on data from previous In order to meet these specific aims MindOut evaluations and open-ended questionnaire predominantly offers two particular types data collected from service users for the of service: advice, information & advocacy, present evaluation, the following section and peer support group work. In addition, shall provide a review of MindOut since 2007 MindOut also provides LGBT training to to look at each of the services offered in mainstream service providers and promotes relation to the aims listed above. The awareness around LGBT mental health presentation of the evaluation in this way will issues to LGBT communities and the enable what follows to highlight how MindOut general public. is meeting its aims and also provide an Each of these four aspects directly understanding of any additional aspects its

addresses the aims listed above. For service users are suggesting it offers them. t

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4.2 information and advocacy service users is a direct reflection of the decreasing services Advice, Information & offered through the public sector. In addition, it was during the first week of Advocacy April that MindOut became independent from Mind and moved to new premises at As highlighted above, during the period April the Community Base, Queen’s Road, 2006 to March 2007 MindOut experienced Brighton. Thus it could be speculated that two hundred and sixteen individuals using moving to the new premises which offer the advocacy service. Of these two hundred more access to MindOut’s services due to its and sixteen, seventy five were men, one central location, coupled with the publicity hundred and eleven women, seventeen were surrounding MindOut going independent, transgender with data on the additional may have had an impact on the demand for thirteen unknown. the service due to an increased awareness of The period April 2010 to March 2011 saw the services on offer. approximately two hundred and forty four The structure of MindOut’s advice, people using the advice, information and information and advocacy service has also advocacy service. Of these, 48% were shifted slightly since the start of 2011. An female, 42% were male and 10% advocacy worker left their post at the start of transgendered. As with previous years, the the year due to uncertainty over funding. The majority of advocacy service users identified recruitment process for a placement was as white British and were aged 18-64. unsuccessful and it was decided to be in the best interests of MindOut for a current part- Increasing demand for advocacy time senior practitioner to undertake These figures represent the continuing need Advocacy Qualification Training and take on for the advice, information and advocacy the post alongside the practitioner work. service and show how demand has In addition, it was also decided that a increased at a steady rate over the period in new ‘case worker’ position should be made which MindOut has operated. However, available, the position was subsequently when reviewing the most recent data filled in the summer with the new ‘case get to make a difference I collected (April 2011 – June 2011) an worker’ starting in August. This position is to discrimination, stigma, unprecedented increase in service users designed to offer a more flexible, person- is apparent. centred approach which can offer more people’s lives, how people This three-month period witnessed one than focused advocacy and longer term are treated when they are hundred and sixty advocacy cases, a figure support for service users and the only eighty four short of that seen during the organisation more generally. in need previous twelve month period. The MindOut advocate, above individuals were once again mainly white Meeting its aims British, with around 10% identifying as l advice, information and advocacy transgender and the other 90% split l improved access to mental health between males and females. services It is not within the remit of this l reduction in isolation evaluation to establish the exact cause of l improved suicide prevention such a dramatic increase in demand for the The advice, information and advocacy service advice, information and advocacy service offered through MindOut offers advice and however it can be speculated that two information on a variety of issues such as, factors would have almost certainly had health, housing, relationships, finance, an impact. mental health treatments and many more. It Firstly, it was during this period that the could be suggested that the organisation first wave of major government cutbacks was provides a service similar to that offered by felt in relation to the 132,000 public sector the Citizens Advice Bureau. job losses implemented in 2010, with worse However, due to the specific focus on predicted for 2011 (Butler, 2011). Therefore, LGBT individuals with mental health issues

it is possible that the increase in advice, the service is tailored for such individuals and t

