The Problem of Suicide in the LGBTQ Community Essay Example

as home, school and at work, the LGBTQ population face harassment, bullying, and violence where they develop suicidal behaviors. With more stress, they attempt to commit suicide and if not enough they end up committing suicide. While analyzing the issue Hass, Rodger & Herman, (2014) suggest that women are more likely to commit suicide compared to men. This is due to the fact, women tend to become more emotional when faced with challenges and quickly give up under intense pressures. Besides, the Suicide Prevention Resource Centre, (2008), indicate that the youth are the most affected population compared to the adults. Youth tend to have a vast network extending to the social media where criticism regarding their sexuality covers a broad range of audience creating a significant impact. Besides, if they are not receiving the family support, they end up moving out and are likely to become homeless hence increasing the chances of committing suicide. Fortunately, due to the increasing mortality rates among the LGBTQ population, there is increased national and international attention on how to reduce and further prevent the suicidal behaviors and attempts.

This paper, therefore, seeks to analyze the past and current findings from various research and influence the development of various interventions and policy changes for reducing the suicidal risks among the LGBTQ population. Specifically, the study will analyze independently; suicidal behaviors, suicidal attempts, and suicidal deaths across the population and analyze the extent of suicide in the LGBT population by examining the prevalence both at the state and national level. Also, various risk factors contributing to the increasing rates will be identified, the current initiatives in place to solve the problem and

finally provide relevant recommendations.

Sexual Orientation and Gender Identity among the LGBTQ population

The LGBTQ population is mostly referred as the sexual minority community. According to Hass, et al. (2011), sexual minorities can be viewed in two distinct characteristics; sexual orientation and gender identity. Sexual orientation is displayed in an individual with dimensions such as sexual self-identification, behavior, and attraction. During growth development an individual may identify him/herself as being lesbian, gay, Transgender or bisexual. However, youth perception of their sexual orientation remains unclear. Priebe & Svedin, (2013, p. 727) state that, “ investigation of the youth sexual orientation is a bit complicated as they may not pass significant milestones in the development of their sexual orientation.” In this regard, youth tend to perceive their sexuality and orientation as more like a changing wave over the generations. Statistically, according to Rosario, Schrimshaw, Hunter, Braun, (2006), 90% of the youth who declared to be gay or lesbian maintained their orientation over time, and 70% identified as being transgender and Bisexual kept their orientation over time. However, 60-70% of the youth who had declared to be lesbians or gay changed their identity after some time.

With young people who are still under development, their sexual orientation will differ with their definition or individual experiences. This means that they refrain from defining their identity as they remain unsure or just don’t want to accept. These mind deliberations among youth can be influenced by external factors such as family and peer’s perceptions on sexual orientation. For instance, when an individual coming from a particular culture or religious background which condemns lesbians or gay and it happens that the person thinks that they

belong to a certain gender contrary to the family’s expectations, then uncertainty on their right orientation becomes real. In a different perspective, Rosario et al., (2006) suggested that the sexual dimensions can be oriented differently within the same individual. For example, youth can have a strong attraction towards another person of the same sex but personally identify themselves as being heterosexual. While comparing between the sexual minority youth with the heterosexuals, Hass et al., (2011) affirmed that the sexual minority youth presented more chances of health risks such as drug abuse, suicidality, and victimization. Further, similar risks of stigmatization and victimization were experienced by youth under the three dimensions.

On the other hand, gender identity refers to an individual internal feeling of being either masculine or feminine. Gender identity ranges from a feeling of femininity to masculinity or identification of neither. Most times, the transgender individuals follow under categories of individuals with gender identity issues. Transgender people can also be referred as transsexual as they undergo surgeries for gender reassignment or hormonal treatment for alignment to their preferred orientation. Nestle, Howel & Wilchins, (2002), suggest that most transgender individuals exhibit both gender identifications hence remaining in between two identities over time without being exclusively male or female.

With the inconsistency among the transgender people, it becomes a challenge to describe their prevalence. Hass et al. (2011) claim that transgender people who move from one identity to the other tend not to accept their identity or use such behavior depending on the environment they are exposed in. Still, the transgender behavior results to more criticisms regarding denial not only from the heterosexuals but also the LGBTQ population. Therefore,

sexual orientation varies in transgender similarly as it does to people who view their gender identity to be associated with their biological sex.

