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Inquiry into Mental Health and Suicide Prevention Select Committee on Mental Health and Suicide Prevention (MARCH 2021) 2 Mental Health and Suicide PreventionSubmission 111 Enquiries regarding this submission can be directed to: Angela Scarfe Senior Policy Adviser 03 9320 1000 angela.scarfe@aasw.asn.au Tegan Leeder Social Policy and Advocacy Officer tegan.leeder@aasw.asn.au 2 Mental Health and Suicide PreventionSubmission 111 The Australian Association of Social Workers The Australian Association of Social Workers (AASW) is the professional body representing more than 13,000 social workers throughout Australia.
We set the benchmark for professional education and practice in social work, and advocate on matters of human rights, discrimination, and matters that influence people’s quality of life.

The social work profession Social work is a tertiary qualified profession recognised internationally that pursues social justice and human rights.

Social workers aim to enhance the quality of life of every member of society and empower them to develop their full potential.
Principles of social justice, human rights, collective responsibility and respect for diversity are central to the profession, and are underpinned by theories of social work, social sciences, humanities and Indigenous knowledges.

Professional social workers consider the relationship between biological, psychological, social and cultural factors and how they influence a person’s health, wellbeing and development.

Social workers work with individuals, families, groups and communities.
They maintain a dual focus on improving human wellbeing; and identifying and addressing any external issues (known as systemic or structural issues) that detract from wellbeing, such as inequality, injustice and discrimination.

Our submission The AASW welcomes the opportunity to make a submission to the Inquiry into Mental Health and Suicide Prevention.

The AASW has advocated, and continues to advocate, for a human rights approach to mental health care.
This is in keeping with the three core values in the AASW’s Code of Ethics: Respect for Persons, Social Justice, and Professional Integrity.

Social workers maintain a dual focus in their work, appreciating the needs of the people they work with, while also understanding the systemic and cultural issues that contribute to mental illness.

3 Mental Health and Suicide PreventionSubmission 111 Mental health is an integral and essential component of health.
The World Health Organization (WHO) constitution states: ‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’.

An important consequence of this definition is that mental health is considered more than just the absence of mental disorders or disabilities.

The social work profession is committed to maximising the wellbeing of individuals and society.
Social work practice seeks to enhance people's access to opportunities for full participation in social and economic life.

Through action at individual, family, community and political levels, social workers seek to overcome the discrimination against, and disadvantage experienced by, people with mental illness, and to promote their rights as citizens.1 Social workers are present throughout the mental health field.
The settings and fields of social work mental health practice include but are not limited to: public mental health; adult mental health; private practice; community teams; child and adolescent mental health teams; and primary mental health care.

