 Hello everyone and welcome to the LGBTIQA Plus and Mental Health Collab Lab. My name is Erin Halligan. I'm the Director of Mental Health and Suicide Prevention at the LGBTIQ Plus Health Australia. My pronouns are she, her, and I identify as someone with lived experience of mental illness and suicide. My background is mainly in mental health and suicide prevention in both government and community sectors. I'd like to begin today by acknowledging the traditional owners of the land on which we come together. I'm meeting from the Wuradjuri Nation. I'd like to pay my respects to elders past, present and emerging. And I'd like to recognise that sovereignty of this land was never ceded and always was and always will be Aboriginal land. And so welcome everybody. I hope everyone's well and they're different places of the country. We've got a bigger audience here and I know you're all from different areas with different disciplines and roles. This is excellent because the spirit of today's session is to learn as much as possible about interdisciplinary collaborative care. And by the end of this session we'll hope to have both an increased confidence to participate in interdisciplinary collaborative care when responding to LGBTIQA plus mental health presentations and a better understanding of how interdisciplinary collaborative care can contribute to better outcomes for LGBTIQA plus community members who are experiencing mental health issues. Today we'll be working in three parts. In part one we'll be together in this main meeting room. I'll provide you with an overview of the field of LGBTIQA plus and mental health with a particular focus on why it's important that we talk about mental health within our community and particularly the most recent impacts of the COVID pandemic on our community and how it has exacerbated the vulnerabilities to mental illness and suicide. Part two is where, as they say here, the fun begins. You'll move to moderated breakout rooms where there will be a task to collaboratively develop a mental health plan for a vignette developed specifically for this activity. You'll be in safe hands. The moderators with selected for this task I'll introduce to you shortly and I'll also be dropping in and out of the rooms to touch base and see what's happening for us to all have come together talk at the end. And that leads you to the part three where we'll turn to the main meeting room and share our learnings and insights about the challenges, merits and hurdles to engaging with collaborative care in our community. I might get Emily to jump in now just to talk through how we can interact with the technology. Thank you so much, Erin. Welcome everybody. So just a reminder in part one and three, you can find the chat box located to the right hand side of your screen. And this can be used to engage with your other delegates and peers. From here, you can also send your other delegates direct messages. Certainly as well, please pop into the chat or the QA box if you have any technical issues and we'll be here to support as well. Just a reminder, your chat box is located on that right hand side of your screen. It should be that first icon and the Q&A is located just below that. Throughout the session, you may also be asked to complete a poll and that's the fourth icon down as well. Again, if you have any trouble locating these or have any tech issues throughout, please don't hesitate to pop it in the chat and we'll be there to support. Thanks, Erin. Great. Thanks, Emily. And I'll put my hand up to ask for your support if anyone else has any issues in the day. I'm mindful of the large numbers that we have for the interactions in the beginning and the end sessions as we'll all be coming together. And this will be limited to the chat feature. We won't be fielding content questions from here. You could send them via direct message or to an individual delegate. And again, if you want any advice from Emily, you can also put that in the chat function as well. In the part two areas, there'll be a lot of interactivity and each moderator will negotiate how this happens directly with the breakout rooms. So one of your first tasks, make sure your camera's on, make sure your microphone's muted and follow the lead of the moderator to establish how you're all going to work together. Great. So I'd like to begin by providing some context to why it's so important to talk about mental health and suicide for the LGBTIQ plus community. And also reflect on the particular adverse impacts COVID has had on our community. So next slide, please. And I'd also like to begin by acknowledging people with lived experience. The individual and collective contributions of those with lived experience essential to co-designing and delivering the work that we do. And every individual journey is unique and is a valued contribution to our commitment to the mental health and suicide prevention programs and advocacy. And I'd like to recognise and thank everyone here today who might be, you know, involved or have experiences or lived experience in however many ways, shape or form with mental health and suicide. So next slide, please. So why is it important we talk about LGBTIQ plus mental health? Although many lesbian, gay, bisexual, transgender, intersex, queer people and other sexuality and gender diverse people live healthy and happy lives, a disproportionate number experienced poorer mental health outcomes and have a higher risk of suicidal behaviours compared to the broader population. It's important to note that not all LGBTIQ plus experiences are a mental illness and not all LGBTIQ plus people experience the stress about their sexuality or gender identity. The adverse health outcomes can be seen often directly related to stigma, prejudice, discrimination and abuse experienced due to being part of our diverse community. Next slide, please. So here are some sobering facts for you to have a look at. As you can see, the rates of mental illness and psychological distress, suicide and suicidality are exponentially higher than the general population. This information I have here has been collected by LGBTIQ plus Health Australia and in its Suicide Data Snapshot and consolidates evidence that we've put together in our private lives report with the Trobe University. It's important to note