We heard how people face a “double burden” of coming out as gay, lesbian or bisexual and also disclosing a mental health issue. Some said the stress they experienced because of discrimination based on their sexual orientation contributed to mental health issues and addictions. Lesbian, gay and bisexual (LGB) people are at greater risk for certain mental health issues, including depression, anxiety and substance abuse disorders.  These often relate to experiences of discrimination. LGB youth are more likely to have experienced suicidal thoughts or attempted suicide than heterosexual youth. 
We heard concerns about stereotypes that gay, lesbian and bisexual people are assumed to be “mentally ill,” even though being gay is no longer identified as a mental illness in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Some people told us of homophobic remarks from mental health service providers, or that their service providers lacked understanding about their experiences relating to sexual orientation.
I was sent to a psychiatrist at [a hospital]. When I mentioned to him that I am gay and wanted to talk about it, he wasn't ready to listen, because he was "not an expert in that area"! I had to wait another five months before I met a gay-friendly counsellor at [a community mental health agency]. – Survey respondent
We heard about homophobic comments from other clients within a service environment, which may be dealt with inappropriately by service providers. Within mental health services, same-sex partners may not be treated as legitimate family members, preventing them from getting information about someone receiving treatment or support.
 Allen M. Omoto & Howard S. Kurtzman, eds., Sexual Orientation and Mental Health: Examining Identity and Development in Lesbian, Gay and Bisexual people (Washington, DC: APA Books, 2006); S.D.Cochran, J.G. Sullivan, & V.M. Mays, “Prevalence of Mental Disorders, Psychological Distress, and Mental Health Services Use among Lesbian, Gay, and Bisexual Adults in the United States,” (2003) 71 J. of Consulting and Clinical Psychology 53; I.Meyer, “Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence” (2003) 129 Psychological Bulletin 674; as cited by W.B. Bostwick, Mental Health Issues among Gay, Lesbian Bisexual and Transgender (GLBT) People, (National Alliance on Mental Illness: 2007) online: NAMI www.nami.org/TextTemplate.cfm?Section=Fact_Sheets1&Template=/ContentManagement/ContentDisplay.cfm&ContentID=54036, retrieved 5 August 2009.
 For a review of the literature, see Dean L, et al., “Lesbian, Gay, Bisexual, and Transgender Health: Findings and Concerns” (2000) 4:3 J. of the Gay and Lesbian Medical Association 101.
 Elizabeth Saewyc et al., Not Yet Equal: The Health of Lesbian, Gay, & Bisexual Youth in BC (Vancouver, BC: The McCreary Centre Society, 2007) at 31.