Collaboration • Knowledge • Leadership
Rainbow Health Australia’s Jackson Fairchild isn’t hesitant on their stance: “All LGBTIQA+ Victorians deserve the freedom to choose the mental health service that is right for them.
"We absolutely support Mental Health Victoria’s call for an ongoing significant boost in funding for LGBTIQA+ community-controlled organisations.”
“LGBTIQA+ community-controlled organisations are critical areas of practice excellence and of innovation and leadership in the issues of mental health.
"They’ve been doing this work for decades now, largely unfunded or with piecemeal funding, often brought over from other priority areas such as drug and alcohol or bloodborne virus money. It's critical that we begin to recognise that work and elevate that work.”
MHV's budget recommendation is for $10 million to be allocated per year to support LGBTIQA+ organisations in their work on community mental health.
Rainbow Health Australia’s research into the health of LGBTIQA+ people, Private Lives 3’s Victorian Report, showed that LGBTIQA+ Australian adults and young people experience disproportionately high poor mental health outcomes.
40.4 per cent of participants reported considering suicide in the last 12 months, with 73.2 per cent seriously considering suicide at some point in their lives. In the four weeks prior to participating in the study, 54.3 per cent of participants reported experiencing high or very high levels of psychological distress.
Private Lives was released last year with Writing Themselves In 4, another major research initiative that focuses on the health and wellbeing of younger LGBTIQA+ people.
As Jackson points out, “Both of these studies were conducted prior to COVID-19, and we know from hearing from our community advocates and services there was an alarming increase in poor mental health and demand on services since the pandemic began.
“This is not new information,” they say, pointing to the experiences of discrimination that people in the LGBTIQA+ community continually report. “These issues are very much long standing.”
Jackson suggests an LGBTIQA+ community-controlled Centre for Excellence would be a good place for work to begin on consolidating mental health supports for the LGBTIQA+ community. Such a centre, they suggest, would be a much-needed space to map and identify community needs, examine the research and form nuanced recommendations.
“These organisations are not sufficiently resources to provide consultation and expertise when required,” they say. “These questions are often asked on an ad hoc basis which makes it difficult for organisations to strongly and consistently advocate for their position.”
Research is also a strong priority, Jackson says, as piecemeal funding has led to an issue which heavily affects the efficacy of mental health services in this area, namely continuity of workforce.
“It's fantastic to see Rainbow Door funded to deliver their services, but more needs to be done and that funding needs to be ongoing,” Jackson says. “Ongoing unstable funding means that it's difficult to develop a coherent and consistent workforce with the skills necessary to meet these high levels of need.
“It's very difficult to develop physical spaces or to build the relationships that you need with other services and to create pathways that really work.”
People in the LGBTIQA+ community have the option to participate in mainstream services, but the existence of community-led, community-controlled services is vital.
“These services are run by and for LGBTIQ people, for the community, which allows for really ready engagement,” says Jackson. “There's existing relationships; rich connections.
"By providing services, through community development, engaging with people's health needs through social events and elements of pride and celebration, it allows those services to not only provide a sort of channel for information, but to demonstrate what best practice that is customised and tailored to the needs of those communities looks like.
“The option of a health service controlled by their community can start someone on their mental health recovery journey earlier. Social dimensions form an important part of mental health. Having that link with community allows organisations to support community connection, an important protective factor in suicide prevention, and to support people to develop a sense of their own community and identity as might be appropriate for their culture.
“The other key element here is that LGBTIQA+ community-controlled organisations are accountable to their communities as their board is made up of members of the LGBTIQA+ community.”
Private Lives 3 found that some members of the LGBTIQA+ community prefer to use a mainstream service that is culturally safe for them.
“We know that when LGBTIQA+ people access mainstream services, they're often looking for what we call ‘green lights’ that they may be safe and that they are in the right place for them,” says Jackson.
“One experience of discrimination or prejudice, no matter how inadvertent or accidental that may be, can lead to someone falling through the cracks of the system and not engaging for some time, if at all."
The potential of being put off in this way can have a huge impact on a person’s decision to receive help with their mental health.
“We know that when people walk through the door, they're looking for signs that they're going to be safe, that they're going to be seen, that they're going to be given the specialised healthcare or mental healthcare that tailors and meets their needs.
"They want care that recognises the unique experience of the world and doesn't attempt to treat everyone the same, but rather meets them where they're at and provides appropriate and connected care. That’s why we need more LGBTIQ culturally safe mainstream services, like those who have achieved Rainbow Tick accreditation.”
Provision of early trauma-informed care can achieve the early-stage engagement in mental health services that prevents a need at a crisis point. These early initiatives can help reduce spending further down the line and save the suffering of many. When crisis does occur, specialist bed-based services play a vital role in supporting recovery.
“It's critical that we provide services that encourage regular engagement earlier on rather than late-stage engagement where things have already gotten to crisis point,” says Jackson.
The Victorian Government has been making investments in works for the LGBTIQA+ community, Jackson recognises, and further investment would help ensure those initiatives are given a chance of success.
“We really welcome the investment into the Rainbow Door program, Victoria's HEY program — the Health and Equal Youth Project — as well as the investment into the Royal Children's Hospital and Monash Health gender clinics and the investment in supporting community organisations and peak bodies to provide peer services to support people to navigate services.\
“But more needs to be done to achieve a system where LGBTIQA+ people have the freedom to choose the supports they need to live happier, healthier lives."