Being gay and mentally ill : the case study of a gay man with schizophrenia treated at a community mental health facility

M. Singer

Gays and lesbians with major mental illness often spend their lives within the public mental health system, in which the existence of gay-affirmative programs is a rarity. This potentially alienating situation is often exacerbated by gaps in the training of psychodynamic clinicians that leave important issues of sexuality unexplored in most programs' core curricula. The Lesbian, Gay, Bisexual and Transgender (LGBT) Affirmative Program at the Heights Hill Mental Health Center in Brooklyn, New York is an exception to this common state of affairs. This case presentation describes the two-year treatment of a gay man at the Center diagnosed with schizophrenia. An important portion of the therapeutic work was disentangling the two issues of the patient's minority status: being gay and mentally ill. At the beginning of treatment, the two categories were undifferentiated for him, and the difficulties of being gay were mixed up with the difficulties of schizophrenia. Over time, the work to expand and clarify what it meant to be gay helped free the patient to explore the relationship between his sexuality and other components of his core identity. Ultimately, the patient's notions about himself expanded and deepened: being gay took its place as one of his core attributes, but was not his only link to the outside world. The clinical work helped the patient to acquire more of a sense of his complexity as a human being, and just as important, a sense that being complex was normal.[Copies are available from: Haworth Document Delivery Center. The Haworth Press, Inc., 10 Alice Street, Binghamton, NY 13904-1580, USA]