Better understanding is needed of LGTBQ mental health issues

Disability Law /
Rupa Karyampudi
Latest posts by Rupa Karyampudi (see all)

By Tony Poland, LegalMatters Staff • Receiving mental health care can be a challenge for those in the LGTBQ community, says Toronto and Markham-area disability lawyer Rupa Karyampudi, who calls for more awareness and understanding of the problem.

Karyampudi, a partner at MK Disability Lawyers, says Pride Month is a good time to reflect on the struggles gays, lesbians, bisexuals and transgendered people face. 

She says even though society is generally more accepting of the community at large, these individuals still face hurdles when filing long-term disability claims.

“Based on my own experience representing LGTBQ clients I would say there is a higher rate of unresolved mental health issues in their community,” Karyampudi tells LegalMattersCanada.ca. “Much of it is due to stigma and discrimination that exists in the health-care system which is preventing people from accessing treatment. It is causing many people to delay or forgo necessary care which can aggravate the condition and even make it worse.”

Subtle and systemic discrimination remains

She says while it can be argued society “has gotten past a lot of the more blatant discrimination, there’s still subtle and systemic discrimination” that leaves many hesitant to seek the help they need and deserve.

“There is anti-discrimination legislation but it only covers the most blatant form of discrimination that you can easily prove, Karyampudi says. “Unfortunately, the more subtle and systemic forms do not fall within our present legislation.”

She points out that it wasn’t long ago that being gay “was seen as a psychiatric disorder and listed in the Diagnostic and Statistical Manual of Mental Disorders.”

That changed in the 1970s but prejudice still remains, she says.

A recent report in the Psychiatric Times found “clinicians may both consciously and subconsciously discriminate against members of the LGBTQI community.”

“For decades, psychiatry viewed being gay as a degenerative disorder. It created a deep scar that the mental health industry must now work to mend by setting aside biases, broadening our understanding, and earning the trust of LGBTQI patients,” writes Summer R. Thompson in the report. “To do so, it is vitally important to refrain from making assumptions about a patient’s gender, sexuality, or sexual identity. It is always necessary to ask about an individual’s pronouns. Do not refer to them as preferred pronouns; they are simply pronouns.

Karyampudi says there is a “distrust for the health-care system” that is justified in many cases.

Help may not be available in small centres

“You can see why that would be the case and as a result some people struggle to find appropriate health-care providers they feel safe with,” she says. “There are some specialty clinics for the LGTBQ community but as you can imagine there is probably a long waiting list.  And those clinics may not be available in all areas of the province. If you’re in a smaller centre you may not have access to specialized health-care.”

Karyampudi says the social stigma of seeking help for a mental health issue can discourage people from seeking treatment. It can be especially daunting for someone in the LGTBQ community who may be afraid to consult a doctor because of mistrust, she says.

Those with a legitimate issue may not seek treatment or file a claim for long-term disability, says Karyampudi.

“Based on my knowledge and experience, I believe there is an under-reporting of disability claims, for a whole host of reasons,” she says.

Karyampudi says that apprehension can extend to the legal profession as well.

“Because we’re dealing with disability claims, some of the questioning and discovery can be quite intrusive and traumatic. I try to minimize that by learning what types of questions can be triggering and upsetting,” she says. “I will talk to the lawyer on other side ahead of time about the appropriate way of getting information that is relevant to see if we can get it in a way that is not distressful.”

Karyampudi says her firm is “trauma informed.”

“We recognize our clients may come with a variety of traumas,” she says. “We acknowledge that the legal system can often trigger distress and try to minimize that as much as possible.”

Many do not realize they can file a claim

Karyampudi says there are many people who do not even realize they can file an insurance claim for a mental health issue that prevents them from working.

The first thing they should know, she says, is that is it important to seek professional help and document the care received. Karyampudi says there is also a limitation period that begins when the claim is filed.

She says if a claim is denied, it doesn’t necessarily mean that is the end of the matter.

“You have a right to appeal,” Karyampudi says. “A denial can also cause stress. We try to alleviate some of that by going after the insurance company to get the benefits we feel they deserve.”

She encourages those in the LGTBQ community facing a mental health issue to reach out for help to following resources:

Karyampudi says the goal is to get people benefits so they can continue to receive treatment, but she realizes that some may be intimidated by the process.

“Many are nervous about litigation in particular and lawyers in general. Some may not have the same social supports as other people and may be having trouble coping,” she says.

“Often there is a fear of authority figures, in both the health care and legal professions. I know that it can be daunting to find someone that you trust.

“We want to raise awareness. Our goal is to try to take away their fear and to make sure they are not being retraumatized in the litigation process. If our client is financially more secure that’s better for them and their mental health in the long run.” 

More from MK Disability Lawyers:

Insurance companies are watching. Do you know what to do?

Stress of the pandemic taking increasing toll on teachers