John Palmeiri and Brian Altman

LGBTQI+ individuals are more likely than their counterparts to exhibit suicidal behavior. According to data reported by the Centers for Disease Control and Prevention, in 2019, nearly half of students identifying as gay, lesbian or bisexual reported seriously considered suicide. These students experienced a near fourfold increase in suicide attempts compared with heterosexual students. LGBTQI+ adults are also at greater risk of suicide. According to the Substance Use and Mental Health Services Administration’s (SAMHSA) 2020 National Survey on Drug Use and Health, 15.9 percent of LGB respondents ages 26 to 49 reported serious suicidal thoughts within the past year, and 2.1 percent reported a suicide attempt.

The experiences of stigmatization, rejection, trauma, victimization, microaggressions, homophobia and transphobia all contribute to this elevated risk. Conversely, support and connection between LGBTQI+ youth and their family or caregiver, peers, school and community, can promote better mental health, fewer negative outcomes and stronger resilience. The federal government, along with public and private sector partners, plays an important role toward building this affirming support and connection.  

On July 16, SAMHSA led the nationwide transition to 988 as the easy-to-remember number to reach the 988 Suicide & Crisis Lifeline — an important step forward to strengthen and transform crisis care in our country. 

Historically there have been notable gaps in accessing needed care for suicidal, mental health and substance use concerns with marginalized groups often facing additional barriers and inequitable outcomes. 

SAMHSA is committed to enhancing access to crisis services for LGBTQI+ youth, including through the 988 Suicide and Crisis Lifeline, and has outlined a number of critical activities. These include enhanced training, service linkage to specialized care and creation and testing of direct chat portals and interactive voice response menu options. 

In addition, research shows the training and expertise of the counselors who respond to crisis contacts matters. A recent survey of 12- to 25-year-old callers conducted by the Trevor Project revealed that nearly half indicated they called specifically because of LGBT-affirming counselors.

Recent federal appropriations direct $7.2 million to provide specialized services for LGBTQ youth within the 988 Lifeline. SAMHSA has been working closely with its partners to do so. Given both youth preferences for digital tools like text and chat and the particular needs of LGBTQI+ youth, such enhancements in access are critically important strategies to promote engagement. 

The implementation of 988 and expanding access to affirming support for struggling LGBTQI+ youth is a critical first step in saving lives, decreasing stigma and linking those in need to compassionate and effective care. If you or someone you know may be struggling with suicidal thoughts, call or text 988 or chat at 988lifeline.org