Abstract
Position Statement 83 ‘Recognising and addressing the mental health needs of people identifying as LGBTI’ was developed in response to member concern that a disproportionate number of Australia and New Zealand’s lesbian, gay, bisexual, transgender and intersex (LGBTI) population experience mental illness and psychological distress. The position statement was developed by the Practice, Policy and Partnerships Committee, in consultation with a number of the College’s expert committees and individual members.
LGBTI identity has historically been criminalised, pathologised or invisibilised by legal and medical institutions in both Australia and New Zealand, and worldwide. This has led to LGBTI people being exposed to institutionalised and interpersonal discrimination, which in turn increases vulnerability to mental illness and psychological distress. The LGBTI populations of Australia and New Zealand currently experience amongst the poorest mental health outcomes of any demographic.
Same-sex attracted people are up to 14 times more likely to attempt suicide, twice as likely to experience anxiety disorders and three times more likely to experience affective disorders compared with the general population. People born with intersex variations exhibit levels of psychological distress comparable to people who have experienced severe physical or sexual abuse.
The College outlines its support for marriage equality in the position statement, on the basis of the evidence showing the link between improved mental health outcomes and legislative change of this sort. Same sex marriage was legalised in New Zealand in 2013, however is not currently legal in Australia. The College’s support for marriage equality in the position statement was welcomed by diverse members of the community, and publicised widely by the media.
The position statement sets out recommendations for psychiatrists working with LGBTI people, including:
maintain an up-to-date understanding of LGBTI issues, and seek advice from the relevant organisations on correct terminology and other issues as necessary
be mindful of balancing the diverse views of the consumer, families, carers and others
avoid assumptions in language and approach, and promote inclusiveness and cultural safety for LGBTI people within services
consider registering with LGBTI health directories and displaying inclusive signage
services should take reasonable steps to accommodate the needs of LGBTI people receiving treatment, including recognising partners and addressing personal care issues as necessary
child and adolescent services should be mindful of the particular stressors young people who identify as LGBTI face, including issues to do with ‘coming out’, bullying and the physical and emotional changes that occur during puberty
enhanced statistical information and greater visibility of LGBTI people in data collection is required.
Ultimately the College emphasises the importance of maintaining a respectful and measured dialogue on these issues. This will be particularly important in Australia at the current time, as the marriage equality debate continues. Any discussions on these topics should keep the mental health of LGBTI people, and especially vulnerable young people, as the priority.
The new document, Position Statement 83 ‘Recognising and addressing the mental health needs of people identifying as LGBTI’ can be accessed on the College website, on the ‘Policy, submissions and reports’ page (www.ranzcp.org).