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LGBTI Suicide Prevention What do we need to do? Barry Taylor Senior Project Officer - Capacity Development.

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Presentation on theme: "LGBTI Suicide Prevention What do we need to do? Barry Taylor Senior Project Officer - Capacity Development."— Presentation transcript:

1 LGBTI Suicide Prevention What do we need to do? Barry Taylor Senior Project Officer - Capacity Development

2 “I thought fellows like that shot themselves“ King George V on learning an acquaintance was homosexual Traditionally suicide and homosexuality were viewed as: –Deviant / Social Taboos –Criminal act –Abhorrent to God (Possessed) –Weak or flawed character –Pathologised Homosexuality was itself the source of self-destructiveness

3 Self fulfilling act – ”I am ….. because I am …..” Psychological distress, depression, anxiety, suicidal ideation and behaviour are common in our experience Suicide as inevitable?

4 A lot. Well kinda-sorta-not-really. To put it simply: there is very little, accessible and reliable data! Most comes from LGBTI specific studies over the last decade: –Private Lives I & II (n ~ 4,000) all LGBTI inclusive since 2005 (national; self- selected) –Tranznation Study (n ~ 290) first trans specific study; in 2007 (Aust & NZ; self-selected; online) –Periodic gay men’s community health surveys (most Aust cities; community intercept) –Ad-hoc lesbian and/or transgender community health surveys (some states – e.g. WACHPR TTI survey in 2006 & WWASH in 2010, n ~ 900; community intercept) –Writing Themselves In I, II & III (n ~ 3,100) same sex attracted and gender questioning youth surveys 1998-2010 (national); self-selected, online What is currently known about LGBTI mental health & suicide

5 36.2% of trans people and 24.4% of gay, lesbian and bisexual people currently meet the criteria for experiencing a major depressive episode, compared with 6.8% of the general population (Private Lives II) This rate soars to 59.3% of trans women (male to female) under 30 (Tranznation Study) Lesbian, gay and bisexual Australians are twice as likely to have a high/very high level of psychological distress as their heterosexual peers (18.2% v. 9.2%) (Private Lives II) Intersex adults show psychological distress at levels comparable with traumatized non-intersex women, eg those with a history of severe physical or sexual abuse (Schutzmann 2009) What is currently known about LGBTI mental health & suicide – key findings

6 20% of trans Australians (TranzNation study) and 15.7% of lesbian, gay and bisexual Australians (Private Lives II) report current suicidal ideation (thoughts) Up to 50% of trans people have attempted suicide at least once in their lives (TranzNation study) Same-sex attracted Australians attempt suicide at between 3.5 and 14x the rate of their their heterosexual peers (various studies between 1998-2007) Suicide attempt rates are on average (across various studies) 6x higher for same-sex attracted young people (20-42% cf. 7-13% –The average age of a first suicide attempt is 16 years – often before ‘coming out’ (Dyson et al. 2003; Howard & Nicholas 1998) What is currently known about LGBTI mental health & suicide – key findings

7 Some of it is simply not available… –As per previous table - ABS National Mental Health Survey includes sexual orientation, but this has not been published per other demographic characteristics –No provisions at present to capture on sexual orientation and/or diverse sex and gender identities at any stage in the process of reporting suicide deaths LGBTI Specific Studies vulnerable to selection issues –Convenience or self-selected samples –Many also conducted online –Concerns about representation - LGBTI-targeted studies often sample participants from within, and connected to, LGBTI communities –Periodic surveys are vulnerable to variance in findings Limitations of available data

8 What proportion of people who die by suicide are LGBTI? –We expect, given the prevalence of suicidal ideation and attempts in this group, that this would be high However - recent international studies offer insight: on suicide mortality Mathy et al 2011 used relationship status on death certificates as a proxy indicator of sexual orientation, analysing data collected in the 12-years following legalisation of same-sex registered relationships in Denmark and found the age-adjusted suicide mortality risk for Danish men in same-sex registered partnerships to be 8x higher than for men with histories of heterosexual marriage As a result, we simply don’t know…

