Reprinted from "LGBT" issue of Visions Journal, 2009, 6 (2), pp. 5-6
Family are the first to notice. My first contact with the mental health system occurred one evening when a friend of my wife’s and mine—we’ll call her Linda—came over for dinner. Linda seemed a bit off. Anxious and awkward, she told us that people at her workplace were invading her mind to control and manipulate her and others using some kind of psychic broadcast.
Linda was reluctant to even make eye contact with us, for fear those conspiring against her would identify and attack us too. I have a fairly open mind, but all this seemed highly unlikely.
A few days later Linda and I went for a walk. During our walk it became very clear to me that she needed medical attention. I calmly told Linda that we were going to head to the hospital. Luckily, she didn’t object.
At the hospital emergency I was torn between Linda’s request that I not tell anyone about the conspiracy and the need to give the nurse information to show how unwell Linda was. And I just couldn’t tell the nurse, in front of Linda, that I thought Linda was delusional.
Linda and I waited together in emergency until 7:30 the next morning. Linda became more and more disoriented and less responsive, and was unconscious when they finally moved her to a gurney in a hallway. I took some blankets and slept on the floor next to her. I stayed because I was afraid if I did not, she might not have anyone to advocate for her to get the help she needed. I left when she was admitted, still not able to tell the doctor privately the things Linda had told me.
The hospital kept Linda for a couple of days and then released her. We’d let our circle of friends, some of whom had been very worried about Linda’s strange behaviour, know she’d been in the hospital, and two of them were checking on her.
A few days after Linda had been released, one of these friends called us to let us know that Linda had not been seen at all for days and was not answering her phone. My wife went by and found that Linda had also left her door unlocked and ajar. My wife called the hospitals, found Linda at one of them and went to see her right away. Linda had been found unconscious in a hotel room and brought in by the police.
Linda had been completely non-responsive for hours, but when she saw my wife, she beamed at her and began to speak. I think that response convinced the hospital staff that my wife and I were important to Linda and would be useful in her care. The psychiatrist interviewed us about Linda, who still wasn’t talking much.
We visited with Linda while she was in the hospital and after, while she recovered. We informed her workplace, made sure her rent was paid and cleaned her place for her return.
During her year of break from work while she recovered, Linda came to events in the community we are part of, like the women’s softball league games and dances. She stayed part of our community.
Linda is now back at work and has been doing well for a few years. With her input and permission, her family of friends have created a plan to make a more formal safety net for her if she gets ill again. A web of friends keep in touch, and if Linda falls out of contact, one of us will go by to make sure she’s all right.
Families are the people who care
All the friends in my story above are lesbian, as am I. Our shared community is the lesbian community, part of the larger LGBT community. Lesbian, gay, bisexual and transgendered (LGBT) people often form “families of choice.” Linda is part of our chosen family.
There is a long tradition in LGBT communities of making our friends and partners into family. This comes out of supporting one another in the face of discrimination. Although some of us are accepted by our biological families, many of us have difficult or distant relationships with our biological family because of prejudice. So, we create families with one another.
These families of choice are every bit as supportive and loving as biological families. We care for our sick, support each other in times of loss, celebrate holidays together and mark each other’s births, marriages and deaths. When we end a relationship, our ex-partners often continue to be key parts of our families. We have distinct cultures, communities and webs of supportive connections that sustain us. There is a long tradition of making our friends and partners into family in LGBT communities, which comes out of experiences of supporting one another in the face of discrimination.
Family are the people who care.
We all need to care
This year is the 40th anniversary of decriminalizing private gay sex in Canada.1 Before 1969, a person found guilty of having consensual, private sex with someone of the same sex could be sent to prison indefinitely as a dangerous sex offender.2-3 At the time, many people thought homosexuality was a mental illness. In 1973 the American Psychiatric Association (APA) publicly declared that homosexuality was not a sexual disorder.4-5 Yet, organizations acting from prejudice still promote “reparative therapy” to ‘cure’ people of homosexuality—a practice now opposed by the APA on the grounds that it has not been shown to work, and there are reports of it causing psychological harm.6-7
The stress of discrimination continues to have serious health effects on LGBT people, who are at an increased risk for all stress triggered problems. These include mental disorders and problem substance use.8 LGBT who people need to hide who they are generally have worse mental and physical health than those who can be open.9
I now work on projects for the BC Schizophrenia Society (BCSS), an organization that helps family members care for their loved ones with a mental illness. One of my projects is an online support group for LGBT persons supporting a loved one with a mental illness. BCSS staff have been very receptive to me and to the idea of supporting lesbian, gay, bisexual and transgendered families. My colleagues understand how being doubly discriminated against as both a LGBT person and someone with a mental illness makes it much harder to access services and get help. Creating overtly welcoming health services is extremely important.
LGBT people and their families of choice are extremely resilient. These family structures may be unfamiliar to many people. But we all need to understand that families of choice are just as important as biological families to the successful recovery of our members with health challenges.
About the authorSophia is Manager of several projects for the BC Schizophrenia Society, and a consultant in private practice in areas including project management, health education and online outreach. She has designed and facilitates an online support group for LGBT persons supporting a loved one with a mental illness.
CBC. (n.d.). Trudeau’s Omnibus Bill: Challenging Canadian taboos [Video recording]. http://archives.cbc.ca/politics/rights_freedoms/topics/538/.
Klippert v. The Queen,  S.C.R. 822. http://csc.lexum.umontreal.ca/en/1967/1967rcs0-822/1967rcs0-822.html.
CBC News. (2005, June 14). Same-sex rights: The Supreme Court and same-sex marriage. www.cbc.ca/news/background/samesexrights/.
American Psychiatric Association. (1998). Psychiatric treatment and sexual orientation (Position statement). Arlington, VA: Author. www.psych.org/Departments/EDU/Library/APAOfficialDocumentsandRelated/PositionStatements/199820.aspx.
American Psychiatric Association. (1973). Homosexuality and civil rights (Position statement). Arlington, VA: Author. www.psych.org/Departments/EDU/Library/APAOfficialDocumentsandRelated/PositionStatements/197310.aspx.
American Psychiatric Association. (2000, May). Therapies focused on attempts to change sexual orientation (reparative or conversion therapies) (Position paper supplement). Arlington, VA: Author. www.psych.org/Departments/EDU/Library/APAOfficialDocumentsandRelated/PositionStatements/200001a.aspx.
American Psychological Association. (2009, August). Insufficient evidence exists to support the use of psychological interventions to change sexual orientation. http://www.apa.org/news/press/releases/2009/08/therapeutic.aspx.
Meyer, I.H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674-697. www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2072932.
American Psychological Association. (2008). Answers to your questions: For a better understanding of sexual orientation and homosexuality [Brochure]. Washington, DC: Author. http://www.apa.org/topics/sexuality/orientation.aspx.