in that this is privately, independently collated data as rates of mortality is currently not reflected in ABS causes of death data nor in any other health data such this places significant limitations on any real trends and subsequent funding and investment into mental health and suicide prevention programs and services and our understanding of the circumstances and impacts on the community more broadly. Next slide, please. And yes, so why are there worst outcomes for LGBTIQ plus people? LGBTIQ plus people are exposed to many experiences and factors that might not exist for non-LGBTIQ plus people. Basic experience that tend to increase a person's vulnerability in society are often more present. This can include homelessness, financial and security, poverty, workplace distress, unemployment, family and domestic violence, social isolation, clinical mental illness, diagnosis, poor access to primary health and poor access to mental health care. These vulnerabilities are compounded in times of heightened environmental risk and disasters where the experiences of these risks are escalated. Next slide, please. So I'd like to talk to a study that LGBTIQ plus Health Australia has recently done in partnership with the Australian Research Centre in Sex, Health and Society at the Trobe University. And it looks at the impact of the COVID-19 pandemic and its impact on LGBTIQ plus people in Australia and their mental health as well as rates of family and domestic violence and economic situations. So next slide, please. So the report highlights the challenges and health disparities of the that are already experienced by LGBTIQ plus people prior to the pandemic that have been further exacerbated during the pandemic in the face of the new challenges. These findings will be used to address the unique and challenging needs of people going forward and now in future crises. We often reflect on circumstances with flooding and climate change and broader social and environmental impacts that, you know, can be identified with the same level of touchpoint for the vulnerabilities of our community. And this report is looking to kind of inform, you know, inform our responses going forward. Next slide, please. So as you can see from this data, almost two thirds of participants felt that their health and well-being had gotten worse since the beginning of pandemic of these respondents who had received a previous mental health diagnosis. Seventy one percent recorded their condition worsening. The group of participants highlighted that the changes in their financial situations, their social social isolation and unsafe living environments were often the driving force for a decrease in their health and well-being. More than half of the participants experienced some form of change to their employment circumstances during the pandemic. Next slide, please. Almost one fifth experienced violence from an intimate partner during the pandemic and more than a quarter experienced violence from a family member. Most participants reported less social interaction with the families of origin, chosen family and friends. But seventy five point eight percent also recorded an increase in the use of social media and online platforms, which is a good buffer for this social isolation, given that we already know that is a significant part that already impacts the mental health and suicidality of people in the LGBTIQ plus community. Additionally, the use of tobacco, alcohol and other drugs increased with over eighty three percent of participants who consumed alcohol and consuming more during the pandemic period. So what I'd like to recognise again is this data is obtained through independent research. LGBTIQ plus data continues to remain uncaptured in Commonwealth health data and as such, there continues to be limitations in our understanding when being able to apply any of what we know and what we understand to proper investment and service provision for our community. The government policies consistently reflect LGBTIQ plus people as a priority population. So there obviously is broader recognition by government that this is an area that needs to be addressed and, you know, we need to have a priority for more work to be done on this, particularly data to resolve this issue. Currently, the National Suicide Prevention of officers developing a new National Suicide Prevention Strategy, which we are closely working with them on to make sure that we include some of these recommendations and the findings of this report. If you go to the next slide, I have put in there some brief detail on our website where you can find the report, but I'm also happy to circulate the resource information, as I can see that coming up as a question for people more generally on our website and on Lautraub's website. So that's my background to the presentations. So I thought I should now introduce you to our moderators. So we have Nova Delaney, who is a consultant psychologist and a board-approved supervisor that operates exclusively in the field of eHealth telepsychology provision in Australia. Emma Love, who works with Diverse Voices, an LGBTIQ plus peer helpline. Emma's experience in mental health and well-being with the LGBTIQ plus community. Brent Mackey, who is the director of policy strategy and research at the AIDS Council of New South Wales. He has experienced an expertise in communications, population health, sexual health, drug and alcohol and mental health policy and research. And Dan Maida, who has extensive experience in narrative practice and currently works with the Dullet Center. So welcome everybody and you will obviously have more detail to talk to about your respective careers and expertise in your breakout rooms. So I'll leave it there. And I would like to get perhaps Emily to jump in to get you out all into your groups, to pop into each of your groups. And it seemed like everyone was really engaged and dynamic and I've just noticed here that there's a comment about it being the most emotional session. And I really just want to pick up on that because talking about these particular case studies and vignettes is a really kind of an intimate experience. And it's always important when we talk about mental health that we do check in and just reflect on sort of individually stuff that we've talked about and how