Social workers provide a range of supports including direct services, assessment, therapeutic supports, case management and care coordination, advocacy, community development, research and policy.
Furthermore, social workers encounter and work with mental health in other settings outside of the mental health sector for example family supports, family violence, child protection, housing, alcohol and other drugs and aged care.
This submission draws on previous work and consultation with AASW members, we will address the following terms of reference: • the findings of the Productivity Commission Inquiry Report into Mental Health, the Report of the National Suicide Prevention Officer, the Victorian Royal Commission, the National Mental Health Workforce Strategy and other recent strategic reviews of the current mental health system in light of events such as the 2019 bushfires and COVID-19 pandemic, including the capacity of the mental health workforce to respond to such events; and • other matters not addressed by these recent reviews, including: o building on the work of the Mental Health Workforce Taskforce and forthcoming National Medical Workforce Strategy, the roles, training and standards for all health and allied health professionals who contribute to mental health care, including peer workers, that are required to deliver quality care at different levels of severity and complexity, and across the spectrum of prevention, early intervention, treatment and recovery support; o the funding arrangements for all mental health services, including through the MBS and PHNs, and whether they are structured in a way that supports safe, high quality and effective care in line with the qualifications of practitioners and needs of consumers across whole of population; 1 AASW social work and mental health position paper, https://www.aasw.asn.au/document/item/3284 4 Mental Health and Suicide PreventionSubmission 111 o the use, standards, safety and regulation of telehealth services and the role and regulation of domestic and international digital and online mental health service providers in delivering safe and high-quality care in Australia o any related matters Summary of recommendations: • That the recommendations from all the inquiries listed above be combined to inform the development of the sixth National Mental Health and Suicide Prevention Strategy • That the sixth National Mental Health and Suicide Prevention Strategy address the social
 determinants of mental health, including overturning mental health stigma and discrimination • That there be a focus on developing an integrated service system to meet the mental health needs of people across the community service system • That all sectors of the current service system be restructured into a person-centred and community-based system • That the sixth Mental Health and Suicide Prevention plan feature a Mental Health Workforce Strategy to provide a comprehensive response to loss of expertise and experience • That government provide incentives for mental health professionals to work outside of main city centres and increase the amount of mental health support available to people who live regionally, rurally or remotely • That there are minimum professional qualification levels for managers within mental health services • That the funding cycle be extended to cover five years to allow for continuity and planning • There be greater recognition AMHSW’s within the Better Access program and there be parity in the rate of Medicare rebate paid to psychologists and social workers • That incentives to bulk bill be increased across all mental health practitioners to reduce out of pocket costs for clients • That the funding for services which interface with the mental health system be increased to reflect cost of coordination between services • That the rate of the Jobseeker Allowance be increased to a level that enables people with mental health needs to cover the costs of treatment for their illness • That telehealth become permanent • That government sets a priority to guarantee reliable telephone and internet connections to all rural and remote communities as an aspect of mental health service delivery • That research is undertaken into methods to better respond to marginalised groups via telehealth 5 Mental Health and Suicide PreventionSubmission 111 Responses to Terms of Reference The findings of the Productivity Commission Inquiry Report into Mental Health,
 the Report of the National Suicide Prevention Officer, the Victorian Royal Commission, the National Mental Health Workforce Strategy and other recent strategic reviews of the current mental health system in light of events such as the 2019 bushfires and COVID-19 pandemic, including the capacity of the mental health workforce to respond to such events The AASW has made numerous and extensive submissions to mental health inquiries over many years.
Our submissions draw on the experience of our members working across mental health and related fields who work with some of the most vulnerable and marginalised people in our society.

The AASW welcomed and supports the National Mental Health and Wellbeing Pandemic Response Plan, and the recommendations from the Productivity Commission Inquiry into Mental Health, both of which call for immediate action.
We also welcomed the Victorian Government’s commitment to implement all recommendations from the Victorian Royal Commission into Mental Health.

As identified in our previous submissions, the system has seen a shift towards a medicalized model of mental health services as community-based services and support have been defunded.

There is resounding agreement internationally that community-based services are an essential component of effectively meeting peoples’ mental health needs.
The AASW welcomed the Productivity Commission’s Draft Report’s recommendations that the whole mental health system be re-oriented around the needs of the people who use it and their families and carers, and that the surrounding support system be similarly re-oriented.

In many ways the Draft Report’s person-centred recommendations align with the person centred, rights based, multifaceted and systemic approach to service delivery that the AASW has advocated for in other forums.
The Black Summer bushfires and subsequent COVID-19 pandemic rapidly changed the mental health service system landscape and we commend the government on its quick implementation of supports through both Better Access and the PHNs.

This period had immediate mental health impacts on the Australian population that will be felt for months if not years to come.
The initial period of both crises was characterised by a fear, anxiety and general sense of panic about the coming events, particularly as the pandemic continued and continues.

Those with current mental health concerns are especially vulnerable during emergencies and will likely experience barriers to accessing the appropriate medical and mental health care they need resulting in decline, relapse, or other adverse mental health outcomes.
It is clear now that people need short and long-term mental health supports that are responsive to their needs.

The likely increasing mental health presentations mean we will see more strain on already limited workforce resourcing that will only continue.