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t provides a safe space for LGBT individuals in such a way that they were able to ‘step with mental health issues to seek advice. outside’ the subjectivity of a disempowered It is of particular importance here to LGBT individual with mental health issues reflect on the information presented in and agentically regain their own sense of I’m very happy with the section 2.1 whereby it was suggested that ‘self’ (e.g. Foucault, 1990). many LGBT individuals with mental health This regaining of the self was also advocacy received and would issues experience discrimination within expressed by another service user that love to be able to use it again mainstream services and thus the specificity suggested the most helpful aspect of the of this service appears essential. In addition, service they received was: but would only use it as a MindOut also provide advocacy via writing last resort as it is under- official letters on behalf of service users, “The way they were happy to take over attending meetings between service users and advise and know who should be resourced and has many and practitioners, and negotiates with service contacted. I feel like a weight has been taken claims on its time providers upholding the rights of the off my shoulders” individual in all cases. Of the one hundred and sixty advice, Here then, it was the stress of the information and advocacy cases seen so far situation this individual was faced with when this year sadly only thirteen returned trying to establish who they needed to evaluation forms for this research, however, contact in order to deal with their situation those returned proved a rich source of data. that was having an adverse affect on their From the returned forms it was clear to see wellbeing. Through the knowledge, support an overwhelming level of gratitude and and advice of the advocacy worker this appreciation for the advice, information and individual experienced a ‘weight being taken advocacy service received. For example, 85% off their shoulders’, a metaphorical way of of respondents found the advocate ‘very expressing their reduction in stress, ability to supportive’ as opposed to ‘fairly supportive’ cope and experience of empowerment, due (8%), ‘fairly unsupportive’ (0%), ‘very to the work of the advice, information and unsupportive’ (0%)(2). advocacy service. This point is reiterated through 46% of service users expressing that High levels of support MindOut’s advocates enabled them to ‘feel This level of support felt by the advice, in control’. information and advocacy users was clearly This level of support can be seen as a an aspect that they valued highly and was clear example of the advice, information and consistently expressed throughout the advocacy service meeting the aim of qualitative element to this evaluation. For providing improved access to mental health example, when asked ‘what was most helpful services. As one service user comments: about the work of the advocate’ one respondent replied: “Helping me with getting the mental health support I needed, helping me with my “Provided support for me in a very housing. Without the help of my advocate I stressful meeting with my employer. Made a believe I would be dead” big positive difference to me” In this extract it is clear to see that access Here then, the service user is clear to to mental health services is explicitly highlight that it was support they needed. The identified as the most helpful aspect of the situation they found themselves in had advice, information and advocacy service. become too stressful for them to deal with on The service user identifies their need for their own and it was through the work of the access to mental health services which also advocate that they were able to overcome the infers that they were struggling to access situation, dealing with issues of employment, such services prior to meeting with the and enjoy positive change in their life. MindOut advocate. Psychologically, it could be argued that In addition, housing issues are also the advocate in this situation (amongst many presented as a source of concern for the

2) One respondent did not answer this question. other situations) empowered the service user individual. It is through the help of the t

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t advocate that not only are the logistical to make about the advice, information and aspects of the service highlighted as advocacy service one service user notes “I important but also that this level of help loved my advocate”. This expression of and support impacts the overall wellbeing affection clearly highlights the importance of ...the advocate service could of the individual. the work carried out by the advocates, a point Thus through the powerful suggestion that is also clear to see when examining be better funded so there that the help of the advocate actually kept comments regarding the ways in which the were more advocates so he the service user alive it appears that the advocate could improve their service. When advice, information and advocacy service asked ‘Was there anything the advocate would have more time directly addresses the aim of suicide could have done differently or better’ two prevention in addition to its foundational aim service users commented: of improving access to services. It was not only this service user that expressed a clear “Could not have been more helpful” link between the work of MindOut’s advocates and the potential for suicide had “Not really I am most grateful for the the service not be available. When asked if availability of the advocate” the service user received the outcome they wanted via the advocates help another In addition, 69% of service users stated service user commented: that they were ‘very satisfied’ with the level of service received and 15% quite satisfied, “Yes – have a home, money, counselling resulting in 85% suggesting that they would and am still alive!” (emphasis in original) recommend the service to a friend (3). The only negative aspect of the advice, It is through comments such as these information and advocacy service expressed that it is clear to see the impact that by individuals using the service was the MindOut’s advice, information and advocacy need for enhanced funding. As the following service has had on the lives of so many. In comment: addition, it is also important to note that despite there being a number of alternative “...the advocate service could be better services available in the Brighton and Hove funded so there were more advocates so he area (see section 2.3) providing an advice, would have more time” information and advocacy service specifically for LGBT individuals with mental health “Very happy with the advocacy received issues is essential. and would love to be able to use it again but This is the case due to the overwhelming would only use it as a last resort as it is under- array of information, active barriers to people resourced and has many claims on its time – using other services due to real or anticipated more funding please” discrimination, previous poor experiences or discrimination from others; resulting in “...still hard due to limited time” feelings of disempowerment and in some cases, suicidal distress. Further, it can also be Therefore, from reviewing the advice, suggested that the empowering effects of information and advocacy service offered by MindOut’s advice, information and advocacy MindOut it appears that this aspect of their service do not stop with the individuals being organisation provides an essential service to able to cope with accessing services but this the local LGBT community with mental also appears to span out into their everyday health issues. Not only does the service life with 46% suggesting that they feel ‘less enable access to appropriate mental health isolated’ due to the service received. services but it also empowers these The extent to which MindOut’s advice, individuals to resolve issues surrounding information and advocacy service was employment and housing. Through this work helpful to the service users is clearly the individuals that access the service highlighted through the examples above. experience increased wellbeing effects as However, it is also reinforced through the documented above. The following section 3) Two service users did not complete page two of the evaluation form therefore these percentages could represent following comments. When asked if there provides an independent review of the peer a total of 100% were any additional comments they wished support groups currently offered by MindOut. t