Prevalence of Suicide in the LGBTQ community

LGBTQ people experience psychological, mental, social and physical stress in their lives while interacting with their peers. This applies to both the youth and adults. Currently, the youth is the population facing many challenges resulting to the increasing number of suicide cases. However, adults have been equally facing challenges hence resolving to suicide mainly due to the persecution they face due to legal condemnation and the discrimination cases at the age centers as they are less likely to have children to offer them support.

Statistics

The Suicide Prevention Centre (2008) explains that suicide has risen to become the third leading cause of death of people between the ages of 15-24 years. Specifically, about 4000 youth commit suicide each year with some contemplating and attempting suicide. Hass, Rodgers & Herman, (2014), analyzed data from the National Transgender Discrimination survey to identify the primary experiences by the LGBTQ community that are associated with the suicidal attempts. Approximately, 46% of the transmen admitted to suicidal attempts which were higher compared to the 42% suicidal attempts in transwomen. Also, youth population recorded higher rates of suicidal attempts with 45% between the age ranges of 18-24 years compared to 33% of those within the range of 55-64 years.

Apart from that, Rainbow Health Ontario (2008) conducted a survey to determine the prevalence of suicide among the LGBTQ youth and found that 9.5% which was equivalent to 99,000 young people in grades 7-12 considered committing suicide within the past year. Besides, in the past three years,

2.8% (29,000 youth) attempted suicide mainly due to peers and teachers discrimination and victimization. In a different study conducted in Canada, the US and New Zealand reveal that 4 out of the 10 LGBTQ youth thought about committing suicide while one out three attempted committing suicide.
In a different report by the National Recovery Month (2016) indicates that mostly Lesbians and bisexual women who underwent emotional stress while growing up were 2- 2.5 times to develop suicidal thoughts and eventually attempt suicide more compared to the heterosexual women. Still, 15.5% gay men who were sexually inactive developed depression over time and attempted suicide. Besides, 5.4% of the sexually active gay men attempted suicide.
According to Rosenstreich, (2013), the LGBTQ in Australia live happily and have minimized health needs compared to those in different regions, however, a significant number experience some challenges that mostly lead to mental disorders and to the extreme, suicide. Unfortunately, in Australia, out of the suicides recorded each year, the LGBTQ population takes the lead. Statistically, 20% of the Australian transgender people and 15.7% LBT youth admit to suicidal ideations. 50 % of the entire LGBTQ population in Australia attempted suicide at some point in their lives.

Mostly, the young age when an individual attempt to commit suicide is 16years where the individual is “coming out.” At this age, most of the people experience serious rejection from their parents which makes them leave their family. Due to lack of enough funds for self-sustenance, they become homeless and develop mental health problems.

Suicidal behaviors

It should be clear that being a Lesbian, Gay, Bisexual, Transgender and Questioning/Queer is not a problem, interacting with people with contradicting beliefs on

LGBTQ is what breeds the whole issue of discrimination. At times youth normally engage in Non-suicidal Self-injurious behaviors (NSSB) to seek attention. Such behaviors include; burning, cutting or hitting themselves. When youth do such behaviors and fail to achieve their goals, they opt for suicidal attempts. According to Grandclerc, Labrouhe, Spondekiewicz, Lachal, Moro, (2016), NSSB is presented mostly during puberty stage 13-15 years and progresses gradually. It is important to note that girls are the most vulnerable gender to develop the self-injurious behaviors. Without intervention, by the age 15-19 years, the individuals develop suicidal behaviors. Individuals who had Non-suicidal Self-injurious behaviors in their childhood are likely to attempt suicide, and most of them may eventually die. Grandclerc et al. (2016), conducted a study to determine the relationship between the NSSB and suicidal behaviors. They found that the association between the two was exhibited in the youth in different ways;

Shared risk factors; for individuals to develop suicidal behavior or NSSB, various factors contribute. These include; depression, drug abuse, attention deficits and personality disorders. Besides, the individual may have a personal history of physical violence, of family rejection. Due to the victimization the individual develop such behaviors to seek for help and if not provided they opt to die.

