February is LGBT+ history month, an important opportunity to increase the visibility of LGBTQ+ people, history and experiences. ARC North Thames PhD researcher Rosa Town talks to the Evidence Based Practice Unit at UCL about her ongoing research into mental health self-management among LGBTQ+ young people.
Could you introduce yourself, and tell us a bit about the aims of your PhD?
I’m Rosa Town, and I’m a PhD student at University College London (UCL) and the Evidence Based Practice Unit (EBPU). My PhD, funded by NIHR ARC North Thames, investigates LGBTQ+ young people’s self-management of their mental health, specifically the strategies LGBTQ+ young people use to self-manage their mental health, the perceived barriers and facilitators to self-management, and their experiences of self-management. As this is a new area of research, I hope my findings will provide guidance for future policy and interventions which aim to improve the mental health of LGBTQ+ young people.
We hear a lot about self-care and self-management on social media. Why is it important to investigate how LGBTQ+ young people specifically manage their mental health?
We know from recent NHS Digital statistics that one in three LGBTQ+ young people will experience a mental health difficulty, which is much higher than their heterosexual peers. Meyer’s Minority Stress Model suggests that marginalised groups experience greater adversity and stress due to discrimination, which can lead to poorer mental health outcomes in some cases. This is not to pathologise LGBTQ+ young people, but to suggest that as a group they may be more likely to experience mental health difficulties which could be mitigated by some form of self-management.
We also know that LGBTQ+ people are less likely to attend specialist mental health services due to fears of discrimination, and that there are long waiting times for many who do choose to access services. It is important to note that there is a parallel responsibility for specialist mental health services to work to improve experiences for LGBTQ+ young people, as self-management should not be prioritised due to the inadequacy of current services to support marginalised groups.
Currently, little is known about how LGBTQ+ young people self-manage their mental health, despite the proliferation of self-initiated strategies on social media. Before we can figure out what will help, we need to understand what LGBTQ+ young people are already doing to self-manage their mental health, what works well, and what prevents them from self-managing their mental health.
You have just completed the first empirical study of your PhD, a qualitative investigation of LGBTQ+ young people’s experiences and perceptions of self-managing their mental health.
Are there any findings you were particularly struck by?
Participants described being part of the LGBTQ+ community as helpful in self-managing their mental health, and interestingly, some described feeling better able to build a self-management routine during the first coronavirus lockdown in the UK, without the stresses of commuting, school, or preparing for exams.
Another sub-theme that particularly struck me was ‘wanting to wallow’ (one of the perceived barriers to self-management) – something many of us will be able to identify with. Participants described being their own worst enemy at times, where although they felt bad or wanted to improve their mental health, they also wanted to ‘wallow’, or felt like that was the only option available to them.
What have the key challenges been, and what have you enjoyed the most?
A key challenge has been re-thinking qualitative research during the pandemic. I feel lucky to be supported by excellent supervisors and colleagues from whom I have crowdsourced strategies for conducing remote research. Another challenge has been working from home (and the general isolation of working on a PhD, which I think would have occurred despite the pandemic). I am looking forward to things hopefully opening up and more opportunities to network in person with other researchers. In the meantime, I’m enjoying not having to commute in the winter!
Despite these challenges, there have been many enjoyable aspects of this PhD so far. I was astounded by the appetite to participate in research from the LGBTQ+ groups and young people I reached out to for my first study. I received many kind emails from staff and young people thanking me for asking about their experiences. It reiterated one of the things I like best about doing research - ultimately, qualitative research allows the researcher to shine a light on others’ experiences and synthesize them in a way that can have major implications for positive change. It has been a humbling learning experience just listening to other people, and it is something I am grateful to be able to do.
What are the next steps for your research?
I plan to use an anonymous online survey to further investigate LGBTQ+ young people’s experiences of self-managing their mental health. I hope that by recruiting anonymously I am able to engage a wide range of participants. Alongside this, I am conducting a scoping review of self-management, self-care, and self-help in adolescents with emotional problems to understand what we can learn from the existing literature.
Top image: Created by a patient who creates free-to-use art
Rosa Town is an NIHR ARC North Thames PhD student, working within our Mental Health theme. To find out more about Rosa and her work, you can visit her profile, follow her on Twitter @rosa_town, and visit the LGBTQ+ self-management in child and youth mental health project page.