it may impact us as people with lived experience or people who might just be newly absorbing information. And so, yeah, so I just reiterate just being able to have some space for yourself to regroup if you need it. Having said that, we are needing to push on the time a little bit. So I managed to pick up on some great sort of topics just off the little bits that I've heard and what's been really interesting is picking up on some of the issues around intersectionality and the collaboration across services and picking up on where existing services can be better connected with the community and how we can better support them to be able to engage. But I will throw to my team of people who, well, not my team, the team of people who are conducting these sessions. So Nova, would you like to start? You're on the top of my list, so apologies. Sure, so I think the group with my vignette, we really sort of really tried to explore and understand how to check our assumptions, understand that we may not or accept that we may not know what we're doing or be as culturally competent as we need to be and be as client centered as we really can. So going from this bottom up approach of how the individual is interpreting themselves, their world, their priorities and where they're wanting to work. It was a very complex vignette and I do thank the group for sort of sitting with the complexities and how there was just a lot of things to challenge and think about the humility that was within the room around just trying to do the best with what we have and what we know and being really quite humble within that. Yeah, great. Thank you. That sounds like a great outcome for that. Emma? Yeah, there was, I think a real sense of overwhelm in terms of the complexities felt by our delegates in my breakout room. There were, again, same as sort of Nova in that my vignette was quite complex and there was a lot going on. There's a lot felt in terms of the collaboration between all service providers and what might be available in a city versus regional as well and how to manage those sorts of things focusing on how to stabilize a person and all the different complexities and levels in which that would need to occur and the barriers that they face as well. So in terms of, you might have all of these excellent providers but they all have extremely long wait lists or available at different times as well. So yeah, so that was very difficult. We all sort of agreed that providing a wraparound support and safety net for the person would be very beneficial and that's where a lot of us would start but being able to effectively do that with the barriers and the lack of those providers being in place, especially ones that are trained and knowledgeable within the rainbow community were certainly felt, yeah. Great, thank you and Brent. Yeah, we had a great discussion in my breakout room and again, we really looked at a range of, obviously we had a, the person in the vignette had multiple issues and the intersectionality of a whole lot of various components of their life impacting on the issues for that person. So we really looked at ways that services code could become more inclusive and more understanding of the issues for LTPTIQ people but also because the vignette also overlapped into Aboriginal and Torres Strait Islander communities, how they can work with the person in the vignette to work with those communities in terms of putting a recovery plan for them, which is really heartening to see from the discussion in the group. We really talked about obviously how to prioritise what was important and how to work with the person in the vignette in terms of working on how to first, you know, developing inroads into providing services for them and getting them into services, which was, you know, it's a complex area, much like Emma and Nova's vignette. And so we talked around where we would go with that. But really, I think it's developing a care plan that looked at a multiple range of services engaging with this person, including mainstream services, but possibly specialist with LTPTI or Aboriginal and Torres Strait Islander services. Looking at a case manager or process, I think it was a discussion around a really interesting sounding service in Victoria around, I think it was called Model and Complex Needs Care Admission, but working around that management plan involving a range of different services to work with the person in question. Yeah, but also acknowledging, I mean, importantly, that these services have to be understanding of and inclusive of LTPTI people and other cultural and community factors that have come into play. Great. Thanks, Brent and then. Thanks, Erin. We were speaking about a non-binary neurodivergent young person of color living with chronic illness, which, you know, sounds like a lot of things. Also sounds like most of the people that I work with. So really a common combination of experiences and identities. In particular, one of the things we spoke a lot about was the intersection of transphobia and racism, the experience of experiencing racism within LBTIQ services and communities, the kinds of expectations that both mainstream and LBTIQ services might have around coming out that can be, you know, essentially like centering white experiences and maybe a really inappropriate kind of binary for people of color or people with cultural communities that are not from the white Christian Judeo complex. We spoke about the importance of having services that can support families, which again, when we have, you know, individualized support, that can be something that really falls short and can make a huge difference in terms of safety of trans young people in particular, but also well-being because, you know, especially when we're thinking about the pandemic and young people being at home with families who may not know how to use their preferred name and pronouns, that can be a highly stressful experience without the opportunity to move into community spaces where they are being referred to in their preferred ways and seen in those other parts of their experience. I think that really as well, we just acknowledged that the idea of trying to facilitate interdisciplinary care is not at all easy when we're thinking about this stuff. It's a totally different conundrum if you're in