NSSB as a preliminary for suicide: as much as both behaviors seem similar, NSSB can be viewed as a step towards suicidal attempt. According to Grandclerc, et al. (2016), NSSB must be treated as an important risk factor for suicide. This is because an individual who had an episode of NSSB at some point will develop suicidal thoughts and in turn use the NSSB methods to commit suicide.

As much

as the two behaviors seem similar, when intentions for each behavior is considered they become different. Suicidal behaviors develop in an individual who has an intention of dying through the elimination of self-consciousness while, NSSB develops in individual undergoing unbearable circumstances and seeks to relieve the emotions. Unlike suicidal behaviors, NSSB seeks to adjust other than eliminating the consciousness. However, an individual with NSSB can eventually die depending on the frequency of such behaviors. Unfortunately based on their study, Grandclerc, et al. (2016), explain that justification of the NSSI behaviors by the youth can be categorized as being intrapersonal. Most youths claim that such behaviors assists them in relieving negative feelings or rather to initiate a feeling which can reduce the thought of a previous bad encounter. Besides, through hurting themselves, they will be able to communicate their issues with attention.

An individual exhibiting suicidal behavior does not want attention, but the pressures around him/her have become too much to handle and resolving to die is the best option. Grandclerc, et al. (2016), describe some suicidal behaviors such as:
· excessive sadness and mood swings
· Feeling hopelessness for the present and the future – the individual does not believe things can improve to be better.
· Sleep disturbances
· Individual suddenly becomes calm and quite. Such behavior can be interpreted as an individual who has already made up his/her mind to die.
· Withdrawal signs. This happens when the person prefers staying isolated and avoid socializing with friends. It is most likely that the person is experiencing depression, a leading sign of suicide.
· Personality changes. An individual contemplating suicide may decide to change their behavior drastically like become slow or

changes in attitudes. In other cases, the person can decide to neglect their physical appearance. This can be attributed to the fact that they have lost hope in life and don’t deserve to stay clean and happy.
· Adapting dangerous behavior. While considering suicide, a person may engage in dangerous activities such as reckless driving, drowning themselves, unprotected sex and substance abuse.
· Another typical suicidal behavior is making preparations. This is where an individual writes a will, clears his/her belongings and even write a suicidal note to leave behind.
· About 50-70% of people planning to commit suicide will share the information with a friend.

It is important that to recognize the suicidal warning signs. This helps in intervention to reduce the chances of the individual to commit suicide. When a person admits being in depression hence considering suicide, it is not necessary to talk the person out of suicide but instead encourage the individual that the depression is temporary and can be easily treated. Through analysis of the suicidal behaviors, intervention techniques can be employed earlier even before the individual attempts to commit suicide. This is because a person who attempted suicide in the past is likely to commit suicide.

Suicide Ideations

The suicide prevention resource center (2008), based on the National Comorbidity Survey report that, 13.5% of the US population comprising of all gender identities and sexual orientation, answered yes to “ Have you ever thought about committing suicide?”. In a study done by Eaton et al., 2006, 16.9 % of students within the age range of 9-12 years belonging to the LGBTQ population thought of committing suicide with the first year of the survey. As much as

statistics indicate a significant number of the LGBTQ population admitting to suicidal thoughts, the data collection process is mainly faced with various challenges such as;

· Reluctance to accept having suicidal thoughts. Most times the respondent may be uncomfortable to share information such as the personal reflections.
· Refusal to disclose their sexual orientation. With the challenges the LGBTQ population is facing, declaring their sexual orientation or gender identities publicly becomes difficult as they will fear further victimization. Therefore, while collecting information, representation of the LGBTQ population may not be successfully achieved.
· At the same time, the respondent for the survey may give exaggerated information concerning the subject.
· Most people while in depression may find it difficult to confirm the seriousness of suicidal thinking.

According to Suicide Prevention Resource Center (2008), suicide ideation is the instances where an individual thinks about committing suicide. Suicidal thoughts can start by just passing thought on committing suicide to the development of a deadly plan. In most studies, suicidal ideation is used as indicators for deaths. This is because an individual who thinks about committing suicide at one time may attempt and eventually die. Suicide ideation is more widespread compared to suicidal attempts and deaths. As much there are various intervention programs currently being implemented. Still, suicidal rates among the LGBTQ population are still increasing. Liu & Mustanski (2012), suggested that to achieve the goal of reducing the rates, understanding comprehensively the etiology behind suicidal ideation becomes a priority. In the study to evaluate suicidal ideation among the LGBTQ population, Liu & Mustanski (2012), found out that ideations in an individual can be predicted through impulsivity as well as through social support.

