988, new suicide number, will help LGBTQ youth, experts say

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On July 16, Americans will be able to call or text a new phone number – 988 – if they feel they are going through a mental health crisis and/or are at risk of suicide.

The three-digit number will replace the 10-digit number for the National Suicide Prevention Lifeline, which can currently be reached by phone or text at 800-273-8255 and also offers online chat. The next move to 988 is due to the passage of the National Suicide Hotline Designation Act, which President Donald Trump signed into law in October 2020 after it passed the Senate with bipartisan support.

The legislation also required that the shift to 988 include a strategy to provide specialized services to LGBTQ youth, who are more than four times more likely to consider suicide than their non-LGBTQ peers, research shows.

Officials say they hope the new, shorter phone number will be easier for Americans to remember, in a bid to help more people in crisis — and LGBTQ youth in particular.

But as the switch to 988 approaches, officials also said more needs to be done to ensure Lifeline’s providers can handle the expected surge in callers. NBC News reported last month, for example, that less than half of states have enacted legislation to pay for the implementation of 988.

“We’re at the beginning of a transition, not the end, and there’s still a lot of work to do,” said John Palmieri, acting director of 988 and the Behavioral Health Crisis Coordination Office at Substance Abuse and Mental Health Services. . Administration (SAMHSA). The Lifeline, he added, has been “massively underfunded and underfunded” since its inception in 2005.

Another major item on officials’ 988 to-do list: finalize LGBTQ-focused organizations that will receive $7.2 million in earmarked funding to provide specialized services to LGBTQ youth who come to the Lifeline.

Experts who study the mental health of LGBTQ youth say it’s crucial that officials finalize plans and funding to ensure they can provide the necessary LGBTQ-specific training to 988 crisis responders – especially given the torrent of legislation across the country targeting the rights of LGBTQ youth. They say LGBTQ-informed suicide prevention services can help offer crucial support in times of crisis — and ultimately save lives.

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“I think this is something they need to address quickly, because they’re going to be getting phone calls from young LGBTQ people,” said Jessica Fish, assistant professor of family science at the University of Maryland.

Fish added that given the onslaught of anti-LGBTQ legislation, the effects of the pandemic on mental health, and existing data showing disparities in depression and suicidality, Lifeline must “be prepared to lead these people to providers on the phone who can navigate that. in a manner that is sensitive, informed, empathetic and aware of the unique experiences of LGBTQ youth in particular.

According to a SAMHSA official and John Draper, executive director of Lifeline and executive vice president of national networks for Vibrant Emotional Health, the New York-based mental health service provider, conversations between Lifeline officials and potential providers of 988 geared towards LGBTQ youth are underway. responsible for administering 988.

Draper added that “all counselors will receive expert training to provide affirmation services to LGBTQIA+ people in crisis.”

A survey conducted by the Centers for Disease Control and Prevention between January and June 2021 found that nearly half of gay, lesbian and bisexual teens said they had considered suicide during the pandemic, compared to 14% of their heterosexual peers.

The Trevor Project, which focuses on suicide prevention among LGBTQ youth, said in a report: “LGBTQ youth are not inherently at risk of suicide because of their sexual orientation or gender identity, but rather at higher risk due to the way they are mistreated and stigmatized. in society.”

Some of that abuse and stigma, experts say, comes in the form of policy, including a Florida law — which critics have dubbed “don’t say gay” — that went into effect Friday and bans K-3 teachers from discussing gender and sexual orientation in class.

And the recent reversal by the Supreme Court of Roe vs. Wade and the concurring opinion of Justice Clarence Thomas who called on the High Court to reconsider its rulings in cases that legalized same-sex marriage and struck down anti-sodomy laws are also likely to have negative impacts on the mental health of young people LGBTQ, according to Jeremy Goldbach, professor of sex health and education at Washington University in St. Louis.

“It creates anxiety,” Goldbach said of these current events. “You don’t even have to be the direct victim of a law for it to affect you.”

