People with LGBTQ+ identities face disproportionate mental health challenges such as anxiety, depression and suicidal ideation. This is not due to LGBTQ+ identity but rather the increased stigma, discrimination, family rejection, trauma and other risk factors resulting from institutional and cultural biases that put LGBTQ+ people at increased risk.  

Risk factors which put someone at risk for negative mental health outcomes or suicide include, but are not limited to, social isolation, low self-esteem, substance use, depression, anxiety, co-occurring mental health issues and public policy.

School, cyber or workplace bullying can also increase risk and may reinforce harmful self-image, stigma, and/or discrimination.

Among LGBTQ+ adolescents, depression and hopelessness are the most significant risk factors for suicidal behavior. Nearly 70% of LGBTQ+ youth reported feeling sad or hopeless for at least two weeks in the past year.

Higher rates of depression, anxiety disorders and substance use disorders have been shown to heighten risk for suicidal behavior among LGBTQ+ people of all ages. Stigma, victimization and discrimination based on LGBTQ+ identity clearly contribute to mental health challenges — and can develop into suicidal ideation and suicide attempts in LGBTQ+ people.   

Mitigating and preventing negative experiences can decrease risk for LGBTQ+ people. The 2023 U.S. National Survey on the Mental Health of LGBTQ+ People by The Trevor Project reported that trans and nonbinary young people whose pronouns were respected by all people they lived with reported lower rates of attempting suicide, while less than 40% of LGBTQ+ young people found their home to be affirming. 

The Family Acceptance Project has found that LGBTQ+ people experiencing more family accepting behaviors are three times less likely to think about or attempt suicide, are at a reduced risk for depression and substance use, and have a greater chance for positive well-being.

Family accepting behaviors include:

• Supporting, being open about, and being proud of your family member’s LGBTQ+ identity

• Learning about, teaching about and defending a family member’s identity within social circles

• Connecting them to resources that include LGBTQ+ identities

There are many things someone can do to support their mental health.

Caring for physical needs is an important first step. While this may look different for each person, getting adequate rest and nourishment, participating in physical and mentally engaging activities, and seeking medical care for physical health issues are all beneficial.

Social relationships are also important. Have honest conversations about mental health with supportive individuals, find purpose and build connections to improve mental health or mitigate a mental health crisis. Sharing mental health experiences with others can help process strong emotions, identify concerns and form a support system. This SAMSHA guide for “asking for help” provides some tools for deciding who to talk to, when to talk and what to share with them.

LGBTQ+ affirming connections that encourage help-seeking and provide support can help us feel safe and less alone. Affirmation and connection with shared identities contribute to a sense of belonging and hope. Omaha ForUs' support groups and events are a great way to connect with LGBTQ+ folks in Omaha.

Being proactive about your mental health is essential. During a crisis, it can be difficult to access coping skills. For people who have more risk factors, it’s important to engage with care when not in crisis. Focus on developing and practicing coping skills, self-care strategies and a safety plan to be prepared for, or even prevent, a crisis.

With trauma comes resilience. Practicing gratitude and finding purpose, even during mental health struggles, nurtures our protective factors, which are critical for enduring and overcoming challenges. Examples of protective factors include social support, LGBTQ+ identified and affirming role models, LGBTQ+ safe environments and healthy coping mechanisms. Reflect with gratitude on any protective factors that have supported your journey thus far and think about ways you can be a protective factor for someone you know.

Some early signs of mental health problems include:

• An increase in anxiety, depression, emotional outbursts, sleep problems, appetite differences

• Substance use/misuse

• Apathy, feeling hopeless, feeling like a burden, anger

• Withdrawal from work, family, friends or other social activities

• Mood swings or any unexplained changes in feelings and behaviors which significantly interfere with your ability to be happy or hopeful

Monitor thoughts, feelings and behaviors of yourself and those you care about, and if any of the above signs are prevalent, you could benefit from seeking mental health support.

We all have bad days, but if these symptoms are continually interfering with your life, persisting for more than two weeks, you should reach out to a health care provider.

If you or someone you love is having thoughts of suicide, contact 988 or another crisis line and seek help immediately.

Reaching out for help when facing a mental health challenge is the bravest thing you can do. If you’re unsure how to ask for help, SAMHSA provides guidance.

If talking to an affirming family member or friend is not an option, others include:

• 24/7 LGBTQ+ affirming crisis lines, listed at the top of this web page

• Online support groups, in-person support groups or therapy. Check out Omaha ForUs’ therapy and support group opportunities.

You are not alone. Reaching out for help when you are having thoughts of suicide can be overwhelming, but help is available, and hope is real.

• Contacting crisis lines is a great first step. Operators will work with you to make a plan to help you stay safe and access the help you need.