How the people interact with other friends in social settings will determine whether they have suicidal thoughts and early intervention will assist in reducing the chances of the individual committing suicide.

Besides Liu & Mustanski (2012), explain that suicide ideation can be divided into two different forms; active and passive form. An individual with active suicide ideation has the desire to die and have already developed a plan that is ready to execute. They do not talk about their situation, and they do not threaten rather they commit suicide when the planned time comes. This case is normally taken as a medical emergency. On the contrary, an individual with passive suicidal ideation will have a strong desire to die but does not have a plan on how he/she want to kill his/herself. Such individuals are characterized by constantly making threats and probably develop noticeable suicidal behaviors. It is fortunate that those with passive thoughts can be assisted early enough before they eventually develop a plan.

Risk Factors

The LGBTQ people develop suicidal behaviors and attempt to kill themselves due to the social pressures they encounter each day from their peers and family at settings like home, school or work. Constant mistreatment of the LGBTQ people leads to them to start questioning whether they need to exist in the first place. Without intervention to keep their spirit up, they eventually succumb to the pressures and commit suicide increasing the mortality rates. To be able to develop efficient and effective intervention methods it is important to analyze various risk factors that contribute to the LGBTQ population and especially the youth, to commit suicide.

Besides, suicidal risk factors can affect the possibilities

of developing suicidal behavior in two distinct ways; synergistically where a single factors results into a greater implication when the individual is exposed to additional risk factors. Also, risk factors can be dynamic where they significantly change in a person over a period. These factors include;

Demographic factors

How the LGBTQ population is treated varies in various parts of the world. This is due to the influence of culture and civilization. The study by Hass, Rodgers & Herman, (2014) under the National Transgender Discriminatory survey analyzed suicidal rates across various demographic factors. Regarding age, they found that individuals between the ages of 25-44 years were more likely to commit suicide compared to those above 62 years. This can be attributed to the fact that at the age group of 25-44, the individual is expected to have a family and if not due to their sexual orientation, they are likely to be criticized by their peers and families. This contributes to depression and eventually development of suicidal behaviors.
Besides, suicidal rates are higher among the whites compared to other races. Statistically, about 76% of the LGBTQ population committing suicide in the United States are the whites compared to 11% of individuals from a mixed race.
Due to mistreatment and discrimination at work or school, there is increased suicidal rates for people working full-time jobs and students of full-time programs.

Mental disorders

There is a strong association between the mental illness and suicidal behaviors. Mental disorders can include depression, anxiety disorder, conduct disorders and drug abuse (Hass et al. 2011). There are increased risks of suicidal rates among the LGBTQ population who were mentally diagnosed with depression and anxiety disorders compared to the

heterosexuals. Furthermore, the LGBTQ youth presented with more chances of developing multiple disorders. Within the population, male LGBTQ were more vulnerable compared to their female counterparts.

Apart from that, Hass et al. (2011), analyzed data from the population-based study done by the National Epidemiologic Survey on Alcohol and Related Conditions. The study aimed at examining the relationship between an individual’s sexual orientation and moods and anxiety disorders. The target population for the study was US youth of age 18 and above. The study revealed that there are higher lifetime moods and anxiety disorders among the respondents identifying as LGBTQ compared to the heterosexuals. Further, men who admitted to same-sex behavior or rather an attraction had increased anxiety disorders while females admitting to the same had a lower prevalence of any mental illness.

It is worth noting that, heterosexual experiencing mental illness are likely to contemplate suicide when not accorded the needed support. For the LGBTQ population experiencing the implications of the disorders and as well dealing with the challenges they face while interacting with people, aggravates the desire of death. Such a situation can be explained as synergistic.

Social environment

With various people holding their beliefs against LGBTQ population, the marginalized group is forced to constantly advocate for their needs amidst people who have negative opinions against them and ready for violence due to their sexual orientation. The Suicide Prevention Resource Center (2008) describes that the sociological framework for the LGBTQ population is stuffed with sociological stigmatization and psychological prejudice where the society openly disregards and condemn the LBTQ people.

