Ms Moninne Griffith:

I am executive director of BeLonG To which is Ireland's national LGBTI youth organisation. I have been there for two years. I have also been a member of the Government's task force on youth mental health and I am on the oversight of the Government's LGBTI+ youth strategy. Much of my work over the past two years has been focused on the mental health and well-being of LGBTI young people in Ireland. Dylan Donohue is with me today. He is a 16 year old person from IndividualiTy, which is our Dublin-based transgender youth group. He has a particular interest in the mental health and well-being of young transgender people in Ireland, and has recently won a prize at the BT Young Scientist and Technology Exhibition for his work in this area.

BeLonG To works with about 150 young people over a fortnight through our Dublin flagship service. We also support a network of more than 30 LGBTI youth groups throughout the country, co-hosted with some of the national youth groups such as Foróige, Crosscare and Youth Work Ireland. We run anti-bullying campaigns like Stand Up, which is the largest anti-bullying in secondary schools in Ireland. It addresses some of the root causes of the harm done to young people's mental health and well-being in schools.

Our services are holistic. We recognise LGBTI is just one part of a young person's identity. We work closely with our colleagues in the Migrant Rights Centre of Ireland and Pavee Point because our LGBTI young migrants, immigrants and Travellers experience sometimes double or triple stigma because of their sexual orientation or gender identity. We provide an array of services. Youth work is very important for LGBTI young people, as is peer-to-peer support. Our Monday chat service is a one-to-one non-counselling support service for young people. We are running a pilot with Pieta House where counselling is provided free of charge to young people who are self-harming or experiencing suicidal ideation. Another aspect of our role is running mental health training courses for mental health professionals in partnership with Jigsaw.

In our youth groups, mental health workshops for young people are mandatory. We run them in each quarter throughout the year. To give the committee some context, since the marriage equality referendum, we have seen over a 100% increase in the number of young people coming into our service. I think that is because they feel accepted and recognised. However, many of the young people coming to us come because they are experiencing a crisis. Many LGBTI young people will never come into our service because, thankfully, they have loving supportive families and communities. They have come out and are happy in themselves. However, for those who do come into our service, very often they require a good deal of support to come to terms with who they are and to come out to their parents and in their schools.

We have also surveyed the young people who use our services regularly on a needs analysis. Mental health issues come up repeatedly as the number one issue. That is not surprising. Many in the room already know about the LGBTI Ireland report published last year. It was paid for by the National Office of Suicide Prevention, which generously supports us, especially our mental health work and the work we do throughout the national network. It found that, in comparison with the My World national youth mental health study, LGBTI young people have three times the level of self-harm, experienced three times the level of attempted suicide and are four times more likely to experience severe or extremely severe stress, anxiety and depression.

Among LGBTI young people aged between 14 and 18, 56% have self-harmed and 70% have had suicidal thoughts. One in three has attempted suicide. That is something our youth workers are dealing with on the front line every day in our youth groups. A very strong link was found between a young person having experienced LGBTI-based bullying and serious mental health difficulties. We knew this anecdotally but the report was able to prove the link. One in four have missed or skipped school to avoid negative treatment due to being LGBTI. Those who have experienced this bullying have much higher levels of depression, anxiety, stress and alcohol and drugs misuse. They are also more likely to self-harm and have suicidal thoughts.

Some of the challenges we recognise belong to them. The usual problems accessing mental health services for young people in Ireland such as waiting lists and gaps in primary health care affect LGBTI young people throughout the country as well. However, the added barriers and challenges are the lack of awareness or understanding or capacity among some mental health care professionals who have not had the training or are not aware of the particular needs or situations experienced by LGBTI young people in Ireland.

We have a particular problem with transgender young people accessing mental health services, and Dylan may speak more about this, but this is something that is urgent. To access health care and legal gender recognition, transgender young people must get a diagnosis of gender dysphoria. In practice, because there is no one else in the country able to do this at the moment, this means they are pushed into the child and adolescent mental health services, CAMHS, pipeline. They are sometimes waiting 18 months to two years to access that service depending on where they are living in the country. The CAMHS service is one for acutely unwell young people. Some of these transgender young people are not experiencing acute mental health illnesses. However, this is the only pathway they have to get this diagnosis so they can access health care or legal gender recognition. The stress of waiting, as can be imagined, can mean that if they did not have mental health problems at the beginning of the process, they may end up having them after such a wait.

Young people in BeLongG To have told us how, even after accessing CAMHS, that health professionals ask them what they are doing accessing the service. They tell them that they are not suicidal or self-harming, and then send them back out without the diagnosis that they need. Sometimes the professionals do not have the capacity or the training and the young person never receives the health care they need. It is very urgent. I understand that the HSE is looking into developing a specialist unit in Ireland that could provide a wrap-around psychosocial service to young transgender people that would provide them with all the services they need in their health care, mental health care and so on. It is urgent that this would be made available to them as soon as possible.

We know that the causes of mental ill health among LGBTI young people are not because they are LGBTI. We know from the report that this is related to stigma, which unfortunately remains in Ireland despite the significant progress in areas such as marriage equality and gender recognition. We know it relates to fear of rejection, social exclusion and bullying. We know that this is happening in our schools, communities and even in some of our homes, despite significant progress being made recently. We also know that there is not enough resourcing or investment in early intervention and prevention or primary care that would deal with some of the speed bumps in the road that LGBTI young people encounter and that may have an adverse affect on their mental well-being. If those are not in place early enough, by the time that they come into us they are already in crisis, and we must refer them on to an already overburdened system where sometimes they cannot access the care that they require.

One major barrier to young LGBTI people accessing mental health care is the requirement for parental consent for 16 and 17 year olds. This affects all young people, regardless of gender identity or sexual orientation. In the case of LGBTI people who are not out to their parents because they are unready or because their parents may not be supportive of their sexual orientation or gender identity, this could pose significant harm to their mental health and well-being if they come out. We see this very much as a barrier. I know it is being looked at in the review of the Mental Health Act. It is something we see as a significant barrier for young LGBTI people.

Among the things we suggest might help the mental health and well-being of LGBTI young people are the removal of the requirement of consent for 16 and 17 year olds and the introduction of the UK-style Gillick principles whereby when a young person wants to access mental health care supports and treatment, the health care professional can deem whether he or she has the capacity to consent to that treatment. We also suggest LGBTI-proofing policies, procedures and practices within the mental health care system. Information and awareness training should be increased so that there is increased capacity among mental health care professionals to provide the supports and services that are required to meet the specific needs of LGBTI young people. Funding should also be increased to youth organisations which undertake this often life-saving LGBTI youth work at the early intervention and prevention stage.

I will now hand over to Dylan in case there is anything he wishes to add.