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4.3 As a large number of the returned forms showed that many individuals attend/have Peer Support Groups attended more than one formal group (11 more than one group, 12 open group only, 3 In addition to the advice, information and out of the blue only, 5 trans group only, 3 advocacy service offered by MindOut, their mixed only, and 1 men’s group only). Further, peer support group services constitute an from analysis of the feedback from service important aspect to their organisation. The users there is considerable overlap in the peer support groups are split into a range of responses from each group[s]. Therefore, the individual groups offering slightly different following section shall evaluate the peer types of group structure and focus. At support groups as a whole followed by a present, MindOut is currently running four specific focus on the themed ‘men’s’ and formal groups and two informal groups. ‘trans’ groups as these represents a new These groups are as follows: aspect to the peer support group system.

Formal Groups Meeting its aims 1) Open group – x1 mixed – provides a l reducing isolation, space for LGBT individuals with mental l suicide prevention, health concerns to meet in a safe setting to l empowerment and wellbeing - Open, talk to each other about their experience, Closed and Out of the Blue groups worries etc – facilitated by a group leader. One of the main aims of the peer support 2) Mixed group – (9 week sessions) – same groups offered be MindOut is to reduce as Open mixed group however has an intake isolations for LGBT individuals experiencing of individuals on week one which stay in the mental health issues. As mentioned in same group for the duration of the 9 weeks, section 2.1 and 2.2, LGBT individuals with people can drop out of the groups but no one mental health issues experience high levels can join after the first two weeks – facilitated of discrimination. by a group leader. Understood as ‘double discrimination’ 3) Themed groups – The themed groups are these individuals often experience stigma a recent addition to the peer support group and discrimination from the general services offered by MindOut. These groups population due to their LGBT identity. In are closed groups with a similar structure to addition, within the ‘safe space’ of the local the closed groups listed above. The first of LGBT community where many LGBT the themed groups offered was a ‘mens’ individuals find a sense of belonging, LGBT group, with the second themed group, a individuals with mental health problems ‘trans’ group, currently running – facilitated often suffer discrimination due to their by a group leader. mental health issues. 4) Out of the Blue (mixed suicide prevention The result of being misunderstood in both group) - provides a safe space for LGBT communities often transpires into isolation, individuals who are or who have experienced anxiety, lack of self-esteem and depression. suicidal distress to meet others in a similar However, the peer support groups position - facilitated by a group leader. offered by MindOut attempt to provide a space in which LGBT individuals with mental Informal Groups health issues can meet with other 1) Weekly social group offering current and individuals in a similar situation and thus ex service users the chance to meet over a provide social support in an environment coffee and food after the formal groups. This that is non-discriminatory. From my space allows individuals from the different evaluation of this service it appears that this groups to come together in a social capacity. goal is being met with the peer support 2) BlackOut- less formal social group that groups providing LGBT individuals with since the departure of the organiser has now mental health problems the chance to feel ceased to meet (still used for publicity to part of a community, offering hope, reducing show that the service is there for BME LGBT isolation, enhancing wellbeing and often mental health sufferers) – un-facilitated reducing suicidal distress.