With the negative social environment, the LGBTQ population suffers psychologically hence having high-stress levels, increased substance abuse, depression hence developing

mental disorders and general health problems. Without improvement in the public perception, the sexual minorities will not value their existence within the society hence develop suicidal thoughts and eventually commit suicide.

Family support

Most LGBTQ people admit to the fact that they develop suicidal thoughts mostly when they lack family support. The increase in the suicidal rates especially among the youth is as a result of family dynamics such as conflict, violence, and rejection. This mostly happens when an individual “comes out” when the family’s beliefs are strongly against the LGBTQ issue. With a family condemning homosexuality, the LGBTQ individual experiences psychological torture, verbal and to the extreme, physical assault. According to Rainbow Health Ontario (2008), most LGBTQ youth fear coming out to their families as they are likely to encounter rejection. When not living as per their desires, the LGBTQ youth finds no point of living hence develop suicidal ideations and eventually commits suicide. At this stage, it is advised that regardless their beliefs, families ought to provide support for the youth so as to prevent future tragedies.

Peer groups

Suicidal rates are also contributed by how the LGBTQ population is treated by their peer groups. This mostly happens during interaction in settings such as home, school or at work. Heterosexism among peer groups steers verbal attacks which may lead to violent activities such as bullying, physical attacks, and harassment. Verbal attacks can be statements such as “That was so gay” or “These Queers make me sick.” Such utterances in the presence of an LGBTQ youth are very offensive, and constant similar statements can become demeaning to the individual triggering frustrations, and hence suicidal ideas starts developing.
Still, within

school settings, an LGBTQ student might be denied important opportunities like participating in school activities such as games or community service due to their sexual orientation. At times, when teachers are part of the condemning group, the LGBTQ student lives with tough experiences in class. A teacher may hate them for their orientation and deny them participation in class. Collectively, the youth get enough of humiliation and decides to take his/her life.

HIV/AIDS

Hass et al. (2011) suggest that men who engage in sexual activity with other men increase HIV/AIDS risks which result in depression and drug abuse which in turn elevates suicidal risks. Still, there is increased chances of suicidal attempts and death among the HIV/AIDS individual. However, there is no clear understanding of the relationship between the viral effect and suicide behaviors. However, drug abuse, various psychiatric disorders, and past suicide attempts can be predictive factors for suicidal behaviors in HIV seropositive individual. This is contrary to their HIV-positive counterparts who have decreased suicidal rates as they have the opportunity of effective antiretroviral which results to a better prognosis. When an LGBTQ individual acquires the disease and that the use of antiretroviral would not be effective then death becomes an option.

Depression and Substance Abuse

People who are clinically diagnosed as depressed or those who abuse drugs do not end up committing suicide. But both depression and substance abuse are suicidal risk factors for people of all ages, gender identities, and sexual orientation. Mostly, LGBTQ youth due to the various challenges they end up becoming depressed and begin abusing drugs and eventually develop suicidal ideations. LGBTQ youth engage in drug addiction with the hope that they will

drive away the stress. For instance, during the initial stages, an individual will feel that whenever he/she takes alcohol, then most things will appear to be normal. Eventually, the person becomes addicted, depressed and starts rethinking on the real importance of living with all the challenges.

Cyberbullying

With the advent of technology, most young people have been glued to the internet, and now the benefits and harmful effects of the technology has raised concerns from various parties. According to Wielderhold, (2014) more than half of American youth within the range of 12-17 use an online social network. The use of internet among the youth is being questioned as some of the messages may spread hate regarding sexual orientation triggering suicidal thoughts. For instance, in a case presented by Wielderhold, (2014) where a college boy committed suicide by jumping off a high bridge after his classmate and roommate circulated to all friends his video with his boyfriend kissing. The video was shared widely via Twitter and most people, friends and strangers criticized him.
Cyberbullying had been identified as one of the challenges that the LGBTQ population and especially the youth are experiencing which evidently leads to suicidal deaths. Wielderhold, (2014), explains that 54% of the youth population are experiencing cyberbullying, and specifically, 45% of them belong to the LGBTQ community. Most LGBTQ youths feel offended and depressed when their sexual orientation is being condemned publicly over the internet.