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In addition to anti-LGBTQ laws, stigma can manifest through politician-shaped speech, media coverage and table conversations, according to Fish. This makes it all the more crucial that 988 counselors be trained to meet the needs of LGBTQ youth in crisis, she added.

“I think this crisis line could – if people are trained to work with this community – provide huge benefits to young LGBTQ people who may or may not feel like they can go somewhere else,” Fish said. . “But it could also create additional harm if people aren’t ready and prepared or trained to work with that community.”

A report released last month by Rand Corp., an independent research organization, found that only 45% of public health officials tasked with helping roll out the new Lifeline said their staff had been trained to interact with LGBTQ people.

Draper said Vibrant provided 988 crisis responders with “several educational webinars and guidance materials” focused on inclusive language and best practices on how to support LGBTQ youth who contact 988.

He declined to discuss the LGBTQ-focused organizations that are considered 988 Providers, but noted that “The Trevor Project has long been a valued collaborator and advisor to Vibrant in supporting Lifeline’s service to LGBTQIA+ populations.”

The Trevor Project operates a 24/7 crisis hotline that serves over 300,000 LGBTQ youth annually through calls, texts and online chats run by more than 2,000 volunteer crisis counselors trained across the country, according to a spokesperson.

Preston Mitchum, director of advocacy and government affairs for The Trevor Project, confirmed that the organization’s officials have been in conversations with officials from Vibrant and SAMHSA about the possibility of providing specialized services to LGBTQ youth through 988. He added that Trevor Project officials hope to be able to begin providing services to LGBTQ youth who contact 988 by September if the organization ends up becoming a contractor.

“It’s not just about getting the funding, it’s about [the] the timing allowed for implementation to happen once funding is finally received,” Mitchum said. “I want to make it clear that the goal of providing the best care and service to people should not be rushed.”

Research suggests that Lifeline’s crisis counselors could also play an important role in the lives of young LGTBQ people who contact them. The Trevor Project’s 2019 National Survey found that LGBTQ youth who said they had at least one accepting adult were 40% less likely to report a suicide attempt in the past year than those who did not. , even controlling for race/ethnicity, age and gender. identify.

Goldbach said LGBTQ-informed crisis counselors are especially crucial for LGBTQ youth in crisis given that they are often “not surrounded by other LGBTQ people who can…help them make sense” of their identity. and their experiences of discrimination.

LGBTQ-informed 988 crisis counselors should also ask young people’s pronouns and avoid making assumptions about their gender identity based on the sound of their voice, Goldbach and Fish said. (Lifeline’s online chat currently allows people to specify their gender identity but not their pronouns.)

Another approach crisis counselors should keep in mind, Goldbach said, is to listen to the extent, if any, of LGBTQ youth talking about their gender identity and/or sexual orientation having a role. in their mental health crisis.

“There are times when young gay people have a crisis that isn’t necessarily about identity” – like going through the pain of a breakup – “and I think sometimes people who don’t have a lot of experience in counseling with gay people keep wanting to come back to that and assume that must be the heart of the matter, and that can be really stigmatizing,” he said.

Other aspects of identity — including socioeconomic status, racial and ethnic identities, immigration status and age — can also shape the particularities of LGBTQ youth experiences, Goldbach added, which makes it important to take them into consideration.

“I think at the end of the day there are a lot of different things that come up at any given time and this crisis is not always about the same thing,” he said.

Amid ongoing discussions about exactly how specialized LGBTQ services will be delivered through 988, Mitchum said Trevor Project officials “will be there every step of the way to make sure we reach the finish line.”

In the meantime, Goldbach urged crisis counselors across the country to use the Trevor Project’s online resources and seek out local LGBTQ centers to learn more about how best to serve LGBTQ youth.

“If we’re all waiting for the government to step in and provide the training, I think we might be waiting a bit,” he said. “There are resources, especially in LGBTQ centres, [that] are great places to start if you want local training.

If you or someone you know needs help, call National Suicide Prevention Lifeline at 800-273-TALK (8255). As of July 16, you can reach the Lifeline by calling or texting 988. Crisis text line also provides free confidential 24/7 support via text message to people in crisis when they text 741741.

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