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.