at present. In a similar light to findings of past t

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t evaluations, the peer support groups aim of suicide prevention. As highlighted received very positive feedback from service above, ‘Out of the Blue’ offers a specific users. Positive words such as: ‘enjoyable’, group setting for individuals experiencing ‘comfortable’, ‘warm’, ‘open’, ‘supportive’, suicidal distress and thus we could expect In the six years I have been ‘understanding’, ‘empathetic’, ‘safe’, ‘caring’, that feedback from users of this group ‘life-saving’, ‘welcoming’, and ‘honest’ among relates to their experiences of suicidal coming to Out Of The Blue it many others were consistently found distress. For example, as one member of ‘Out has been the most amazing throughout the service users evaluations of of the Blue’ comments: MindOut’s peer support groups. experience and is my life line. In this feedback it is clear to see that the “In the six years I have been coming to It allows me to face myself peer support groups provide a specific space Out of the Blue it has been the most amazing in which LGBT individuals with mental health experience and is my life line. It allows me to and my issues. I honestly issues can meet each other enabling a look within and find ways to face myself and don’t think I would still be reduction in experiences of isolation. For my issues. I honestly don’t think I would still example, one service user comments that be alive without it” alive without it MindOut’s peer support groups provide: It is clear from this account that providing Service user talking about MindOut’s “A very useful opportunity to share a specific group for the needs of LGBT suicide prevention peer support group experiences with others in a similar position, individuals with mental health issues who are who will understand rather than judge. It can also experiencing suicidal distress is reduce the feelings of stigma and isolation” essential. As this account suggests, without the invaluable work of MindOut and in Thus, it is apparent from this account particular the ‘Out of the Blue’ support group that the experience of ‘double this individual does not feel that they could discrimination’ is not simply an academic cope with the situation they are faced with. hypothesis but rather a real experience for Therefore, it appears that MindOut is LGBT individual with mental health issues. enabling individuals with suicidal distress to The peer support groups offer these cope better and to essentially ‘stay alive’. At individuals with a space in which they do not this stage it is hoped that the words of the feel judged, an experience presumably far service user above emphasise just how removed from their everyday life in which the important the ‘Out of the Blue’ peer support general population or LGBT community do group is for the local LGBT community with not understand them resulting in feelings of mental health issues. isolation and experiences of discrimination. However, through analysis of responses It is here then that the peer support from all the service users that returned the group service enables an alternative group evaluation forms, it becomes apparent understanding of the ‘self’ and their that the peer support groups more generally ‘identity’ which would not be possible (e.g. open group, closed group) also facilitate without such a specific service on offer. As the reduction in suicidal distress for their another service user elaborates: users. For example, there are many examples when peer support group service users have “Since attending the groups at MindOut it commented how their engagement with the has helped me enormously. I don’t feel so service has “Kept me alive”, or been “Life isolated and alone with my problems. Being changing and saving”, to highlight but a few. able to relate to other LGBT people has really As a current/past member of the open helped me” group and both closed groups (not ‘Out of the Blue’), one service user elaborates on this Therefore, the peer support groups do not issue in more detail stating: only enable a reduction in isolation by default of bringing people together. Rather, these “Over the past few years, I have been groups enable a reduction in isolation which living with frequent suicidal thoughts and I helps these individuals to better understand strongly believe that the support that I have their experience of being an LGBT individual received from MindOut has helped stop me with mental health issues facilitating an acting on them!!!” enhanced ability to ‘cope’. In addition, they provide a sense of ‘belonging’ which has long It is clear then that although not been linked to enhanced self-esteem and specifically established to facilitate the confidence (e.g. Lee and Robbins, 1998) reduction in suicidal distress all peer support Peer support group service users also groups offered through MindOut are having offer insights into the benefits they receive that effect on their service users.

through attendance in relation to MindOut’s In addition to meeting the specific aims t