9 Fully understand the nature of suicide risk amongst LGBTI people –Many studies demonstrate link between discrimination, mental ill-health and suicide risk Fully understand the extent (prevalence) of mental illness, and distribution of risk and protective factors What other factors, demographic or otherwise, may account for, interact with, compound or increase risk of suicide and mental ill-health? –Aboriginality –Cultural background –Religious beliefs – while usually protective against suicide, may escalate risk for LGBTI individuals –Geographic isolation – rural and remoteness –Family history of mental illness and/or suicide –Experiences of discrimination, social exclusion and harassment But nor can we, with present data…




13 Self harming behaviour Mood Disorders Esp. Depression & Anxiety Social Isolation Marginalisation Mental Illness & Disorders (Axis 1) Excessive Drug & Alcohol Use History of Suicide Attempts History of Suicide in family Anti – social / risk taking behaviour Sexual Orientation Sexual abuse &/or family violence Suicide

14 Intersectionality Points of concordance / conflict SEXUALITY IDENTITY STATUS PURPOSE / ROLE MEANING RELATIONAL SHARED EXPERIENCE Gender Culture Ableness Age

15 Depression Biological Determinants Psychological Determinants Familial Determinants Life Stressors Social Determinants Cultural Determinants

16 Social Discrimination Self Stigma Hetero- normative Assumptions Minority Stress Homo / bi / trans / intersex negative trauma

17 Suicide Prevention Not just preventing the person from dying Invitation for person to live and to thrive SUICIDE PREVENTION

18 Universal Selective Indicated Case identification Standard treatment for known disorders Compliance with long-term treatment After-care (including rehabilitation ) Empowerment Competence SupportiveEnvironments Strategies for promoting well-being & quality of life Resilience (Barry, 2001)

19 Primary Prevention: Activities that enhance protective factors and reduce the vulnerability of people Early Intervention: Activities which identify and support people at risk of social, emotional or physical health problems and who may be vulnerable to self harm and suicide Suicide Prevention Continuum

20 Intervention: Activities that provide immediate crisis support to people expressing suicidal ideation, exhibiting suicidal behaviours or attempting suicide Treatment: Activities that treat the underlying or associated mental health problems and/or address the underlying life issues Suicide Prevention Continuum

21 Post-vention: Activities that provide support to those affected by a completed suicide and minimises the potential for suicide contagion. Suicide Prevention Continuum

22 Overused term Helpful to explore degrees of emotional distress  Sad  Miserable  Depressed DEPRESSION

23 “Depression sucks the pleasure out of life?” An all encompassing “blackness” Usually is longer term (more than two weeks) DEPRESSION

24 MindOUT! LGBTI Mental Health & Suicide Prevention Project First national project of its kind Funded by the Commonwealth Department of Health and Aging

25 To work with LGBTI organisations and mainstream mental health and suicide prevention organisations to improve mental health and suicide prevention outcomes for LGBTI people and communities. MindOUT! LGBTI Mental Health & Suicide Prevention Project

26 Assisting LGBTI organisations to be more responsive to suicide prevention and mental health issues for LGBTI persons and communities Working with mainstream mental health and suicide prevention organisations to assist them to be more responsive to the needs of LGBTI persons and communities MindOUT! Target Audiences

27 Cultural Competency Framework for Inclusive Practice Piloting a LGBTI champions program in mental health and suicide prevention services Practice wisdom resource for clinicians on working with LGBTI clients MindOUT! Phase Two Mainstream Services

28 Policy advice and advocacy on LGBTI related mental health & suicide prevention Network MindOUT! –Facilitating a forum for discussion, information sharing and research on LGBTI suicide prevention and mental health MindOUT! Phase Two Policy & Research

29 Training workshops and consultancy on mental health & suicide prevention. Mental health promotion framework MindOUT! LGBTI Organisations

30 Contact Details Barry Taylor Senior Project Officer MindOUT! LGBTI National Health Alliance Email: Phone (02) 8568 1124 Mobile 0405 746 228

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