The measures implemented during the bushfires and pandemic to address mental health needs have been welcomed by the AASW.
The introduction of no-referral mental health sessions for those affected by bushfires, the rapid shift to and roll-out of telehealth nationwide, the increase in the number of sessions available through Better Access from 10 to 20, and the introduction of these 6 Mental Health and Suicide PreventionSubmission 111 measures into aged care facilities, which were most significantly impacted by COVID-19, have addressed many mental health needs across Australia.
However, the rapid rollout of COVID-19 MBS items and policies was patchy and should have been done in consultation with the sector to ensure that the unintended consequences were minimised.

Our members struggled with the ever-changing nature and requirements of the items and frustration at bureaucracy was experienced whilst trying to support their clients through difficult times.
Recommendations: • That the recommendations from all the inquiries listed above be combined to inform the development of the sixth National Mental Health and Suicide Prevention Strategy • That the sixth National Mental Health and Suicide Prevention Strategy address the social determinants of mental health, including the overturning mental health stigma and discrimination • That there be a focus on developing an integrated service system to meet the mental health needs of people across the community service system • That all sectors of the current service system be restructured into a person-centred and community-based system Building on the work of the Mental Health Workforce Taskforce and forthcoming National Medical Workforce Strategy, the roles, training and standards for all health and allied health professionals who contribute to mental health care, including peer workers, that are required to deliver quality care at different levels of severity and complexity, and across the spectrum of prevention, early intervention, treatment and recovery support.
People experiencing poor mental health need and deserve highly skilled and knowledgeable professionals with a rights-based and collaborative focus and who have rigorous and appropriate- level training.

Social workers have expressed the importance of ongoing professional support, training, and supervision as part of their work in mental health.

As a self-regulating profession, the AASW is responsible for setting the education standards for entry into the social work profession.
These standards are articulated in the Australian Education and Accreditation Standards (ASWEAS).

setting out the minimum standards for the delivery of a social work program at entry level by a higher education provider including minimum requirements for the provision of education in mental health and mental illness.

In essence, there are two different types of programs offered to study at an entry level into the social work profession.
• A Bachelor of Social Work or Bachelor of Social Work (Honours) is typically a four-year degree which combines an academic social science program with social work education and offered at an AQF Level 7 / 8 (Honours) • A Master of Social Work (Qualifying) is typically two years in duration and available to students who already hold a relevant social science undergraduate degree and is offered at an AQF Level 9 Further accreditation is available for social workers wanting to advance in the mental health space through becoming an Accredited Mental Health Social Worker (AMHSW).
The AASW is the accrediting body for AMHSWs and stipulates that they must have at least 2 years’ full-time 7 Mental Health and Suicide PreventionSubmission 111 equivalent (FTE) post-qualifying social work experience in a mental health setting/field within the last 5 years, totalling a minimum of 3360 hours, prior to applying for this accreditation.
The AASW is the assessing authority, on behalf of the Federal Government, for social workers interested in providing mental health interventions through Medicare Australia.

As well as practicing in specialist mental health settings, social workers are employed in a wide variety of services and in a wide range of fields such as education, justice, housing or employment services.
People using these services may already be at their most vulnerable experiencing escalating psychological distress, and at risk of developing mental ill-health.

Social workers are trained and skilled in identifying and intervening at this critical juncture.

Social workers are also more likely to be located in regional, rural and remote areas of Australia where mental health services tend to be limited by geography and technological access.
AMHSWs, in particular, fill the gaps in these areas compared with other professions such as psychology.

Despite this, our members have told us of the difficulty in managing growing wait lists and limited referral options for those seeking mental health treatment outside of cities.

Government needs to provide incentives for mental health professionals to work outside of main city centres in order to reach these under-resourced populations, and training to meet their specific needs.
These incentives should include relocation incentives and/or higher rebates under MBS.