Stigma, Prejudice, and Discrimination

The elevated suicidal rates have also been attributed to the issue of stigma, prejudice, and discrimination related to the sexual orientation of individuals. Hass et al. (2011) suggest that LGBTQ population experience both personal and institutional discrimination.

Individual discrimination

The LGBTQ

people normally experience discrimination in ways like a personal rejection, bullying, harassment and physical violence. Personal rejection is a case where the LGBTQ individual is rejected by peers and family due to the sexual orientation. In this case, the LGBTQ person feels isolated and not neglected. In some families, once the individual “comes out,” they will be overlooked, and their needs will never be met. When this happen an individual will opt to leave the home and given that the family does not care, funds will not be enough to sustain themselves on their own. In the end, the LGBTQ individual will become homeless and depressed. In such a situation it is guaranteed that the person will start contemplating on how he/she can commit suicide.
There is an interrelationship among most risk factors, but most of them vary between race and ethnicities. For instance, in the study by Meyer, Dietrich & Schwartz (2007), about 400 ethnically diverse and self-identified as LGBTQ participants aged 25-74 were recruited into the survey. The study revealed that the white respondents had higher mood disorders compared to the black participants but still the black participants had higher suicidal attempts compared to the white participants.

Institutional discrimination

Institutional discrimination mostly results from various laws and policies which demonstrate inequalities and does not protect against sexual-orientated discrimination. According to Hass et al. (2011), approximately 19 states in the US lacked specific laws protecting the sexual minorities against hate crimes and even employment discrimination. This resulted to a higher prevalence of anxiety disorders, substance abuse and moods compared to the heterosexuals. Also, the LGBTQ people living in states which do not have protection rights were 5times

more likely to develop mental disorders compared to the LGBTQ people in other states with the protection rights.

After the passage of the 1996 Federal Defense of Marriage Act, DOMA, marriage for the same-sex was constitutionally banned (Hass et al., 2011). DOMA maintained that states should not take a relationship between people of the same sex as a marriage regardless the fact that they may be taken as a married couple in other states. In 16 states which the amendments were against same-sex marriage, there was increased rates of mental disorders. The ban, therefore, elevated stigmatization within the society which eventually marginalized the LGBTQ social and legal status as well.

In healthcare settings, the LGBTQ population has been facing difficulties in health insurance coverage is not meant for same-sex couples. (Hass et al., 2011) Suggest that partnered gay, and lesbians are more likely to be uninsured. This means that they are being denied access to affordable treatment. Besides, lack of the insurance coverage especially to an LGBTQ person with mental disorders will lead to the delay in treatment where the individual will choose to self-treat through substance abuse resulting to physical comorbidities.

There has been an expanding conflict between the homosexuals and the religious institutions. Most religious entities condemn same-sex marriage which becomes a critical problem to the LGBTQ population due to the influence of the religions in the society. Religious people against LGBTQ community consistently condemn them without the knowledge of the negative impact they are cultivating.

When various critical institutions rise against the LGBTQ populations with combination of other additional risk factors, then the sexual minorities are likely to encounter various challenges either within or outside the

states which at the end it becomes tiresome to fight. The LGBTQ individual eventually opts to commit suicide.

Intervention and Recommendations

With the known risk factors contributing to suicide cases and the knowledge of warning signs for individuals contemplating suicide, it becomes easier to develop intervention plans to help support not only the LGBTQ population but also the entire society. Various institutions have made efforts towards the concern. The most vibrant groups are the LGBTQ organizations which work towards ensuring that all the needs of the marginalized community are met. Some of the current interventions include;

Mental Health Interventions

The LGBTQ organizations are working towards ensuring that the nations are aware of the health risks that the LGBTQ community face. The efforts are meant to seek for solutions to improving access to high-quality healthcare services.

Initially, the mental health professionals had categorized homosexuality as a disorder which required a couple of therapies to align the person into their true gender identity assigned at birth. In 1973, during the American Psychiatric Association conference, homosexuality was dropped from being a disorder hence no need for therapies. However, most LGBT people experience mental illness such as depression, anxiety, and moods which are attributed to the social pressures they face at home, school or work. Given that, they exhibit mental problems; they still require intervention from the mental health professionals so as to deal with the disorders as they are indicators for suicidal ideations. Improved mental health interventions among the LGBTQ community increases the acceptability of treatment and effectiveness.

