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By December 7, 2022 No Comments

Authors: Georgie Hartigan, Chloe Wilson, Jemma Mead, Karen Field, Sarah Morrison, Ned Evans, Claire Smith

Year: 2022

Event: 2022 TheMHS Conference

Subject: lgbt, services, diversity

Type of resource: Conference Presentations and Papers

Abstract: LEAD PRESENTATION: Bridging the Gap Between Clinical and LGBTQ+ Community
Georgie Hartigan, Chloe Wilson

Stigma and discrimination create significant barriers to LGBTIQ+ people accessing mainstream mental health services. This reluctance to seek care, or to remain connected with mental healthcare providers, compounds other predisposing factors unique to LGBTQ+ communities resulting in significantly higher rates of suicide and self-harm than the general population.

The aim of this presentation is to present a holistic approach to suicide prevention integrating clinical and peer services, that are trauma-informed, and founded on the principles of inclusivity to support the LGBTQ+ community.

It is important that mainstream suicide prevention services are inclusive and affirming, particularly to the needs of specific priority groups. Flexibility to tailor services to effectively engage and support all lived experiences and intersections of identities and experiences is vital to reducing the barriers to appropriate mental health care. This can be achieved through the integration of peer workers as it centralises the voice and knowledge of lived experience within service design and delivery.

LEAD PRESENTATION: Implementing a Victoria Statewide LGBTIQA+ Family Counselling and Support Service
Jemma Mead, Karen Field

LGBTIQA+ individuals, families and communities are diverse, strong and resilient, however discrimination, abuse and violence towards the community impacts greatly on health and wellbeing. Rates of mental health issues, family violence, AOD and homelessness are disproportionately high for LGBTIQA+ people compared to cis-gendered and heterosexual people. Positive connection to family (in all its forms), peers, community, education and employment, financial and housing security are critical for good mental health. For LGBTIQA+ folks in rural and remote communities, this sense of connection and access to inclusive and safe services can be even more challenging. This is highlighted in recent LGBTIQA+ Victorian and national research.

"Participants residing in inner suburban locations reported lower levels of psychological distress, suicidal ideation and attempts and better self-rated health than participants in outer suburban areas, regional cities or towns or rural/remote locations." (Private Lives 3; The Health and Wellbeing of LGBTIQ People in Australia, p 117)

"Overall, participants in rural/remote and regional areas reported feeling less supported by classmates about their sexual sexuality or gender identity, and reported experiencing higher levels of psychological distress, and, in the past 12 months, suicidal ideation and attempts, and verbal harassment based on their sexuality or gender identity, compared to those in outer suburban and inner suburban capital cities." (Writing Themselves In 4: The Health and Wellbeing of LGBTQA+ Young People In Australia, p 173)

Drummond Street Services (DS) has been providing services to LGBTIQA+ individuals, families and communities for over 50 years. In 2009, we established Queerspace (QS), a LGBITQA+ mental health and wellbeing service for community, by community. Over the years, we have received increasing referrals for LGBTIQA+ folk in regional and rural communities who struggle to find local, inclusive services delivered by LGTBIQA+ practitioners. So, in 2021, we partnered with three family service providers across Victoria to establish the Statewide LGBTIQA+ Family Counselling and Support Service, Anglicare Victoria, Upper Murray Family Care and Mallee Family Care. The service is delivered from five regional locations, providing both face to face and online support, from Barwon, Kyneton, Morwell, Wangaratta and Mildura. The program offers two key activities:
1. The Q-Space Counselling and Support Service, providing wrap around, integrated support and counselling to LGBTIQA+ people, their families and support networks.
2. The Beyond the Rainbow capacity building training package, building LGBTIQA+ inclusion and specialist practice, enabling regional organisations to deliver more inclusive and affirming services to LGBTIQA+ Victorians and their families (family of origin and family or choice).

The service intentionally situates family support within a key life-course transitions framework, recognising the need for equitable, inclusive and safe specialist services within the family services sector. This is based on a social health ecological model of mental health and wellbeing, rather than ‘medicalising’ LGBTIQA+ people and thinking of mental health solely as a ‘health’ issue. Evidence shows that the risks for a range of poor health and wellbeing outcomes including mental health (and inversely, protective factors for wellbeing and to support recovery), are largely relational-social-cultural and reside in community, peer and family settings levels.