Workforce supervision The profession of social work has long regarded professional supervision as central to the maintenance of best practice and has taken a leadership role in asserting the significance of supervision in health and human service settings.
Active participation in professional supervision is a core practice standard for social workers, as outlined in the AASW Practice Standards.2 AASW members have told us that in order to be supported to do their jobs properly that service managers overseeing staff should have minimum standards with regards to their professional qualifications.

These should be clinical standards enabling managers to provide clinical supervision.
Accredited Mental Health Social Workers AMHSWs are highly trained and educated mental health professionals, meeting some of the highest standards of professional regulation in Australia.

AMHSWs are one of the few designated allied health professional groups eligible to provide private mental health services to people with diagnosable mental health conditions or people ‘at risk’ of developing mental health conditions under the Commonwealth Medicare initiative.
There are currently more than 2,200 AMHSWs with approximately 40% practicing in rural and regional areas.

As a group of providers, AMHSWs are the second largest after the combined group of Clinical Psychologists and Registered Psychologists.

AMHSWs work from a biopsychosocial, whole-of-person perspective and their training provides an appreciation of the impact that social, environmental and cultural factors have on total health and wellbeing.
Their person-in-environment approach (that is the bedrock of all social work education) makes AMHSWs experts in dealing with complexity.

This is also akin to the National Disability Insurance Scheme 2 https://www.aasw.asn.au/document/item/6027 8 Mental Health and Suicide PreventionSubmission 111 framework of client-centred capacity-building therapeutic inputs that AMHSWs also provide.
AMHSWs work with people across the lifespan (including children, adults and older persons) and provide a unique contribution to the mental health space in their holistic approach to working with a person.

The advanced training that is expected of an AMHSW prepares and provides them with the skills for working with people with very complex presentations and comorbidities.
They have the skills and knowledge to assess and intervene around the impact of physical illness, specifically chronic and advanced chronic or terminal illness has on a person’s psychological wellbeing.
The AASW is responsible for the accreditation of AMHSWs and is committed to maintaining the high standard of practice of the profession in this sector.3 Moreover, a strength of the social work perspective also allows the AMHSW to appropriately collaborate with other agencies, practitioners and allied health professionals to provide a holistic and case management approach to achieving evidence-based outcomes.
Peer workers The AASW strongly supports the formal development of the lived experience workforce within the clinical and nonclinical mental health systems.

Systematic development and implementation of the lived experience workforce as a discipline with a diversity of roles and career structure requires careful planning and dedicated resourcing.
There are significant roles and opportunities at all levels for the Lived Experience workforce, including in community agencies to combat the stigma of mental illness and to foster hope, encourage social inclusion and recovery at a grass roots level.

The AASW is concerned however that most of the literature about lived experience ignores the fact that many highly qualified mental health practitioners also have lived experience, on which they draw in their professional work.
It is important that people with lived experience differentiate which aspects of their experience are appropriate to share and which are not; and that task itself is something that requires professional education and supervision.

Recommendations: • That the sixth Mental Health and suicide Prevention plan feature a Mental Health Workforce Strategy be revisited to provide a comprehensive response to loss of expertise and experience.
• That government provide incentives for mental health professionals to work outside of main city centres and increase the amount of mental health support available to people who live regionally, rurally or remotely.
• That there are minimum professional qualification levels for managers within mental health services 3 AASW AMHSWs: Qualifications, Skills and Experience report, https://www.aasw.asn.au/document/item/11704 9 Mental Health and Suicide PreventionSubmission 111 The funding arrangements for all mental health services, including through the MBS and PHNs, and whether they are structured in a way that supports safe, high quality and effective care in line with the qualifications of practitioners and needs of consumers across whole of population General funding and commissioning The experience of social workers is that the current mental health funding and the commissioning model of a collection of discrete compartmentalised items of service creates difficulties for people who need a comprehensive coherent response to their evolving and complex needs.
It has long been recognised by social workers that three-year funding cycle for mental health services and community services inevitably results in poor outcomes for the people who use these services.

It is impossible to plan long term consistent support for people, and difficult to attract staff.

