Creating safer spaces in healthcare for 2SLGBTQ+ young people

What happens when you invite people who have been systematically ignored or silenced to contribute to big policy discussions?

“The floodgates open,” says Lynette Schick, research and policy analyst with the Mental Health Commission of Canada (MHCC), who recently organized a forum, together with Kam Tello, Knowledge Broker at MHCC, on creating safer health care spaces for the 2SLGBTQ+ youth community. “We are talking about young people who have higher rates of mental health problems, more frequent incidents of suicidal ideation, a greater likelihood of homelessness, and a general mistrust of the medical profession.”

To better understand the needs of this underserved group and guide the development of the conference — led by and designed for 2SLGBTQ+ youth — the MHCC sought advice from a nine-member advisory group, which struck a balance between the perspectives of eminent 2SLGBTQ+ academics, advocates, and young people.

“It was a privilege,” says Schick, “to do this the right way. It was a learning curve but, without a youth-centric approach, the disconnect between what young people want and what services they actually receive will continue. It was also inspiring to see how these young people want to be engaged and want to do it respectfully and inclusively.”

Held on November 8th and 9th, the conference brought together nearly 70 young people from across the country who identify as 2SLGBTQ+. The goal was to hammer out recommendations on what a safer health care space could look like. The MHCC was overwhelmed, both by the number of applicants and by the participants’ genuine desire to see positive change.

“Too often, 2SLGBTQ+ youth are left out of conversations about their own identities and experiences — particularly when it involves health care access,” says Fae Johnson, a member of the MHCC’s 2SLGBTQ+ advisory group and forum planning team. “This forum sought to change that. 2SLGBTQ+ youth are the true experts about their own lives, experiences, and well-being. They know the gaps 2SLGBTQ+ youth fall through when accessing services — all too well. These young people have the answers, so it’s time we listened to them."

Many of those who applied identify as queer and/or non-binary, terms gaining prominence that are less prescriptive and more fluid. Still, almost all of them face barriers to employment, and many are living on social assistance. Neither of which is surprising, since 2SLGBTQ+ youth face regular discrimination and often live with the threat of abuse or violence.

Homelessness rates are also higher among the 2SLGBTQ+ community, though exact data is still lacking. The most recent Point-in-Time Count by Employment and Social Development Canada — which literally fans out across jurisdictions to do a “head count” of people experiencing homelessness — was the first time that information specific to gender identity and sexual orientation was gathered. Data is also lacking for suicides and homicides, in part because of a refusal by some families to recognize their loved one’s gender identity.

“The problem,” explains Louise Bradley, MHCC president and CEO, “is that if we don’t measure it, it doesn’t count. And to say that the 2SLGBTQ+ community has been discounted is an understatement. Young people who identify as 2SLGBTQ+, and who are experiencing mental health problems, are doubly stigmatized. That’s why we didn’t presume to know their experience; rather, we invited them to share with each other and share with us, so we could amplify their messages and recommendations.”

As we found out, creating safer spaces in health care means something different to each applicant.

“We wanted to hear from people about why they want to be there and what they want to contribute,” explains Ed Mantler, Vice-President of Programs and Priorities at the MHCC. “We got all that and more. The passion, insight, and desire to help others shone through in virtually every application.”

Fundamentally, it was this ambition to come full circle that drove the forum, to engage people who have been marginalized and give them a voice, validate their perspectives, and embrace their needs. A future system of recovery-oriented mental health care must evolve with the changing needs of the people who access it. A full report on the forum’s findings will be available in early 2019.