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t of MindOut, the peer support groups also “Keep themed groups” enable a sense of empowerment and enhance general wellbeing. For example, “Themed groups are very useful” when asked to write down what comes to mind when thinking about attending peer In addition to the general positive support groups one service user notes: experience of having such themed groups, the majority of service users that had used “I have never been to anything like this the men’s group, or were currently using the before and now I am good Tuesdays and feel trans group, elaborated on the benefits of positive after the group session and all day such specific group interactions. For Wednesday” example, as one ‘men’s’ group service user comments: From the above extract the service user implicitly documents the daily struggle [s]he “A specific group has enabled me to feel faces through his/her suggestion that the safe and to understand and share week tends to be filled with negative experiences with others in similar situation” emotions. It is through participation in the group that this service user feels empowered Thus it would appear that offering a to overcome some of these negatives even if group with a more specific ‘identity’ enabled only for a short period. the service users to feel more embedded in In addition, another service user the collective identity of the sub-group rather highlights how the peer support groups than the more general LGBT identity. This enabled the taking control of a situation and aspect of belonging to a sub-group within the ability to cope. Commenting on the peer broader LGBT community was a particularly support group service offered by MindOut the salient feature in the evaluative comments service user quite aptly comments: offered by individuals accessing the ‘trans themed groups’. As a number of the service “Thank you for turning my life around” users’ comment: Only other trans people can ever know what it is really Themed groups: Men’s and Transgender “It was very useful being in an all trans group space so I did not feel I had to explain myself like, and how much we are As mentioned in the introduction to this or worry about being judged. Essential. The rejected by society evaluation, dedicated focus shall now be mix of mental health and trans issues was given to the ‘Men’s’ and ‘Trans’ ‘themed’ peer very important” (emphasis in original) support groups due the their recent Service user talking in relation to one of introduction as an additional service offered “Totally invaluable. I could not have MindOut’s themed peer-support groups by MindOut. spoken about a huge amount of stuff if I At present such themed groups are at the hadn’t been in this specific group, especially early stages of a ‘trial period’ with the early on in my transition, exactly what I completion of the ‘men’s’ group, the ‘trans’ needed” group currently being offered and three other groups expected to run over the coming 18 “Only other trans people can ever know months. Therefore, this evaluation can only what it is really like, and how much we are offer a relatively small insight into the rejected by society” usefulness of ‘themed’ groups. However, bearing in mind the that “I was able to ask questions that are very transgender service users consistently felt as personal to me without feeling like a prat or a though their specific needs were being freak. I was therefore able to deal with these overlooked at times by MindOut in the 2010 trans issues and feel confident in doing so” feedback forms, it is expected that the findings from this aspect of the evaluation “Trans issues are so often ignored/ could prove extremely significant. relegated or worse deemed the same as LGB The feedback from the themed groups that this trans group has proved a godsend. suggests that such groups were a welcome While I am not discounting that LGB does addition to the peer support group services cross over with trans, things like surgeries, offered by MindOut. For example, users isolation and trans phobia are often suggest: different”

“It was very useful to be in the Men’s Thus, from this feedback it appears that group, more of the same please” offering specific groups, in conjunction with