The Beyond the Rainbow capacity building component has advanced the clinical and practice models developed by DS and Queerspace, through the provision of training, mentoring, communities of practice, and ongoing support provided by DS to our partner organisations. This component of the project has allowed us to share our practice and research knowledge-tools and to continue to build and support capability within committed ‘mainstream’ family organisations that have a breadth and range of service provision within rural and regional Victoria. This has built specialist LGBTIQA+ clinical capability, and the application of an LGBTIQA+ lens over their entire suite of services, as well as strategic initiatives providing leadership within local service sectors, networks and communities that promote inclusion and responsive approaches at the local level. These services bring to the Q-Space Network access to well-known, recognised and experienced locally-based services that all have substantial reach and engagement with their communities.

This presentation will cover:
• The complex and intersectional issues faced by LGBTIQA+ individuals, families and communities, impacting on mental health and wellbeing
• The compounding impact of isolation and lack of inclusive services for LGBTIQA+ folk in regional and rural communities
• The establishment of the program across Victoria, including the focus on mental health and wellbeing across the life-course of LGBTIQA+ families
• The challenges and successes of embedding LGBTIQA+ inclusive services, delivered by LGBTIQA+ identified practitioners in mainstream regional services
• The impact of the service on mental health and wellbeing during the first 12 months of service delivery
• What we have learnt and recommendations

Embedding intersectional and inclusive service delivery in mainstream rural and regional services has made a significant difference to LGBTIQA+ individuals and families, increasing their sense of connection and belonging and supporting positive mental health and wellbeing outcomes.

PANEL PRESENTATION: Out Social - LGBTIQ+ mental health support group for identifying or questioning individuals.
Sarah Morrison, Ned Evans

Out Social is an initiative focusing on delivering monthly engagement to LGBTQIA+ individuals that are questioning/identifying. Out Social activities are designed to be inclusive, providing levels of social support that consumers desire due to ongoing isolation due to social stigma/mental health.

Out Social is designed from an evidence-based framework ensuring consumer preferences are at the forefront of the initiative. Participating consumers are also provided with mental health support and warm referrals into appropriate services if needed. Within the last twelve months consumers have been provided with suicide prevention training (QPR) as well as in-service delivery from other services within the greater MLHD.

Using codesign approaches, we are able to leverage off Out Social to assist in development of content for campaigns focusing on the lived experience of the LGBTQIA+ community. Members have been the drivers behind the implementation of relevant support pathways for identifying young people and have been encouraged to use their lived experience to assist in eliminating stigma faced by people from the LGBTQIA+ community.

Out Social has a heavy focus on utilising living/lived experience, community allies/advocates, and appropriate services providers to support the removal of stigmatising language, attitudes, and behaviors toward identifying individuals within the LGBTQIA+ community.

PANEL PRESENTATION: Reducing loneliness for youth and older Bi+ individuals through creative workshops and transgenerational peer support.
Claire Smith

LGBTQIA+ organisations are focused on improving wellbeing outcomes for the LGBTQIA+ community, however. Bi+ youth and older adults still feel isolated within the community, highlighting that the nuanced needs of this subgroup have not adequately been addressed. Critical and honest reflection of the LGBTQIA+ community structures and hierarchies, will provide LGBTQIA+ organisations with deep Bi+ community insights, that can be utilised to improve their current and future services for Bi+ youth.

Whilst there are support services available to the broader LGBTQIA+ community focused on increasing social connection and improving wellbeing outcomes there are few Bi+ specific services available in Australia. Based on the negative experiences such as rejection and microaggressions many Bi+ youth and older adults experience there is evidence to suggest that specific Bi+ loneliness interventions are required to meet the unique needs of this sub group.

The development of creative workshops dedicated to providing transgenerational peer support to Bi+ youth and older adults will allow a safe space for connection leading to a reduction in loneliness and improved wellbeing, whilst also providing vital data to assist in the development of future Bi+ youth and older adult specific services.

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