LGBTIQ mental health crisis can't be ignored any longer
A critical but neglected issue in the reform agenda for the mental health system at both state and national level is addressing and meeting the needs of lesbian, gay, bisexual, trans and gender diverse, and intersex communities.
A large body of international and Australian research has established significant disparities in mental health for LGBTIQ communities, compared to the general population.
Recent national surveys of LGBTIQ health and wellbeing conducted by the Australian Research Centre in Sex, Health and Society have added to this picture, finding alarming levels of mental health diagnoses, psychological distress and self harm.
There are a thousand statistics in this research, but perhaps most concerning are levels of suicidality that are many times the levels reported in the general population.
And yet, investment in programs specific to LGBTIQ communities are a tiny percentage of mental health and suicide prevention funding. And LGBTIQ communities are rarely a policy or program priority at any level.
How can this be?
Prioritisation in both government policy and investment in services should follow research — that’s how to determine “at-risk” status for particular populations, and focus actions to address their needs.
So what more evidence do we need? And more importantly, what can we do about it?
The poorer mental health outcomes for LGBTIQ communities are not a product of individual pathology, but are related to experiences of stigma and discrimination, violence and abuse driven by homophobia, biphobia, transphobia and intersexphobia.
This context also contributes to barriers in accessing health and mental health services, due to actual or anticipated experiences of stigma and discrimination.
LGBTIQ communities have long been subject to social, political and legal exclusion. Unless policy and funding priority is allocated to changing this, exclusion will remain the default setting and the harsh reality for many service users.
We also already know from existing research what LGBTIQ communities want and need in terms of services — a mixture of services delivered by trusted and skilled LGBTIQ community-controlled organisations, and mainstream services delivered by organisations and systems that have committed and taken action to become truly LGBTIQ-inclusive.
The latter takes time, it takes effort — but many LGBTIQ lives depend on it.
We also know from demographic research that these issues will become more important into the future — with a growing proportion of young people identifying as sexually or gender diverse.
Greater social acceptance, legal reform and more positive representation in the media have made the lives of many LGBTIQ people easier over time as they are affirmed and supported to be themselves.
But stigma, discrimination, abuse and violence are still a daily experience for many — and the mental health impact is insidious and cumulative.
This cannot continue to be ignored.
Marina Carman is Director of Rainbow Health Victoria and Chief of Staff of the Australian Research Centre in Sex, Health and Society.
She can be heard as part of a panel discussion about service reform and vision arising from the Royal Commission’s final report, on Day One of the symposium Putting It All Together. Full program