the more general LGBT groups, is an t

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t essential element to the wellbeing of the offered by MindOut and shall not feature in service users. It is clear to see that although a the recommendations of this evaluation. sense of belonging is felt within the broader Nonetheless, it is suggested that these LGBT identity, these individuals often feel particular recommendations are taken up, MindOut has shown me how that the specifics of their situation can be or rejected, at the discretion of the Director overlooked when such a broad focus to the of MindOut. peer support can work; it needs of LGBT individuals is adopted. However, within the recommendations helps those needing support, In addition, for this group of transgender service users listed there appears to be one individuals, they were able to express and that does warrant more consideration that of is beneficial to those offering understand shared experiences with other group size and member retention. As two support, and builds group trans people which are often different to the service users comment: shared experience they have with the other cohesion and a sense of LGB service users at MindOut. “Not changing the groups as often. We community In fact, it would appear that celebrating get used to the group and then the dynamics each aspect of the general ‘LGBT’ identity, seem to change and people seem to MindOut volunteer worker rather than homogenising LGBT individuals disappear. In the past the closed groups as a collective, indistinct group, is important stayed the same, different now as new for the service users of MindOut. This is a people all the time” point highlighted by one of the ‘trans’ themed group users through her recommendation “Very understanding and supportive, that the identity of ‘trans’ also needs to be however several people dropped out and the unpacked in more detail to cater for the group got smaller and smaller” differing experiences of trans-women and trans-men. As she comments: Issues with group retention are not easily resolved and it is not within the remit of this “As I was the only trans-woman for most evaluation to speculate on possible ways in of the time I was at a disadvantage, a which this could be done. However, it is minority within a minority...Would very much suggested here that research should be like a trans-woman only group or a lesbian conducted with peer support group service group with T women next time please” users and members that have left, in order to establish possible causes for drop-out rates Therefore, it appears that operating within the closed groups. ‘themed’ groups has been very successful In addition, it is also recommended that a further providing support for LGBT individuals review is conducted to explore the group with mental health issues. Based on the structure to see if there could be structural success of the men’s and trans themed changes, such as a specific group for long groups so far, it is suggested that more serving members, which may facilitate attention needs to be paid to the diversity of greater retention rates. It is however needs within the broader ‘LGBT’ identity in acknowledged that the current system was order to enhance the level of service put in place to provide wider access to the experienced by all of MindOut’s service users, service and also accepted that the current particularly in light of negative feedback from financial situation may not permit changes. the trans group in past evaluations (e.g. 2010 In concluding on this evaluation of the feedback forms). peer support service offered by MindOut it is clear that this aspect of the organisation Service user recommendations meets its specific aims whilst also providing Within the group evaluation forms the added benefits such as empowerment and service users were offered the chance to enhanced wellbeing. The overwhelming suggest any recommendations they feel majority not only commended MindOut’s could be made. Of the recommendations peer support groups for the safe space it listed a number of individuals commented provides, opportunity to meet other LGBT that more funding was needed in order to individuals and reduction in stress and offer more services. Other service users isolation, but also, as one service user noted the need for “more social activities”, points out: “Perhaps having a quiet room for those who get anxious when it’s busy”, and another “MindOut is a life saver” suggested that MindOut should revise its food policy recommending “Healthy food – It is on this comment that I wish to finish vital when suffering with depression”. the evaluation of the peer support groups as I Such recommendations are relatively believe that it encapsulates what so many

minor when considering the overall service other service users have said and felt. t

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distress to remember those that have been 4.4 lost. This event was held in 2010 but did not go ahead in 2011 due to constraints on LGBT mental health resources. Of the strategies aimed at increasing awareness and support within the promotion LGBT community, MindOut write monthly articles for the local LGBT magazine As highlighted in section 4.1 two of MindOut’s GScene, their work with GScene has also aims concern: increase involvement in included special editions in June 2006 and mental health promotion by LGBT people September 2009. with mental health problems, and increased MindOut is also actively involved in awareness and support around mental Brighton and Hove’s Pride Festival. This year health in the LGBT community. Although saw headline the festival these aims will, in part at least, be fulfilled with between 33,000 to 50,000 people through the offering of MindOut as a service attending the main event and hundreds of within the local LGBT community promoted thousands at the street parade (Manson, through leaflets, and through ‘word-of-mouth’ 2011). For this year’s festival MindOut once in relation to those using the service passing again organised their open-top bus for the on information and advice. street parade and to take service users to the There are also more targeted measures main event. Brief comments were obtained adopted by MindOut to meet these aims. For on the day from those service users that were example, MindOut is successfully in its fifth on the MindOut bus during pride and through year of the comedy night ‘MindOut For The analysis of these comments it appears that Laughs’ at the Komedia in Brighton. This the MindOut open-top bus was once again a event is run by LGBT comedians and thus great success and benefit to those facilitates an increased involvement in individuals. The comments obtained include: mental health promotion by LGBT people with mental health problems. In addition, the “This is the first time I have been on the annual event helps to raise money and bus and it is great. My anxiety and awareness for MindOut whilst also increasing agoraphobia make it hard in the crowds and awareness and support around mental this is such a cool and safe way to take part” health in the LGBT community. MindOut also organise the event ‘Stamp “The bus for pride is so important for me Out Stigma’. This event is run on the annual to be able to take part...It also provides a safe world mental health day and constitutes an way in terms of anxiety to get to the park ‘open’ walk (e.g. anyone can join in) along without having to cope with all the crowds on Brighton seafront to show a commitment to the streets, which would also be too much to ending stigma and discrimination against cope with” LGBT individuals who have mental health issues and raising awareness for the general “It [the bus] helps lessen the anxiety public. Last year this event was attended by being with friends and workers from hundreds of people including guest MindOut, who work hard making sure we are speeches from Paul Elgood Leader of hydrated and have the suncream we always Brighton Liberal Democrat Party and Scott forget to put on. I’m proud to represent Durairaj from Sussex Partnership NHS MindOut, an amazing organisation, without Foundation Trust. Thus, as with the ‘MindOut whom I probably wouldn’t be alive even today, For The Laughs’ event, ‘Stamp Out Stigma’ let alone feeling able to take part in Pride” facilitates the engagement of LGBT individuals with mental health issues in the “Because of my mental health problems, promotion and awareness raising of LGBT I wouldn’t be able to come to the Pride mental health issues to the LGBT community festival in Brighton because I’d get too and general public. anxious because of the crowds. Staff always More specific events and strategies look after us really well, and, don’t look after aimed at increasing awareness and support us in a disempowering way, but just in a way within the LGBT community include the that they are there for us and supportive and ‘MindOut Annual Suicide Memorial Candlelit we all just feel part of a team. Erm, MindOut Vigil at MindOut Memorial Tree’. This event as a whole continually save my life was set up to raise awareness of suicidal throughout the year, so it’s good to celebrate distress within the LGBT community, and my Pride with a service that saves my life and offers the chance for friends and family of keeps me living, keeps me breathing, keeps

