The landscape and characteristics of LGBTQ+ community-controlled organisations delivering mental health and alcohol or other drug services in Australia

OBJECTIVE: Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) people experience disproportionate mental health and alcohol and other drug (AOD) burdens and have distinct care needs, yet limited evidence on the characteristics of LGBTQ+ community-controlled organisations constrains optimal service design and delivery. This study aimed to map the landscape of LGBTQ+ community-controlled mental health and AOD organisations that provide mental health and AOD services across Australia. METHODS: A mixed-methods study involved 16 LGBTQ+ community-controlled organisations, using an online cross-sectional survey and semi-structured interviews. Descriptive and content analyses examined organisational characteristics and service provision. A common practice elements approach integrated both data sources to identify shared organisational and service elements. RESULTS: Organisations varied substantially in size, workforce composition, and service models. All organisations provided mental health services, and nine provided AOD services. Eight common practice elements were identified: LGBTQ+ governance and infrastructure, embedded community responsiveness, integrated holistic services, collaborative partnerships, community building, foundational knowledge, relational practice, and safety-oriented approaches. CONCLUSIONS: LGBTQ+ community-controlled organisations provide essential, contextually safe mental health and AOD services and operate through distinctive yet commonly shared practices. IMPLICATIONS FOR PUBLIC HEALTH: Workforce development and integration with mainstream systems are critical to sustain LGBTQ+ community-controlled organisations and meet growing community demand for inclusive care.