integrated care for people with complex mental and physical health issues

Luka Ritter is a Peer Worker in cohealth’s Integrated Complex Care (ICC) Program, assisting people with complex, chronic and often dual diagnoses navigate the health system and care for their mental, social and physical wellbeing. 

“I’ve wanted to work in mental health for a while. I studied Psychology as part of my undergraduate degree and I’m currently doing my Masters in Occupational Therapy,” said Luka. 

 “I had volunteered as a peer worker before coming to cohealth, but this is my first formalised paid employment opportunity,” said Luka. 

Luka’s peer worker role allows him to support his clients by drawing on his own experience of mental health issues, complimented by further training and professional development. 

Luka underwent gender-affirming surgery in January 2020, which resulted in several serious health complications, and impacted his mental health. 

“My own personal experience of accessing Emergency care and hospital admissions and seeking gender affirming care showed me just how limited the services were and how disjointed they were. Every time I was referred to a new specialist or service I had to repeat my entire story from the beginning,” he said. 

Luka has been passionate about improving the health system for transgender people – so much so that he wrote his honours thesis on the health system from the perspective of a trans man seeking gender affirming surgery. 

Luka’s role as a peer worker involves supporting a wide range of people with mental and physical health needs, not limited only to those who are transgender. The support provided by the ICC may be brief, moderate or comprehensive, depending on the client’s needs. 

“It can be anything from someone who needs a few referrals such as accessing physio, while others need to be connected to more comprehensive services such as NDIS, or to have weekly phone calls to check in on their wellbeing, or assistance to apply for housing,” said Luka. 

“For some clients it’s about sharing my general experience of mental health issues to create a connection, and with some clients I have been able to use specific parts of journey to help them navigate the system,” he said. 

“I have a client who is gender diverse and relatively new to navigating care systems. So I can relate deeply to what they’re going through and give them guidance,” said Luka. 

“Some of our referrals come from the local area mental health, but the vast majority come from other parts of cohealth. A GP or community nurse may pick up on a client that seems to have much deeper issues than just the symptoms they’ve presented with,” said Luka. 

Many ICC clients have competing priorities such as managing complex mental health, unstable housing, and social isolation, making connection with services is challenging.  

Over 60 per cent of ICC clients are born overseas and 20 per cent require interpreters which can increase barriers to meaningful service engagement, if proper care is not taken by services to ensure they are provided. 

“It can be exhausting and overwhelming to have multiple health issues requiring different treatment and multiple practitioners. You may have five different specialists and it can get confusing as to who to contact for what and which appointment you have coming up,” said Luka. 

Luka points out that for people who have significant mental health concerns, or don’t have good health literacy, or tech literacy, or refugees, the system is even less accessible. 

Luka says that even he – someone who was born and raised in Australia and with full command of the English language – finds the health system confusing, and fully understands why it would be even more difficult for people who are marginalised. 

“It’s so important to have organisations like cohealth, and programs like ICC, which fill the gaps and create greater health equity,” he said.