’LGBT+ History Month — Creating a psychologically informed environments for LGBT+ homeless young people’.

25.02.2022: For this week’s PIE blog, as the lead for Psychologically Informed Environments (PIE), at the national youth homeless charity — Centrepoint, I am again delighted to be co-writing it with a colleague; Adelle Berman (PIE Trainer, Skills Development Team & Member of Centrepoint’s LGBT+ Staff Inclusion Group). This group, following on from the Equities Network highlighted in the last PIE blog (c.f. https://drhelenmiles.medium.com/actionsnotjustwords-a-psychologically-informed-reflection-on-race-equality-week-a762c1540ec0), was also created at the request of staff within the organisation following a series of PIE team and HR led workshops in 2020, looking at how we can better support wellbeing and inclusion within the organisation as part of our ‘People Strategy’. The mission and purpose of this group is outlined below:

Mission:

· To ensure that at Centrepoint we offer a fully inclusive culture paying attention to the needs of LGBT+ employees and their allies. To help build and create an environment where everyone feels safe to be their whole authentic self at work.

· To increase the knowledge and education around LGBT+ matters and feed this into policy and practice.

· To work towards achieving Stonewall Workplace Equality Index accreditation.

Purpose:

· To maintain LGBTQ+ inclusion in all areas of the workplace.

· To hold informative events and networking sessions for all staff across the organisation.

· To create opportunities for LGBTQ+ employees and allies, in order to celebrate identities and experiences.

· To work in partnership with all other Diversity groups, while taking into account intersectionality, and to align our work within a psychologically informed environment (PIE).

The topic of this week’s PIE blog reflects that we are coming to the end of the LGBT+ history month (c.f. https://lgbtplushistorymonth.co.uk/), which has been a focus of events, webinars and communications across the organisation. For example, we have learnt about key figures in LGBT+ history and have been reflecting upon some of the key issues that effect this population, as well as further considering how we can promote equality, diversity and inclusion. The theme of ‘inclusion’ was also specifically reflected upon as a specific topic at the Senior Leadership Team meeting that I attended with other organisational leads this week. LGBT+ history month is particularly important to increase the visibility of lesbian, gay, bisexual and transgender individuals, their history, lives and experiences within society. It also aims to raise awareness and advance education on matters effecting the LGBT+ community, make institutions and wider society a safe space for all LGBT+ individuals, and promote their welfare so that they can achieve their full potential within wider society and live meaningful fulfilled lives that recognise and value them regardless of their sexual orientation or gender identification.

Within a psychologically informed environment or PIE, addressing the issues that impact on LGBT+ individuals, as with race, is not just an important issue in terms of the impact on our staff, but also how these issues can potentially impact, or have previously impacted upon, the homeless young people we support. Therefore, whatever our sexual orientation or gender identification (i.e. whether or not these issues may affect us directly) it is important that we work together to make society a move diverse and welcoming place, because as I have argued before, a more inclusive society benefits us all (c.f. https://drhelenmiles.medium.com/are-we-inclusive-a-psychologically-informed-perspective-on-national-inclusion-week-bfc0a3063519).

Being aware of the specific issues that impact on LGBT+ individuals is particularly important within a PIE, because of the historical context of discrimination (c.f. https://centrepoint.org.uk/about-us/blog/lgbt-history-month-memories-of-centrepoint-during-the-aids-crisis/) and how this combined with ongoing negative attitudes and behaviours towards LGBT+ individuals can affect their psychological well-being (c.f. https://www.mentalhealth.org.uk/statistics/mental-health-statistics-lgbtiq-people). Experiences that are perhaps unique or more likely to occur to you if you are LGBT+, including discrimination, homophobia, transphobia, being a victim of ‘hate crime’, health inequalities, social isolation, rejection or difficult experiences of ‘coming out’ can all increase the risk of mental health issues and/or affect your psychological well-being.

For example, various research studies (e.g. Fergusson et al, 1999; Herrell et al, 1999; Cochran, 2001; Gilman et al, 2001; Sandfort et al, 2001) have found that compared to a heterosexual population, LGBT+ individuals have a higher prevalence of mental health disorders and are at a greater risk of suicide. This is often suggested to be a result of the increased stigma, prejudice and discrimination that an LGBT+ population can experience within their social environment (Friedman, 1999; Meyer, 2003), suggesting that a truly psychologically informed environment that works for the benefit of all must work towards reducing and eliminating these factors. Moreover, Meyer (2003) specifically notes that the ‘experience of prejudice events, expectations of rejection, hiding and concealing’ and ‘internalised homophobia’ can have a powerful further influence an LGBT+ individual’s coping abilities that mitigate against these risk factors for mental health issues.

In addition, research has highlighted how LGBT+ individuals may be discriminated against in the work place through a ‘heterosexism’ organisational culture in the workplace (e.g. Waldo, 1999), that can impact not only on psychological well-being but also other job-related outcomes (e.g. promotions). It is therefore important when creating a psychologically informed workplace to ensure that our culture (e.g. through our policies, procedures, and opportunities) are not either implicitly or explicitly biased against LGBT+ individuals. It is key to create psychologically safe places wherein an LGBT+ individual can be their authentic self at work, particularly given psychology research has demonstrated that the concealment of one’s homosexuality is a significant source of stress (e.g. DiPlacido, 1998).