It can take a period of months for professionals to build the trust between organisations on which a co-ordinated service system depends.
Referral and treatment pathways take time and trust to operate effectively.

The inability to guarantee long term employment – let alone a career structure - makes it very difficult for these services to attract and keep qualified staff.

Furthermore, whereas services in major cities can draw from a large pool of qualified clinicians, services in rural and remote communities have difficulty persuading staff to re-locate for a short-term contract.
PHNs While PHNs have been identified as the mechanism to address many of the shortcomings in the mental health service system, including those unable to access support through Better Access, their capacity to identify needs, plan for the services to meet those needs and ensure that the services are delivered effectively, have been hampered.

PHNs vary in their understanding of what it means to engage with the people who use services, and the people who care for them or provide services.
The report found that many PHN’s are not encouraging genuine participation or co-design opportunities, in the way that the 5th National Mental Health and Suicide Prevention Plan encourages.

This is particularly noticeable with respect to the lack of partnerships with Aboriginal Controlled Community Health organisations.

The reliance of PHNs on “market forces” as the determining factor in allocating tenders has distorted the service system, by favouring larger generic services over specialist ones.
This has poor consequences for rural communities, people from culturally or linguistically diverse communities or people with specialist mental health needs, such as survivors of trauma.

Inevitably, the consequence of current short-term tendering and associated processes are that services will be de-commissioned.
By contrast, if PHNs were to include the benefits of maintaining on-going relationships as a factor in their considerations, it is more likely that services which have already been operating could continue to do so, and people with mental health needs would be able to maintain the trusting relationships with staff which form the basis of recovery.
Recovery-oriented services AASW members have identified that there has been a drastic reduction in a wholistic and therapeutic approach to services that puts someone on a trajectory out of services.

Instead, members are experiencing a greater emphasis on short term crisis interventions.

The focus on crisis funding is 10 Mental Health and Suicide PreventionSubmission 111 resulting in professional burn-out as workers are becoming increasingly aware of how their work is no longer providing long term results.
This is compounding the loss of skilled and experienced mental health workers already caused by the overall de-funding of services.

The sector currently doesn’t have the capacity or funding to do the supportive or preventative work that is desperately needed.

Funding is required for prevention or early intervention strategies which need to also consider the broader structural and systemic issues which impact on mental health, including ways of building resilience and developing healthier societies.
Commonwealth funded programs such as Partners in Recovery, Personal Helpers and Mentors (PHaMs) and Day to Day Living played important roles in assisting people to connect to services, create communities and contributed to recovery.

These programs have had their funding withdrawn and transferred to the NDIS, and their loss is contributing to the loss of support for people experiencing mental ill-health.
The prevalence of market-based incentives are unlikely to replicate this organic and community-based offering supported by block funded organisations.

AASW members identified a general loss of recovery oriented supported services - services that provided support and maintenance over the medium-to-long term to provide assistance to consumers in their recovery.
These services were key in ensuring consumers stayed engaged with therapeutic services, were able to attend their specialist appointments, and crucially prevented deterioration or non-adherence to treatment which might result in an emergency department presentation, or worse.

Better Access and MBS The AASW supports the Better Access initiative as an effective mechanism to meet the mental health needs of many people who would not otherwise receive mental health care.
AMHSWs are one of the few professional groups eligible to provide private mental health services to people with diagnosable mental health conditions or people ‘at risk’ of developing mental health conditions, under Better Access.

There are currently more than 2,200 AMHSWs working across major cities, regional, rural and remote regions, with approximately 40% practicing in rural and regional areas.
Many AMHSW’s operate out of ‘shopfront’ type offices and some operate from GP clinics, making them more approachable for people who wish to avoid the stigma of entering a health setting.

Despite their high- level of mental health specific training and experience, AMHSWs are paid less under MBS than their psychologist-counterparts.