LGBT individuals suffering from suicidal me sane-ish” t

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t Therefore, it is clear from the comments settings and also with mainstream mental above that not only does the organisation of health services...Users could also be more the open-top bus at the Pride festival raise involved in publicising the project” (p4). awareness of LGBT mental health issues Therefore, with the activities organised by amongst the LGBT community (and general MindOut such as ‘Mind Out For The Laughs’, public), but it also facilitates the involvement in conjunction with their participatory action of LGBT individuals in this promotion as it approach adopted in their staffing provides a ‘safe space’ through which the demographics, it appears MindOut have service users can engage with the festival expanded on and gone beyond their 2007 more generally. It is also clear to see that aim for the increased involvement in mental without the involvement of MindOut in this health promotion by LGBT people with festival, many of these individuals would mental health problems, by involving LGBT avoid participating altogether due to the individuals with mental health issues not only issues surrounding anxiety and stress these in the promotion, but also in the very heart of individuals experience in busy public places. the running and management of the MindOut In addition, MindOut’s involvement in Pride organisation. enables these individuals to feel part of the In order to include the opinions of the broader ‘LGBT’ community through the staff and volunteers at MindOut in this ’taking part’ in the festival whilst also offering evaluation an open-ended questionnaire was many of the benefits associated with sent out to those concerned. Unfortunately MindOut’s more general services in isolation only four of these forms were returned. reduction amongst other aspects. However comments from these workers shall now be presented in order to conclude this evaluation and capture some of their opinions with regards to the work they do and 4.5 the work of MindOut more generally. Staffing “I get to work in a field I believe matters. I get to make a difference to discrimination, Although there are clear drives for MindOut to stigma, people’s lives, how people are empower LGBT individuals to be involved with treated when they are in need...MindOut is a the promotion of LGBT mental health issues great employer – very responsive, inclusive of (as highlighted above) it would appear that staff views. We do so much to really include their inclusive, or participatory action service users in all aspects of our work and approach, goes much further than their organisation” outward activities. It is only from a review of the current staff and volunteer data that it is “Very proud or the work that I do, very clear to see the extent to which MindOut has supported by team/manager, I have a lot of truly embraced such a commendable confidence in Helen and the Trustee Board, approach. For example, the current staffing flexitime is fab, I love MindOut for the Laughs, and volunteer figures include: 8 trustees, 6 I get lots of job satisfaction, good outcomes staff and 3 volunteers. Of these 17 from case work/advocacy, user involvement individuals currently involved in the running and participation” of MindOut 4 identify as female, 6 male, 3 trans and 2 other (with 2 not completing this “Helping people feel good/better. It’s an aspect of the form); 5 of these identify as gay, ideal way to get involved in a project that 4 lesbian and 3 other (with 5 not completing means something to me. It has shown me this aspect of the form. Finally, 10 of the how peer support can work; it helps those individuals currently working or volunteering needing support, is beneficial to those for MindOut declared lived experience of offering support, and builds group cohesion mental health issues with 7 being current or and a sense of community...Seeing how ex mental health service users and 3 current people who talk about feeling suicidal can be MindOut staff regularly feature in Brighton or ex MindOut service users with the supported. It’s great seeing how the advocacy & Hove’s local LGBT magazine, GScene remaining 2 people identifying as carers. service can benefit some people – they have Not only does this highlight MindOut’s a weight taken off their shoulders” commitment towards inclusivity, but it also shows the extent to which they act on experts’ “Volunteering in this role at MindOut recommendations for their service. For gives me lots of scope to contribute to all this example, this level of inclusivity can be seen happening. It is great to be able to do this as a direct response to, and improvement on, with some personal involvement with service a key recommendation made in the first users via the cooking and growing work” independent review conducted by Hazel Platzer (2000). In this review Platzer Thus, it is clear from these comments comments “User-led activity should be that it is not only the service users that supported and encouraged to promote peer benefit from MindOut as an organisation, support mechanisms such as drop-ins or but also those working and volunteering for socials in safe lesbian and gay community the service. n