a metropolitan region versus a regional area because in regional and remote areas, the services just don't exist. The safety concerns are different and it can be really hard work trying to imagine who we might refer folks to and whether that's going to be a safe enough kind of service. So what's our responsibility as practitioners to kind of go above and beyond and do the work of finding out about what are the practices of these services that we're referring to? What is their level of skill and competency? What do they need to know about the name and pronouns that, you know, are used by the folks that we work with and in what circumstances in order to keep them safe? So, yeah, I guess the only one other thing I mentioned, which I think is really important to consider is considering sexual violence services and such. You know, obviously domestic violence services will fit within this as well, but services that are likely to be quite binary gendered centric and what it might look like for non-binary folks navigating those services, especially for folks who've experienced sexual violence from women or trans folks. Obviously queer and trans people experience sexual violence at comparable and higher rates as cis women. So if we are not ensuring that those services can not make assumptions about the gender of the perpetrator and things, we can make sure that they are more inclusive. Anyway, there's a lot of work. We've all got to do. Woohoo! Woohoo! Thank you. Thanks so much, guys. That was really good. And I think, I mean, I think so a few takeaways. Firstly, the word complexity and complex has obviously come up in each of your feedback. And I think that's a really important thing to pick up on because I think often in the world where the LGBTIQ plus people, you know, service providers and community workers, we kind of become a little bit lost in how complex the group is, our community is. And it is, we're talking about, you know, what they say, diversity within diversity. We've got in LGBTIQ plus people, we've got all these people from all backgrounds with all different needs and being able to come up with particular situations and vignettes where, like you said, Zan, although it sounds complex, this is sort of people that we engage with often and all the time. And these are the people who sort of present and, you know, first and foremost in needing support because of all these barriers. So I'm really glad that that was picked up on and I'm really grateful that everyone kind of was able to engage and, you know, feel compelled to contribute, even though there was that huge complexity there. And noting as well that the emotional toll that takes in those discussions. I think that the two bits that I can identify have come up with was the idea around wraparound services and taking person-centered approaches to care and looking at how to connect existing services and provide inroads for collaboration with stuff that's already happening, having care plans for people to be able to, like, move through the system and identifying where the barriers might be that we could improve the service system to help support the community better. I think the other area that we talked about a lot was the intersectionality of the community and intersectionality across different areas. I think we noticed people talking about racism and sexual violence and gender and then, you know, just you're saying then, you know, Aboriginal community groups and how the challenges are in being able to connect those levels of vulnerability that coexist already with the vulnerabilities that the LGBTIQ plus people already have. And these are big questions, you know, we don't have answers to these and so that's why these discussions are really good and important and I'm really, really motivated that everyone's kind of been out to have these, yeah, these meetings and talks. So, now, where are we at? So that's with some of that up. I think we've got a bit more time. Was there anything else, Emily, that we needed to touch base on? I know some people were doing some polls. Did they get reflected anywhere? Hi, everyone. Yeah, the polls in the breakout rooms and they're not currently in this session, but what we would love to encourage everyone to do is get started on the event survey. So that's just located on the right hand side of your screen and it's available there to start completing. But certainly, Erin, if there wasn't anything else, I can let everyone know what's coming up next as well. Yeah, look, I just wanted to again take the opportunity to make sure that we all take some space to reflect on things that we've talked about today, to be able to have some self-care and recognise that all these conversations are very challenging and confronting and we're talking about things that are very, distressing for a lot of people and distressing for people to hear about should you not have been exposed to these stories before and also people with lived experience of mental illness and mental distress and suicide and suicidality. Myself, as someone with lived experience, being able to engage in these conversations in a strong way can sometimes require some fortitude and so I'm really grateful for people with lived experience, particularly who've come today to be able to provide that input and to feel, I hope, supported and encouraged by these conversations. But yeah, I mean, I, if anyone has sort of further feedback that they would like to provide in relation to that by all means, you know, put something in the chat or reach out via one of the messages. And I note that there is a guided mindful session, mindfulness session, which will be beginning 15 minutes for 15 minutes at 5.15. So that's also a good opportunity for, you know, yourself as, you know, to personally kind of take some time to reflect. But yeah, I mean, I just, other than that, I'm really grateful and thankful for you all participating today and hopefully you got something good out of it and I'd like to thank Xan, Brent, Emma and Nova for all their work and development of the vignettes as well because they were quite comprehensive and like from what I heard in the little bits that I attended were very well managed and had lots of good conversations. So yeah, thank you everybody and if you want to finish off Emily about the surveys.