Crisis line use and mental health care access among LGBTQ+ young people in the United States

Youth who are lesbian, gay, bisexual, transgender, queer or questioning, and other diverse sexual and gender identities (LGBTQ+) experience disproportionately high rates of suicidal thoughts and behaviors compared to heterosexual and cisgender peers, yet many face barriers to care. Data came from a national online survey of 18,663 LGBTQ+ youth aged 13–24 years in the United States (September–December 2023). Analyses focused on participants who reported wanting mental health care in the past year and assessed access, barriers, service modalities and suicidal ideation/attempts. Half of LGBTQ+ youth who wanted mental health care did not receive it. The most common barrier was fear of talking about mental health concerns (42%). Among those who received care, one-on-one therapy was most common (69% in-person and 53% online). Suicidal ideation was lower among youth in therapy (46% in-person and 40% online) compared to those using crisis lines (75%). After adjusting for demographics, hotline use remained strongly associated with elevated risk: adjusted odds ratio (aOR) = 3.77 (95% confidence interval [CI]: 3.11–4.56) for suicidal ideation; aOR = 3.21 (95% CI: 2.62–3.94) for attempts. Despite strong willingness to seek care, structural and identity-related barriers leave many needs unmet. Expanding culturally competent services is essential to reducing suicide risk

Health care · Hotline · Lesbian · Mental health · Mental health care · Sexual orientation · Suicidal ideation · Suicide prevention · Transgender · Cancer survivorship and care · Digital Mental Health Interventions · LGBTQ Health, Identity, and Policy