Equal Not the Same: LGBTTIQA+ inclusive Practice

Lesbian, gay, bisexual, takatāpui, transgender, intersex, queer/questioning, asexual and people of other diverse sexual and gender identifications (LGBTTIQA+) people are over represented in the statistics for people living with a mental illness, an addiction or have died by suicide. Given there are no dedicated LGBTTIQA+ mental health or addictions services in Aotearoa, it is essential that mainstream services, mental health NGO organisations, student health and counselling services and private counselling practitioners ensure that their services and programmes are LGBTTIQA+ inclusive.

LGBTTIQA+ people report that their experience of mainstream services is that they are not inclusive and operate mainly from a heteronormative worldview. They often felt vulnerable in disclosing issues around their sexuality or gender and often had to educate the clinicians and counsellors about sexuality or gender diversity. Despite various mental health, addiction and suicide prevention action plans identifying LGBTTIQA+ as priority, there has not translated into actions to improve responsiveness of services.


Two surveys of LGBTTIQA+ service users, conducted 10 years apart, would suggest that there has not been a significant improvement in the inclusivity and responsiveness of mental health and addiction services. In the most recent survey, the numbers of rainbow service users reporting that the services were heteronormative in their approach or that the clinicians were not very knowledgeable of the lived experience of LGBTTIQA+ people had not reduced. Those from diverse sex and gender identities reported high levels of vulnerability in discussing issues around their gender and that often clinicians pathologised their gender or sex diversity.


A common view held within services is that there is no need for targeted programmes for specific populations as the service “treats everyone the same.” This workshop will define clearly what is meant by inclusive practice for LGBTTIQA+ people and put forward the rationale as to why mainstream services need to consider their responsiveness to LGBTTIQA+ population. Participants will apply the principles inclusiveness from the perspectives of organisational inclusiveness and clinical practice.


Developed by the presenter as part of the MindOUT LGBTI Mental Health and Suicide Prevention Project in Australia, the content of the workshop is based on the latest evidence and thinking and has been peer audited by leading international thinkers and clinicians. It has been delivered to mental health and addiction services across Australia and has been adapted to be more culturally inclusive on the New Zealand context.


Clinicians and service managers of both DHB and NGO organisations and primary care are strongly encouraged to attend. With the current redesign of mental health services in this country, this is an opportune time to ensure that the new models are LGBTTIQA+ inclusive.


Learning Outcomes

Participants will:

  • Have a working knowledge of the principles of cultural competence and cultural safety as applied to LGBTTIQA+ persons

  • Assess current service delivery against key principles, criteria and recommended actions for LGBTTIQA+ inclusiveness to their service provision

  • Identify opportunities and challenges for improving LGBTTIQA+ inclusive practice in their organisation

  • Be familiarised with the considered practice wisdom in delivery clinical and support services to LGBTTIQA+ people


Recent studies show that mainstream services in New Zealand have not significantly improved in their service delivery to clients who are members of the rainbow communities (Lesbian, Gay, Bisexual, Takatāpui, Transgender, Intersex, Queer, Asexual - LGBTTIQA+). 


Many LGBTTIQA+ people using mainstream services report feeling unsafe or that issues relating to their sexuality or gender are either stereotyped or misunderstood, adding extra stress in a time of acute distress.

A learning opportunity to explore what LGBTTIQA+ inclusive practice means and why services and clinicians need to ensure their practice is inclusive.

Topics covered:

  • Unpacking LGBTTIQA+ – Sexuality, Sex and Gender

  • Intersections not collisions - Intersectionality of gender, sexuality, culture and religion

  • Mad, Bad or Sad – The determinants that contribute to positive and poor mental health outcomes in LLGBTTIQA+ people

  • Equal but not the Same – What do we mean by Inclusive Practice

  • LGBTTIQA+ Cultural Competency and Safety – What does it look like?

  • How inclusive is Inclusive – Principles of Inclusive Practice

  • Auditing your service or clinical practice for LGBTTIQA+ inclusive practices

  • Strategies for implementing inclusive practice into organisations and clinical practice

  • Inclusive Practitioners - LGBTTIQA+ practice wisdom

Feedback from other participants

“The clinical examples using the broader sociological lens made the course so much more relevant and of use to all clinicians. Will recommend it to all my colleagues and hope the rest of my team attends”


"The highly skilled presenter with a wealth of knowledge and experience meant I could be confident in the content"


“Now realise how much I failed to appreciate the significance of certain life events of rainbow clients I have worked with."

Addiction Worker

“This course should be part of all mental health nurses training. Informative, relevant and valuable"

Mental Health Nurse