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Concluding remarks 5. Concluding remarks commending success and recommending improvements

5.1 5.2 Highlights of MindOut Independent as a unique service recommendations This evaluation has not only highlighted space in which such individuals are for future improvement the need for an LGBT mental health interacting with other people in similar service in Brighton and Hove (and situations, reducing isolation and to the services offered potentially elsewhere) through a review suicidal distress. of the problematic situation faced by In evaluating the recent by MindOut such individuals (such as ‘double implementation of ‘themed’ peer support stigma’), but it has also shown how groups this report finds that this added In light of the findings of this independent MindOut is meeting the needs of this addition to the services offered by review, the following recommendations are community. In addition, the bold move MindOut has been a success. Although in suggested to further enhance the service taken by MindOut to run independently the early stages, the ‘themed’ peer offered by MindOut: from Mind in Brighton and Hove, coupled support groups enable the homogenous with the increasing public sector cuts, ‘LGBT identity’ to be understood as more l Expansion of both advice, information and rising service user figures, suggests diverse, offering service users the chance and advocacy and peer support services, that MindOut as a mental health service to express issues specific to particular including funding sources, staffing and for the LGBT community should continue aspects of their identity and experiences. quantity or services on offer to cope with the to flourish for years to come. This development in MindOut’s increase in demand (potentially due to The extent to which MindOut provides services appears particularly important public sector funding cuts and/or MindOut an indispensable service to LGBT for transgender individuals who in going independent), reduce waiting lists, individuals with mental health issues can previous evaluations have suggested that and enable the continuation of this be emphasised no clearer than through their specific needs are sometimes essential service. the numerous suggestions of its service overlooked. Finally, MindOut continues to l Extend the model employed by MindOut users who state that MindOut provides a successfully raise awareness of mental to other LGBT communities. A high number of ‘life line’ and offers the strength, support health issues experienced by LGBT referrals from outside Brighton & Hove and determination to ‘stay alive’. individuals through its promotional demonstrates need across Sussex. This evaluation has found that strategies. l Independent research investigating through the hard work and dedication of In addition, this evaluation the issues around the benefits of group the workers, MindOut meets its aim of commends MindOut’s efforts to involve membership in terms of recovery, factors improving access to appropriate mental LGBT individuals with mental health involved in group retention rates and health services for LGBT people. issues in the awareness raising activities experiences of new members within In addition, the advice, information and the running of MindOut as an the group service which would comprise and advocacy service provides support organisation. a full evaluation of the peer support and guidance on a range of additional group structure. issues such as housing and employment. l MindOut needs to continue with the This achievement is reflected in the development of ‘themed’ peer support increasing demand for the service and groups and targeted groups for particularly the voices of those currently using the isolated people, eg older people. service who also suggest the advice, l The promotion of MindOut within information and advocacy service statutory services and the further empowers them and offers hope in times development of relationships between the of adversity. The most important focus of two parties. It has also been documented that MindOut’s immediate efforts MindOut’s peer support group work Having highlighted these recommendations provides an essential service to LGBT ought to be on securing it should also be made clear that the most individuals with mental health issues. It important focus of MindOut’s immediate funding to enable such a vital offers support to individuals that they efforts ought to be on securing funding to cannot find elsewhere due to the safe service to continue enable such a vital service to continue. n

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References

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