This is replicated across other funding areas such as Department of Veterans Affairs and state-based Work Cover programs.
It is also despite the fact that AMHSWs work with some of the most complex cases and with highly vulnerable and marginalised people.

AASW members have submitted extensive evidence to numerous of our submissions of significant out-of-pocket costs of mental health care incurred by consumers or their carers.

This is particularly the case for people in community-based services or those referred through Better Access.
It will come as no surprise that the inadequacy of income support payments, which makes day to day survival a significant stress, also makes the out-of-pocket costs of mental healthcare completely unaffordable, with the result that people living on Jobseeker cannot afford to pay for medication, childcare during appointments or travel to appointments.
Social workers reported many instances where people’s mental health needs are unmet because of their inability to afford medication or to pay the unfunded segment of MBs rebated items.

Social workers in rural areas report on the additional burden that 11 Mental Health and Suicide PreventionSubmission 111 arises from the cost of transport to treatment.

They report instances of people’s health deteriorating after having been discharged from a mental health facility, particularly in rural areas.
Funding for services that interface with Mental Health Services Our members have reported needing to devote a significant amount of time to assisting vulnerable people through liaison and advocacy with community and health services to ensure that people receive the full range of appropriate community supports.

There are particular issues in multiple system intersections, such as those between the mental health sector and child protection, the NDIS, family violence services or the family court.
While this complex case management work is well within the skillset of social workers, the issue is that this role is not always recognised in funding agreements or is not funded adequately.

Recommendations: • That the funding cycle be extended to cover five years to allow for continuity and planning • There be greater recognition AMHSWs within the Better Access program and there be parity in the rate of Medicare rebate paid to psychologists and social workers.
• That incentives to bulk bill be increased across all mental health practitioners to reduce out of pocket costs for clients.

• That the funding for services which interface with the mental health system be increased to reflect cost of coordination between services.

• That the rate of the Jobseeker Allowance be increased to a level that enables people with mental health needs to cover the costs of treatment for their illness.
The use, standards, safety and regulation of telehealth services and the role and regulation of domestic and international digital and online mental health service providers in delivering safe and high-quality care in Australia There has been an increased emphasis on digital mental health following the start of the COVID-19 pandemic.
Although they are regarded as relatively new, we note that the term digital health refers to a number of different service models including telephone services such as lifeline, which have been operating for many years.

As a group, they have been identified as a cost-effective way of taking services to people who have difficulty accessing services for a range of reasons, but they vary according to whether they feature personal contact and the extent of this contact.
The implications of this variation are profound, and the AASW’s position is that they cannot be considered as a generic group but must be considered according to their specific features and in reference to their specific intended audience.

The AASW agrees that there are particular features that render them attractive to many audiences: they allow people to obtain advice and information in privacy, at a time that suits them and without travelling long distances.
Nevertheless, the actual services delivered are entirely dependent on the quality of the communications infrastructure.

Therefore, the AASW recommends that the government set a priority to guarantee reliable 12 Mental Health and Suicide PreventionSubmission 111 telephone and internet connections to all rural and remote communities as an aspect of mental health service delivery.

We also recommend that telehealth remain permanent post-COVID-19.
AASW members have told us women experiencing family and domestic violence have been reluctant to access telehealth or online counselling, fearing their abuser will overhear or gain access to their computer or phone.

Members have also raised concerns that the focus on phone and online methods of communication puts many of these women at a disadvantage.

These include being denied access to technology by their abuser, speaking a language other than English, or not knowing how to use technology.
Although there are no quick ways to overcome these issues, the AASW recommends further research into innovative methods to reach women who are disadvantaged by technology.
Recommendations: • That telehealth become permanent in the recovery phase of COVID-19 • That government sets a priority to guarantee reliable telephone and internet connections to all rural and remote communities as an aspect of mental health service delivery • That research is undertaken into methods to better respond to marginalised groups via telehealth Any related matters The AASW wants to highlight that many consumers with a mental illness are unable to work or struggle to find sustainable work, leaving them reliant upon Jobseeker and the Disability Support Pension to survive.
These payments are, as has been advocated for by the AASW and ACOSS previously, far below what is necessary to live comfortably.

