Politicians’ anti-gay policies and homophobic speech can play a role in the suicides of LGBT people, according to one of the world’s leading psychiatrists.
Professor Dinesh Bhugra's remarks follow the decision last week of Belfast-based suicide prevention charity Lighthouse to suspend a board member for tweeting that the Democratic Unionist Party's opposition to equal rights leads to suicides.
Bhugra, a former president of both the Royal College of Psychiatrists and the World Psychiatric Association, told BuzzFeed News that discrimination on the grounds of sexual orientation “can contribute to suicide, suicidal ideation and self-harm”.
There is, said Bhugra, “a very clear link between policy, social factors and psychiatric problems in LGBT groups” with one of the three main causes of suicide being the social environment in which lesbian, gay, bisexual, and transgender people live.
“Social causation [of suicide] is well linked with the state of the society and how people feel they fit in – or don’t,” he said. “If there is no equity and one group is seen as inferior then it is inevitable that there will be problems in self-image and self-esteem and that may contribute to the feeling of worthlessness.”
This feeling of low self-esteem is a key factor in many suicides, said Bhugra, who characterised the internal thought process as, “If I don’t feel valued by the society – who’s going to miss me? – I might as well die.”
Bhugra, who also takes up presidency of the British Medical Association this summer, spoke out after Lighthouse mounted an investigation into Malachai O’Hara, a trustee, for tweeting that the DUP’s “homophobia is killing kids across the country”. Northern Ireland has the highest suicide rate in the UK.
O’Hara also mentioned in his tweet newly appointed DUP councillor Dale Pankhurst, who in turn made a complaint to Lighthouse, prompting the investigation. Pankhurst told a local newspaper he “doesn’t have a homophobic bone” in his body and “knows many people who are gay”. Lighthouse said O’Hara’s views do not “reflect or represent” the charity.
But according to Bhugra, whether or not politicians consider themselves to be homophobic is immaterial if they support policies that deny LGBT people equality.
“There is very clear evidence that common mental health disorders like anxiety and depression are higher in LGBT groups,” he said, “and there was a study in the States where they showed that if you go for equality and change the [anti-gay- laws] the rates of common disorders start to drop among the LGBT population. So it indicates that there are social causes at play which can cause psychiatric distress which can then lead to suicide.”
As such, he added, politicians must consider the rhetoric and policies they promote. “If you are not homophobic then you should be fighting for equality for everyone. You can’t say, ‘I’m not homophobic’ but somehow they should be treated differently.” Those who deny any link between their opposition to LGBT rights and the worsened mental health of this community are, he said, “not connecting the dots”.
According to the World Health Organisation, “discrimination [against LGBT people] […] can lead to the continued experience of stressful life events such as loss of freedom, rejection, stigmatization and violence that may evoke suicidal behaviour.”
A 2017 study in the British Journal of Psychiatry into sexual orientation and suicidal behaviour in young people concluded that lesbian, gay, and bisexual people are at greater risk of suicide. And the work of psychiatric epidemiologist Ilan Meyer since 2003 into the adverse psychological effects of prejudice on LGBT people has given rise to “minority stress theory”, in which groups subject to discrimination are thought to suffer worse mental health.
Bhugra also called on mental health practitioners to "ask about sexual orientation" so that treatment can be best tailored to the individual's needs. Coroners, he added, should in future be required to record – where possible – the sexual orientation of those who take their own lives, in order that the authorities have data on the scale and proportion of LGBT people who kill themselves. Combatting LGBT suicide, he said, "has to work at policy, service delivery and social attitudes – all three levels".
The policies of the DUP within a range of social issues have come into sharper focus since last summer after Theresa May agreed to give Northern Ireland an extra £1bn in exchange for the support of the DUP’s 10 MPs – enough to secure her a majority in the House of Commons.
The DUP, Northern Ireland’s largest party, has blocked five votes on same-sex marriage this decade, and has opposed equal rights for LGBT people since its formation in 1971 by the late Ian Paisley.
Later that decade, Paisley ran the “Save Ulster From Sodomy” campaign in opposition to the proposed decriminalisation of homosexuality. Since then, his party has voted against an equal age of consent, fertility rights for lesbian couples, civil partnerships, and against transgender people to have legal recognition.
DUP politicians have also been outspoken in opposing LGBT rights. Paisley’s son, Ian Paisley Jr, also a DUP MP, has described gay relationships as “immoral, offensive and obnoxious”, has said he is “repulsed by gay and lesbianism” and that “these people harm themselves and, without caring about it, harm society”.
The former First Minister Peter Robinson described homosexuality as an “abomination” after his wife said homosexuality and sodomy was “viler” than sexually abusing children. And in 2015, Jim Wells, then the DUP health minister, said a child is “far more likely to be abused and neglected” if raised by gay parents.
Bhugra said everyone, including those in public life, "should be aware of the words we use" and that politicians "have an ethical responsibility to make sure [it is] equality first".
Yesterday, Cllr Pankhurst tweeted to say he had been to visit Lighthouse, and that the charity told him that O’Hara’s views did not reflect theirs.
The board will meet later this week to decide on further action, BuzzFeed News understands. Pankhurst declined to comment on the matter, directing BuzzFeed News to the DUP for a response. The party did not respond to a request by BuzzFeed News. O’Hara said he would not comment until after the investigation.