Towards sustainable equity in mental health services for LGBT people : a rhizomatic contribution from nurses constituted at n - 1

Abstract

For decades, people who identify as lesbian, gay, bisexual and/or transgender (LGBT) have expressed dissatisfactions with the mental health services provided to us. Previous researchers, the majority working within the disciplines of psychiatry, medicine and psychology, have used representational models of thought and conventional research methods to produce interpretations of how stigmatisation and discrimination towards those who are different ‘from-the-same’ normative sociocultural standards also affect LGBT people within mental health services. Research recommendations and problem-solving practice guidelines developed on the basis of representational approaches are typically presented as the iterative obverse of the issues described. Yet, according to LGBT people, problems with mental health services persist. Gilles Deleuze and Félix Guattari argued that difference ‘in-itself’ could be used to drive social justice-inspired change, and they created rhizomatic philosophical precepts as an expansive antidote to what they saw as the arborescent, or self-limiting nature of ideas rooted in representational thought. This qualitative study has used the creative power of difference ‘in-itself’ and the rhizomatic precepts to develop an unconventional non-fascist engagement between twenty mental health nurses as participant- collaborators in the production of a baroque rhizomatic assemblage of our ideas. The study folds ‘lines of flight’ about difference awareness and knowledge gain through training and education into ideas about how organisational leadership and policy development are needed to support culturally competent practices. This study has implications for the development of sustainably inclusive mental health services for LGBT people. For the first time, the views of mental health nurses regarding our practices with LGBT service users and our ideas about how to develop service environments inclusive of cultural difference are presented. A reflective assessment of the usefulness of taking a rhizomatic research approach is also provided. Our ideas provide strategies on which to base structural decisions in the design and development of educational curricula, organisational policy and nursing practice standards. Further development of the rhizomatic approach is required. This will include consideration of the impact of participating as collaborators on individual participants’ future practice. Also, as this study involved only twenty nurses in two states of Australia, it is recommended that further research be conducted into refining the approach to incorporate an electronic or online capability. This could involve professional nursing organisations and enable more mental health nurses across a diverse range of practice environments and geographies to participate in an immanent and nursing-inclusive expansion of the multidisciplinary research and practice development discussion focused on achieving equity for LGBT people in mental health services.

Date of Award	2015
Original language	English
Supervisor	Mary Cruickshank (Supervisor) & Danny Hills (Supervisor)