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New Book Offers Guidelines for Working With Gender-Diverse Groups

Sex and Gender Education (SAGE) Australia has completed its three-year global research project into suicide in sex and/or gender diverse (SGD) communities. The result is a comprehensive guide providing much-needed training and education for health care professionals.

Suicide in Intersex, Trans and Other Sex and/or Gender Diverse Groups: A Health Professional’s Guide is the first book for sexologists, sex therapists, psychiatrists, family doctors, nurses, psychologists, psychotherapists, counsellors, social workers, naturopaths, and health care managers on suicide prevention with clients who are intersex, trans, and gender nonconforming.

Written by Tracie O’Keefe, DCH, BHSc, ND, a clinical psychotherapist, registered mental health professional, and sexologist in Sydney, Australia, the book provides a review of the incidence of suicidal thoughts, attempts, and successful suicides in people from SGD groups. These are people who are intersex, androgynous, transgender, transsexual, nonbinary, and more.

It offers information into the experiences of people from SGD groups, the discrimination and abuse they have encountered, and the many reasons why they might contemplate, attempt, or succeed in ending their own lives.

The book is a culmination of a three-year research project Life Over Suicide by SAGE, a lobby group cofounded by O’Keefe that campaigns for the rights of people who are SGD in Australia.

“Research shows that suicidal thoughts in these groups is between 60% to 70% in Australia, which is higher than any other group and more than 20 times the Australian national average,” says O’Keefe, herself an intersex and trans woman. “Other countries also report similar figures.”

One of the clearest things to emerge from the research and O’Keefe’s own clinical practice is the level of PTSD suffered by people from SGD groups.

Poverty, homelessness, bullying, exclusion, and discrimination are among the key drivers for suicidal thoughts or attempts, combined with a lack of or poor medical services for these groups of people.

“Religious institutions and far-right politicians continue to demonize SGD people,” says O’Keefe, an experienced clinician who has worked in community with SGD groups for more than 50 years. “Many are unable to get proper legal documents that match their identities and are excluded from families, work, education, and social spaces. When you are an excluded and oppressed minority your future can seem like an insurmountable, unsurpassable wall that is impossible to climb.”

Against this backdrop of multiple traumas, discrimination and exclusion culminating in high levels of suicidal thoughts or attempts, is a severe lack of understanding and education from in the health care professions about SGD communities.

“Intersex children are being operated on to change their genitals without their permission, often encountering unempathic clinicians and prejudice,” O’Keefe says. “Trans and other sex and/or gender diverse people are often faced with confused clinicians who have no idea how to help them. Many avoid having medical check-ups, screening, or scans because they are afraid of the ignorance, prejudice, and discrimination they will face.”

Suicide in Intersex, Trans and Other Sex and/or Gender Diverse Groups aims to remedy this by giving health care professionals practical knowledge and research-based skill sets for working in suicide prevention with people who are sex and/or gender diverse including the following:

  • why these groups are at extremely high risk of suicide;
  • how to spot potential suicidal clients well in advance;
  • where the funds for treatment and client support come from;
  • your legal and ethical obligations as a health care professional; and
  • what treatments you can apply for FAST recovery from suicidal thoughts and actions.

Along with an urgent need for more specialist care for people who are SGD, O’Keefe stresses the importance of community and for voluntary and public services to work together more.

“I was locked in a tiny cell in a mental institution with iron bars on the windows for years in the 1960s because a court decided that intersex, trans children like me were a danger to the public,” she says. “I attempted suicide more than once but what saved me were kind professionals, community groups, and friends who didn’t judge me and helped me. People can overcome suicidal, thoughts, emotions, and attempts with the right kind of care and attention.”

— Source: Australian Health and Education Centre


AMA Adds New Behavioral Health Guides

The American Medical Association (AMA) has added four new practice guides to the Behavioral Health Integration (BHI) Compendium of best-in-class resources designed to help physicians and health systems create practices that incorporate health services for both the mental and physical needs of patients.

“For medical practices looking to accelerate behavioral health integration, particularly given the acute increases in psychological distress and trauma created during the COVID-19 pandemic, the trusted online resources offered by the BHI Compendium provide a proven path toward implementation and sustained success,” says AMA President Gerald E. Harmon, MD.

The new how-to guides expand and enhance the ongoing work of the BHI Collaborative, established and supported by the AMA and seven other leading medical associations, to make mental health care more accessible by helping physicians and their care teams through the barriers to successful behavioral health integration.

Several key barriers to accessible and equitable treatment for patients’ behavioral, mental, and physical health needs are addressed in the new guides, along with practical strategies to overcome each barrier. These barriers include the following:

  • Practice workflow design: The workflow guide identifies key questions and criteria to help establish an efficient and effective integrated workflow for addressing the behavioral health needs of patients.
  • Pharmacological treatment: The psychopharmacology guide offers strategies for reducing stigma associated with psychopharmacology and includes best practices to treat patients with psychotropic medications, when needed.
  • Substance use disorder screening and treatment: The substance use disorder guide provides actionable, evidence-based steps to identify and address unhealthy substance use and misuse among patients.
  • Suicide prevention for at-risk patients: The suicide prevention guide helps identify at-risk patients and connect them with the most appropriate treatment plan.

The BHI Collaborative also offers a webinar series with free access to remote learning opportunities to accelerate behavioral health integration. The growing series covers BHI topics that include collaborative cultures, billing and coding, privacy and security, telehealth, and health equity.

Through the ongoing work of the BHI Collaborative, and in partnership with other leading medical organizations, the AMA is committed to helping physicians navigate and succeed in a continually evolving health care environment, while ensuring a professionally satisfying, sustainable physician practice experience that meets the comprehensive health needs of patients.

— Source: American Medical Association


Authors Unveil Autism Handbook for Schools

The Everyday Autism Handbook for Schools by Claire Droney and Annelies Verbiest is a practical, easy-to-read introduction to the ideas and strategies that can be implemented within the classroom to help children with autism achieve their full potential. With an introduction to autism and its key differences, insights from autistic individuals, and case studies drawn from years of experience, this is the definitive resource for busy teachers supporting these children within a mainstream or specialist school environment.

This book provides guidance on a variety of topics related to teaching children with autism in primary school, including adapting the curriculum, ensuring effective communication with staff and parents, fostering emotional regulation, and staff self-care. Each chapter includes easy-to-follow guides and resources, providing solutions, direction, and support for teachers to help students on the autism spectrum to thrive.

“This is a must-read handbook for school staff working with autistic young people. It is written by educators who share their rich and varied experience in a clear and friendly style that is both accessible and informative. Autistic voice and experience informs each section of the book. This is sure to be a much-read and recommended resource in schools,” says Claire O’Neill, an autism class teacher, teacher-educator, and neurodivergent coach.

— Source: Jessica Kingsley Publishers