Conversely, creating psychologically safe spaces that give an individual the ability to embrace being LGBT+ can have a positive impact upon their psychological well-being. It can increase self-confidence, a sense of community, feelings of relief and self-acceptance and lead to more positive relationships with accepting others. Of note, one study of LGBT+ adolescents found that family support and self-acceptance can actually go a significant way to ameliorating the negative effects of external homophobic abuse on mental health outcomes (Hershberger & D’Augelli, 1995). However, this may not necessarily be a ‘biological’ family. Often the creation of a ‘chosen’ family can be just as important, cherished or sought after for many LGBT+ young people, especially for those who may not feel comfortable or welcomed in their own families. This is an important point for those working in our supported accommodation services, such as our amazing ‘key-workers’, who often have a ‘corporate parent’ role, and whose acceptance of and connection with an LGBT+ homeless young person can therefore be very powerful.

When reflecting on LGBT+ history month this week, I have also been thinking specifically about some of the homeless young people that I hear about within staff reflective practice sessions in the organisation, who reveal often heart breaking stories of rejection, broken attachments, identity challenges, and previous traumatic experiences before coming to Centrepoint. Research from the Albert Kennedy Trust (AKT, 2015) noted that up to 24% of young people at risk of homelessness identify as LGBT+, with 77% citing familial rejection and abuse after coming out as the primary cause (e.g. see here for a case study from Centrepoint: https://centrepoint.org.uk/youth-homelessness/real-stories/tams-story/). Significantly, this family rejection can lead to LGBT+ young people feeling that they do not belong in their ‘home-town’, captured powerfully by this pop song from Bronski Beat (c.f. https://www.youtube.com/watch?v=88sARuFu-tc). This often results in LGBT+ young people gravitating to ‘beacon’ cities like Brighton, London or Manchester with the idea that this will allow them to be ‘accepted’. However, this can cause specific challenges with regard to housing, because they do not have any local connections to these cities. This means that they will not be eligible for any assistance, increasing their risk of rough sleeping and creating problems when homelessness services try to support and intervene to access suitable accommodation.

In addition, once homeless, LGBT+ young people are significantly more likely to experience targeted violence, sexual exploitation, substance misuse, and physical and mental health problems than any other homeless youth. (c.f. Albert Kennedy Trust, 2021; https://www.akt.org.uk/report). It was noted that there can be high levels of ‘transactional sex’ (i.e. sex for money or other resources) and the exploitation of vulnerable young gay men was often similar to the situations that some homelessness women can face. This report also found that 50% of LGBT+ young people interviewed feared expressing their LGBT+ identity to family members would lead to them being evicted from home or being unable to return once they had ‘come out’ (c.f. https://centrepoint.org.uk/youth-homelessness/real-stories/garys-story/). Almost two thirds (64%) of LGBT+ young people said homelessness made it hard for them to establish or maintain new relationships, and almost a fifth (17%) stated that they felt that they had to have causal sex to find somewhere to stay whilst they were homeless.

Therefore, what can homeless organisations like Centrepoint do for LGBT+ young people, building upon the work we already undertake with this population? The full AKT (2018, 2021) report(s) are a shocking read; identifying the abuse and isolation that LGBT+ homeless young people experience, thus inhibiting their opportunities to build relationships within their communities and peers. There is clearly more work to be done to offer LGBT+ young people the right support in the community, and moreover ensuring that this support is available and accessible when young people need it most, ideally before they are homeless or ‘at risk of homelessness’. It is essential that we as an organisation, reflect on these issues particularly as the AKT report(s) note that over half (59%) of LGBT+ homeless young people have faced some form of discrimination or harassment while accessing services. The report rightly concludes that ‘as a society and as a sector we can and must do better for our young people’ (AKT, 2021).

It was also concerning to read in the AKT report(s) that many LGBT+ homeless young people report feeling that staff do not always understand why they had become homeless and in addition, that supported accommodation services do not always understand what specific support related to their sexual orientation or gender identity that they may need as a result. As noted in Keats et al (2012), one of the key ingredients of a PIE are ‘relationships’, in particular the powerful and important relationship between a keyworker / staff member and the homeless young person. Therefore, the onus is on us as staff to try to engage meaningfully and empathically with the homeless young people we support, viewing each young person holistically, taking into account their thinking, emotions, personalities and past experiences, including but of course not limited to the specific issues that relate to being them LGBT+.

The AKT report (2021) also suggests that homeless organisations should introduce mandatory monitoring of gender identification and sexual orientation to improve the visibility of this over-represented group in homelessness services. There should also be an emphasis on prevention focussed intervention and developing referral pathways between specialist and mainstream statutory and voluntary services, including cross sector partnerships that work together to support an LGBT+ homeless young person. The AKT report (2021) goes further to also suggest that within homelessness services we should be working to creating inclusive environments where LGBT+ young people feel safe to disclose their gender identity and sexual orientation. It is also suggested that organisations provide LGBT+ training programmes for staff, which also include a focus on homeless young people who are in multiple minority groups; for example considering the intersectionality between race and sexuality. Finally, as per a PIE and the important role of co-production, we should be involving homeless young people as much as possible in the design, commissioning and operation of support accommodation services.

Consequently, as the UK’s leading youth homeless charity, it is essential that we at Centrepoint continue our work to address these inequalities though our PIE journey and within our HOMES (Housing Operational Model; Environments & Services) and our ‘People Strategy’ work streams. Historically, Stonewall Housing provided training for Centrepoint staff on understanding the experiences of LGBT+ rough sleepers. However, more recently our Skills Development Team have developed a specific in-house LGBT+ Awareness for homeless young people, which is now available for all staff to access. We would therefore encourage all our staff to attend this training to explore what our organisation can and should be doing to become more accessible and equitable to the LGBT+ community, as well as understanding the specific issues that are relevant to LGBT+ homeless young people. This is one small simple step towards providing a more accessible and inclusive service for LGBT+ homeless young people that we can all do in order to #changethestory. It may also ensure that this is an issue that we are not just reflecting upon for one month a year, but moving forward is something we consider as part of our ongoing ‘business as usual’…