• If you can, tell someone you trust. They may be a friend, physician, therapist, teacher, relative or other affirming adult. If that person does not respond the way you need them to, tell someone else. Not everyone is able to provide the help you need, and you deserve someone who can.

• Remove yourself from any method that you have considered using to end your life. Ask your support person to stay with you and remove anything you might use to end your life.

• While it can be tempting to self-medicate with drugs or alcohol, it reduces your ability to access the coping strategies you need during times of crisis.

• While it may feel like this moment of crisis will not pass, it will. Stay and get the help you need to move through this overwhelming time.

• If you have developed a safety plan, refer back to it. If you haven’t, ask the crisis hotline or a therapist to help you develop one.

• If you are unable to be in a safe environment, have already done something to cause your death, or are unable to find relief through coping strategies, call 988 or 911 immediately or go to your nearest emergency room.

If you notice something that makes you concerned about someone else, take a deep breath. It can be easy to assume someone else will reach out, but you may be the only person who has noticed. Trust your gut and reach out.

People who are suicidal commonly believe that they are a burden and that no one cares about them. You cannot convince them otherwise with words, but your willingness to walk this path with them can make a difference.

• You can contact crisis lines and ask them to walk you through what to do. They will first ask you if you are having thoughts of suicide, because this can be an overwhelming situation. They will then help you find resources and make a plan to help the person you're calling about. The crisis line will not contact this person as a result of your call, but if the person you're calling about is willing, you can call the crisis line together.

• Make intentional space to talk to the person. Talk to them in private, listen to their experience, express concern, and encourage them to seek help. Use open-ended questions and reaffirm that you care about them and will support them. If you are unable to be that support person, find someone who can. Be honest about your capacity to keep yourself safe while supporting someone in a crisis.

• Ask the person directly if they’re having thoughts of suicide. It is a misconception that this question will put the idea in their head. In reality, it shows the person that you care about them and noticed something seems wrong.

• Avoid minimizing feelings, trying to convince them that life is worth living, or giving them advice to “fix it.” In a moment of crisis, these approaches are not helpful. The priority is keeping them safe and getting them the help they need to get through the crisis.

• The most effective thing you can do is to stay with them, as long as your safety is not at risk. Ask them about how they have thought about ending their life and work with them to reduce access to any lethal means, especially firearms and medications. Putting time and distance between a person in crisis and their chosen way to end their life is one of the most effective steps to prevent suicide. This creates time for the intense moment of crisis to pass and for them to access help.

• If possible, work with the person in crisis to find the safest way to get them immediate help. Consent and collaboration can go a long way to deescalate the situation. Regardless of the outcome, you reached out to them when maybe no one else has, and that matters.

• Offer to go with them to get help, whether that is calling a crisis line or going to a medical facility. If you have to call 911, tell them that it is a mental health emergency and ask for a crisis intervention team or CIT-trained officer.

If you feel like your safety is in jeopardy, you are unable to physically be with the person, or they have taken action to end their life, call 911 or take them to an emergency room.

This can be a stressful situation. Once the crisis has passed, reach out for support to process your experience. That can be through a crisis line, a therapist or your own support people.

For more ideas on how to have this conversation, check out the American Foundation for Suicide Prevention’s “Talk Away the Dark” initiative.

Local resources

• American Foundation for Suicide Prevention Nebraska

• More Tomorrows

• The Kim Foundation

• Region 6 Behavioral Healthcare

• Nebraska Family HelpLine

• Community Alliance

• Safe Harbor Peer Crisis Services

• Heartland Family Service Lasting Hope Recovery Center

• Stephen Center

• Boys Town

• Lasting Hope Recovery Center

• One World Community Health Centers

• Charles Drew Health Center Inc.

• Douglas County Community Mental Health Center

• NAMI Omaha

• The Collective For Hope

• United Way 211

National/virtual resources

• IMI Guide

• The Trevor Project

• Teen’s Guide to Mental Health

• Family Acceptance Project

• Seize The Awkward

• Center for Interactive Mental Health Solutions (CIMHS)

• iPrevail

• Your Life Your Voice

• Talk Away the Dark

• To Write Love on Her Arms

• Vets4Warriors

• American Foundation for Suicide Prevention

• National Alliance on Mental Illness (NAMI)

• Family Acceptance Project

• National Institute of Mental Health (NIMH)

• Substance Abuse and Mental Health Services Administration (SAMHSA)

• Depression and Bipolar Support Alliance (DBSA)

• National Institute of Health (NIH)

• Anxiety & Depression Association of America (ADAA)

• Bad Bitches Have Bad Days Too

• National Queer & Trans Therapists of Color Network