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By Kathi Wolfe

BALTIMORE – At the start of every school year when she was a teenager, Paula Lafferty, 37, said she was like every other teen, pledging to get good grades and hoping to get picked for sports teams. But two things set her apart from her peers: her bisexuality and her depression.

At 19, she began treatment from her bipolar disorder, also known as manic-depression.

"I went to boarding school, I was there because I was disruptive, which was due to my mental illness," recalled Lafferty, director of Hearts & Ears, a Baltimore support group for gays living with mental illness. "I'd go for three months, gettingo nly an hour of sleep a night."

Lafferty told her story on Oct. 25 at Mission Possible: a Conference Focusing on the Issues of Gay, Lesbian, Bisexual & Transgendered People Living with Mental Illness.

Nearly 150 people from the U.S. and Canada gathered at the New Shiloh Baptist Church in Baltimore for this event-the first to be held on this topic.

The gathering was organized by Hearts & Ears and the Committee on Sexual Minority Issues of the Maryland chapter of the National Association of Social Workers. Baltimore Mental Health Systems,Chase Brexton Health Services, Maryland Mental Hygiene Administration, Maryland Youth Suicide Program and On Our Own of Maryland provided funds and in-kind support.

Gays with serious mental illness have "virtually no voice in the mental health system," said clinical community psychologist Alicia Lucksted, who was a member of the conference planning committee.

"Often they are also silent in the GLBT community. That leaves people in an isolated place." Serious mental illnesses, she said, include disorders like schizophrenia, bipolar disorder, and clinical depression.

Lucksted explained that the illnessesare "debilitating and disrupt [someone's] life over a long period of time."

Stigmatized twice

Gays and heterosexuals with mental illness are stigmatized by society, mental health experts said. Gays, they add, encounter stigma in the mental health community and in the gay community.

Many lesbians and gay men receive counseling, said Steve Holochuck, an activist in the psychiatric survivors movement in Boston. This movement, also known as the consumer movement, is an advocacy and civil rights movement of people with mental illness.

"What gay [man] or lesbian isn't in therapy?" Holochuck joked, adding that he was "labeled as mentally ill" in the late 1970s. "A certain amount of 'eccentricity'-especially among gay men-is OK," he said. "But you can imagine the stereotypes [people have]around mental illness. They think you're 'psycho'-'crazy.'"

Gays are wary of "people with mental disabilities because for so many years the mental health establishment defined homosexuality as a mental illness," said Bert Coffman, founder of the Zappalorti Society, a New York support group for gays with mental illness.

Coffman, 53, began seeing a psychologist for the first time at age 7 and had his first breakdown during his adolescence. Describing himself as "gay with a capital G," he said, "I was at the June 1969 Stonewallrebellion." Yet, Coffman added, "I've been ostracized [because of his mental illness] when I've gone to gay groups."

Cookie Gant, president of Psychiatric Alternatives Alliance in Okemos, Mich., said she had a similar reaction from her peers.

"I'm an over-50 gay black woman," said Gant. "I have a multiple personality disorder. My gay and lesbian friends act like my mental illness in contagious." At times her illness causes her to behave in upsetting ways, Gant said. "Sometimes I start goin' off on folks. It hurts people's feelings."

Class is an issue "if you're GLBT and have a mental illness," Lafferty said. "I was stigmatized when I wasn't working and couldn't drive," she recalled. People are "OK with me now that I have a car and a middle-class job."

This acceptance only goes so far, Lafferty said. "People are fine if I'm upbeat about my mental illness." But, she added, they "turnaway" if she discusses the difficulties of having a mental illness, such as managing medication, finding emotional support and obtaining health insurance coverage.

Mark A Davis, 46, a gay man who has been HIV-positive for 14 years, said he lives with manic depression. "My HIV status is more accepted. It's in the gay community," said Davis, the liaison to the gay and HIV/AIDS communities for the Philadelphia Office of Mental Health. "I've been rejected from relationships. I'm a pariah. People are scared of mental illness."

Fear and ignorance are at the "core of stigma" in the GLBT community and the mental health system, Davis said.

Add in homophobia

Though gays have become more visible in and more accepted by society, they still often face homophobia when they seek mental health care, Davis said. "I couldn't feel safe in many treatment facilities sharing about my sexual identity."

In both in-patient and out-patient facilities, he said, "I might trust one person on staff but not the entire staff."

It can be dangerous for gays to come out in group homes for people with mental illness, Davis said. "Group homes are often located in poor areas. If you're out as gay, you could be gay-bashed in the neighborhood around the home."

Davis lived for a year in a group home in 1983. At the time, he wasn't open about being gay. He recalled that he would have to "sneak into downtown Philadelphia. I'd have to go to a bathhouse because the trains and buses wouldn't run until the next morning. It made me feel dirty."

Too often the mental health system views sexuality as a problem, said Dannia Southerland, a member of the research faculty of the School of Social Work of the University of Pennsylvania. "This is especially true when it comes to sexual diversity.Sexuality isn't seen as healthy. At best it's ignored. At worst it's pathologized."

Chris Kraft, an instructor and clinician at the Johns Hopkins Center for Marital and Sexual Health, agreed. "In mental health there's been a history of pathologizing a lot of minority groups," he said. "Homosexuality was just removed in 1973 from the diagnostic manual which came about from a lot of political work and research proving that there was no difference for homosexuals than non-gay lesbian people."

That hasn't fully happened yet on transgender issues, Kraft said. "Some people still pathologize [being transgender]," she said. "There's still a diagnosis that exists called gender identity disorder. I think that's a problem. But, I've heard some people sayits important because of insurance reimbursement."

Courtney Murphy, co-chair of Marylanders Advocating Towards Transgender Equal Rights (MATTER) in Baltimore, said that often transgender persons with serious mental illnesses "find it harder to get [mental health] services because of trans-phobia. Some mental health professionals don't understand what it means to be transgendered, "she said. "I was fortunate. The therapist I saw hadn't dealt with anyone who was transgendered before. But she did a lot of research, so she was able to help me."

Despite the difficulties and stigma, gay consumers and mental health professionals are fighting for change. Southerland, a lesbian,comes out to her social work students every year to "give them an opportunity to bring up clinical issues related to sexual diversity."

Holochuck said change will come about "through people working with the psychiatric survivors and gay liberation movements."

Copyright 2002, Used with permission from The Washington Blade.