It is unnecessarily difficult for those on these support payments to meet their needs, let alone attempt to afford transport to services and treatment options.

The Productivity Commission’s report on The Social and Economic Benefits of Improving Mental Health has made two points that illustrate the interaction with work, and lack of it, on people’s mental health.
The first is that it pointed to the harsh and punitive nature of the current income support compliance regime as a significant contributor to poor mental health.

The second is that they demonstrate the connection between the experience of discrimination and prejudice, and the higher rates of poor mental health in people from marginalised groups.

Aboriginal and Torres Strait Islander peoples The mental health system is deeply failing Aboriginal and Torres Strait Islander peoples.
The disproportionate rates, including youth suicide, are a national emergency that needs immediate state and federal action.
The AASW strongly supports the recommendations from National Aboriginal Community Controlled Health Organisation (NACCHO) and other peak groups calling on governments to: • Provide secure and long-term funding to Aboriginal community-controlled health services to expand their mental health, social and emotional wellbeing, suicide prevention, and alcohol and other drugs services, using best-practice trauma-informed approaches 13 Mental Health and Suicide PreventionSubmission 111 • Increase funding for Aboriginal community-controlled health services to employ staff to deliver mental health and social and emotional wellbeing services, • Increase the delivery of training to Aboriginal health practitioners to establish and/or consolidate skills development in mental health care and support, including suicide prevention • Commit to developing a comprehensive strategy to build resilience and facilitate healing from intergenerational trauma, designed and delivered in collaboration with Aboriginal and Torres Strait Islander communities Family violence The AASW also calls on the government to implement a Medicare item number for family violence counselling and therapeutic services, as distinct from a general practitioner mental health treatment plan.
This is in anticipation of the increase in family violence related cases before the Family Court as a result of this pandemic.

This would ensure that perpetrators can no longer use the presence of mental health plans as a weapon against their victims throughout the court process.
Lesbian, Gay, Bisexual, Trans and Gender Diverse, And Intersex (LGBTI) People As the United Nations Human Rights office highlighted4, LGBTI people are among the most vulnerable and marginalised in many societies, and among those most at risk from COVID-19 needing focused actions from governments.
The AASW strongly supports the Joint Statement from Health Organizations that call on the Royal Commission into Victoria’s Mental Health System to consider LGBTI Mental Health, which we believe should also apply to the Federal government.

As the statement points out: “All lesbian, gay, bisexual, trans and gender diverse, and intersex (LGBTI) people deserve to live happy and healthy lives, and to enjoy the benefits of a mental health system that is respectful, safe, affirming and supportive.
The life experiences of LGBTI people are diverse and the majority of LGBTI (people) are happy and content.
However, a range of mental health outcomes are known to be associated with experiences of marginalisation, discrimination, stigma, violence and abuse.”5 The AASW calls on the Federal government to engage in extensive consultation with community-controlled LGBTI organizations, experts in LGBTI health and consumers who have significant appreciation of the limitations and opportunities to improve the mental health of LGBTI people.
Conclusion The AASW welcomes the opportunity to discuss any of the matters raised in this submission.
4 https://www.un.org/en/coronavirus/un-supports-lgbti-community-during-covid-19-pandemic 5 https://cdn.thorneharbour.org/media/documents/Joint_Statement_LGBTI_Mental_Health_June_2019.pdf 14 Mental Health and Suicide PreventionSubmission 111 © Australian Association of Social Workers Level 7, 14-20 Blackwood Street NORTH MELBOURNE VIC 3051 PO Box 2008 ROYAL MELBOURNE HOSPITAL VIC 3050 P: 03 9320 1027 E: socialpolicy@aasw.asn.au www.aasw.asn.au ACN 008 576 010 ABN 93 008 576 010 www.aasw.asn.au 15 Mental Health and Suicide PreventionSubmission 111