Effects on Services: Effects on Services: Alcohol Treatment Alcohol Treatment ServicesServices

Please make a note if you Please make a note if you think any of the points raised think any of the points raised are relevant to your serviceare relevant to your service

Hellman et al 1989Hellman et al 1989 heterosexual bias in treatment and evaluation (including either heterosexual bias in treatment and evaluation (including either

focussing primarily on sexual orientation when inappropriate or focussing primarily on sexual orientation when inappropriate or ignoring important factors linked with sexuality),ignoring important factors linked with sexuality),

ignorance about lesbian/gay issues and discomfort at ignorance about lesbian/gay issues and discomfort at approaching matters of sexuality,approaching matters of sexuality,

ignorance about the inter-relation of homosexuality and alcohol ignorance about the inter-relation of homosexuality and alcohol misuse,misuse,

lesbians and gays felt discomfort in the mainly heterosexual lesbians and gays felt discomfort in the mainly heterosexual environment of agencies and were fearful of being viewed as environment of agencies and were fearful of being viewed as pathological or stereotyped. pathological or stereotyped.

Neisen & Sandall (1990)Neisen & Sandall (1990) difficulty in being open about their sexual orientation due to fear difficulty in being open about their sexual orientation due to fear

of staff/client harassment,of staff/client harassment, staff telling them it wasn't acceptable to discuss sexual staff telling them it wasn't acceptable to discuss sexual

orientation,orientation, some were forced to disclose their sexual orientation,some were forced to disclose their sexual orientation, as soon as their sexuality was known, some were discharged,as soon as their sexuality was known, some were discharged, some said that after disclosure the treatment they received was some said that after disclosure the treatment they received was

different due to an atmosphere of condemnation,different due to an atmosphere of condemnation, some feared that if their sexual orientation was known about this some feared that if their sexual orientation was known about this

would receive more emphasis than their chemical dependency,would receive more emphasis than their chemical dependency, some services were not happy having their partner attend a some services were not happy having their partner attend a

family programme. family programme.

O’Hanlan (1996)O’Hanlan (1996) the majority of detoxification and rehabilitation programmes the majority of detoxification and rehabilitation programmes

were insensitive to issues of sexual orientation and did not, were insensitive to issues of sexual orientation and did not, generally, encourage its disclosure; generally, encourage its disclosure;

homophobia limits the success of recovery and treatment for homophobia limits the success of recovery and treatment for lesbian substance abusers (Hall, 1990; de Monteflores, 1986); lesbian substance abusers (Hall, 1990; de Monteflores, 1986);

failure to acknowledge sexual orientation makes relapse more failure to acknowledge sexual orientation makes relapse more likely (Cabaj, 1992); likely (Cabaj, 1992);

lesbians were more likely to attend treatment services which lesbians were more likely to attend treatment services which address lesbian social issues and provide lesbian counsellors address lesbian social issues and provide lesbian counsellors (Hall,1986, 1990, 1992, 1993, 1994; Morales & Graves, 1983).(Hall,1986, 1990, 1992, 1993, 1994; Morales & Graves, 1983).

Other IssuesOther Issues Rofes (1989): traditional networks Rofes (1989): traditional networks

which people use to support recovery: which people use to support recovery: family, church, school, employers, are family, church, school, employers, are often closed to LGBsoften closed to LGBs

Hawkins (1976): closet gays attend Hawkins (1976): closet gays attend het-oriented AA groups: detrimental het-oriented AA groups: detrimental effects as key to sobriety is “open and effects as key to sobriety is “open and honest relationship with one’s peers.”honest relationship with one’s peers.”

Bridget (1994)Bridget (1994) more than half of the 121 respondents never more than half of the 121 respondents never

discussed sexual orientation with their clients,discussed sexual orientation with their clients, only a handful had had training and supervision in only a handful had had training and supervision in

relation to lesbian clients,relation to lesbian clients, the majority had little knowledge about the treatment the majority had little knowledge about the treatment

and evaluation of lesbian alcohol misusers, and evaluation of lesbian alcohol misusers, 84% felt able to treat lesbian clients,84% felt able to treat lesbian clients, 67% said they would like training on these issues. 67% said they would like training on these issues.

Mainstream Services in Mainstream Services in BritainBritain 1991-1992 Alcohol Directory: 120 agencies 1991-1992 Alcohol Directory: 120 agencies

welcomed LGB peoplewelcomed LGB people 1998-1999 Alcohol Directory: 17 agencies 1998-1999 Alcohol Directory: 17 agencies

make special provision for LGB peoplemake special provision for LGB people 2002 Alcohol Concern : only 7% of users of 2002 Alcohol Concern : only 7% of users of

450 alcohol treatment agencies in UK LGB450 alcohol treatment agencies in UK LGB Alcohol Concern, 2013: no publications and Alcohol Concern, 2013: no publications and

nothing on website about LGBTs and alcohol nothing on website about LGBTs and alcohol misuse despite research which identifies it as misuse despite research which identifies it as a problem: gone backwards!a problem: gone backwards!

FeedbackFeedback Were any points relevant to your Were any points relevant to your

service?service? Write on flip chartWrite on flip chart Who will take responsibility for Who will take responsibility for

feeding back to your feeding back to your management? (both good and bad)management? (both good and bad)

Preventing suicide in Preventing suicide in England 2012England 2012 LGBTs one of groups identified for whom LGBTs one of groups identified for whom

a tailored approach to their mental health a tailored approach to their mental health is necessary if suicide risk is to be is necessary if suicide risk is to be reducedreduced

Staff in health and care services, Staff in health and care services, education and voluntary sector need to be education and voluntary sector need to be aware of higher rates of mental distress, aware of higher rates of mental distress, substance misuse, suicidal behaviour and substance misuse, suicidal behaviour and ideation and self harm amongst LGBTsideation and self harm amongst LGBTs

NHS Training videoNHS Training video What do you want from the NHS?What do you want from the NHS?