Transforming Phone Line and Text Crisis Intervention for 2SLGBTQI+ Callers and Texters in Canada

Background and Purpose:

Individuals who belong to the 2SLGBTQI+ community experience significant discrimination and are at a higher risk of suicide and poor mental health outcomes than heterosexual Canadians. 2SLGBTQI+ people are four times more likely to attempt suicide compared to their straight cisgender peers. They have shown hesitation in accessing crisis services due to the absence of 2SLGBTQI+ competent providers and barriers such as discrimination, transphobia, homophobia, and lack of 2SLGBTQI+2+ knowledge. Although evidence shows that suicide/crisis hotlines are effective at supporting individuals who are suicidal, there is limited research on how effective they are with 2SLGBTQI+ callers.

Research objectives: 1) Explore the perspectives of stakeholders and frontline staff on gender affirming (GA) practices in suicide/crisis lines; 2) To understand how the gaps in services impact 2SLGBTQI+ callers and suicidality; 3) Identify what additional training is needed in GA practices in Canadian suicide/crisis hotlines to better support 2SLGBTQI+ callers; 4) To inform national research, suicide/crisis helplines, and suicide modalities in how they work with 2SLGBTQI+ callers.

Methods:

This qualitative study gathered the perspectives and wisdom of 10 frontline suicide/crisis intervention responders (N=10). Recruitment was conducted through social media (LinkedIn, Instagram, and Facebook), snowballing sampling, and six community organizations located in the Canadian Prairies. Data collection encompassed one-hour qualitative interview with each participant conducted on Zoom, recorded, and transcribed by Otter.AI. Data analysis followed the phenomenological research method and analysis by Clark Moustakas. Ethics certificate obtained at the University of Calgary (REB23-0926).

Results: specific results in summary form.

Our results reveal that most common training and suicide intervention models focused minimally on gender affirming care. Responders identified that they learn how to support 2SLGBTQI+ callers experientially/in practice and by self-directed learning vs. by crisis intervention gender affirming trainings at their agencies. Some challenges were identified: the mentality of one-model fits all, lack of effective data collection in hotlines, lack of training on gender affirming care, lack communication from agencies on their gender affirming positions (i.e., using 2SLGBTQI+ flags), lack of referrals to the right resources, or lack of inclusive language. Recommendations included: enhancing trainings on 2SLGBTQI+ suicide risk knowledge, gender studies, gender affirming care, integrating 2SLGBTQI+ in crisis intervention trainings and certifications, and promoting transgender and 2SLGBTQI+ specialized care.

Conclusions and Implications:

This qualitative study holds substantial benefits for service providers, 2SLGBTQI+ diverse callers, trainers, and academics. By addressing gaps in knowledge concerning best practices for suicide/crisis support for 2SLGBTQI+ people, helplines will enhance service for queer equity-deserving populations so their needs are met and suicide rates decrease in these communities.