At times, due to the challenges they face while seeking treatment at various facilities, the LGBTQ people opts for self-treatment which mainly involves substance abuse to

replace the pain. A study by Jaffe, Shoptaw, Stein, Reback & Rotheram, (2007) showed that the inception of gay men tailored cognitive behavioral therapy had resulted in the decline in substance abuse and depressive symptoms which in turn reduced the suicidal rates among the gay population. Therefore to ensure that the entire LGBTQ community gets access to quality healthcare serviced more focused treatment ought to be offered to the member developing mental disorders.

Recommendations for mental health interventions

· To ensure that all the mental health needs of the LGBTQ population are given priority in national agendas.
· Both private and public organization ought to work towards initiating campaigns which aim at educating the LGBTQ community on how the mental disorders such as anxiety, moods, and depression lead to suicidal behavior and attempts.
· The LGBTQ should be informed to learn how to seek help whenever they suffer either of the disorders or when they develop suicidal thoughts.
· Actively advocate for equitable and efficient health care services for all the LGBTQ community regardless the location. This means that those living in rural areas need to be given equal attention.
· Development of promotional programs that are unique to the LGBTQ community and seek to provide education on gender variations and further encourage both family and society connectedness.
· While initiating such programs, it is important that the LGBTQ population from diverse background are involved in decision making during development as well as the implementation of the promotional programs. For instance, LGBTQ from various races, ethnicities, age and gender identities.

Suicide prevention strategies

According to Hass et al., (2011), suicide prevention strategies focus on four categories which include;
· Development of awareness programs targeting the

community and organizational gatekeepers, the general public and the primary care physicians.
· Initiation of screening programs which assists in identifying the LGBTQ people with suicidal behaviors and directing them for treatment.
· Restricting the public from dangerous means utilized to commit suicide
· Development of programs which aim at providing suicide prevention education to the public

One of the major suicide prevention programs as described by Suicide Prevention Resource Center, (2008), is The Trevor Project. The project operates on a national level for suicide prevention among the LGBTQ population. Some of the activities that the project engages in include; conducting workshops, providing educational materials and online resources all which aim at educating on how to prevent suicide. However, it remains unclear how The Trevor Projects contribute to the reductions in the suicidal rates among the LGBTQ population.

Earlier, cyberbullying was identified as one of the factors that contribute to the increasing suicidal rates, especially among the LGBTQ youth. In this regard, Johnson, Oxendine, Taub, & Robertson (2013) explain that most colleges and universities are now working towards creating a safe environment for all members of the community. Enrollment rates for the LGBTQ students have increased with reduced cases of suicides. To achieve a comfortable environment, the universities have allowed development of LGBTQ associations where the members come together and share their experiences and most importantly offer support to one another. By creating a diverse environment, the students, teachers, and the staff will be able to interact with one another freely regardless of their sexual orientation. A case example given by Johnson et al., (2013) describe The Zone Program from The University of North Carolina at Greensboro which was initiated

to educate all members of the school on how to create a safe and comfortable environment for the LGBTQ. An LGBTQ person joining such a university will be guaranteed that they will face minimal or no discrimination. This will make them never to get a reason to start thinking about committing suicide.

Most LGBTQ youth experience stigma and discrimination while at school. This mostly occurs as students are not aware of how they should handle other people with different sexual orientation. Maguth & Taylor, (2014) explain that through the incorporation of the LGBTQ issue in the curricula, all students will be aware of their LGBTQ friends and how to interact with them. Specifically, Maguth & Taylor, (2014) suggest the introduction of the LGBTQ in social studies. The inclusion of the LGBTQ topics in classroom settings can trigger various open questions and debates. This will allow the students do investigations using practices like performing extensive research, conducting interviews and reflection on their perspectives. With this, most students will be able to get a clear understanding of the dynamics of the LGBTQ community including the challenges they face each day. Such information will promote the reduction of heterosexism and homophobia.

Besides, a similar project is The Difference Maker project which aims at leading the students to research and learn about the LGBTQ constitutional provisions. Improving school climate can lead to more LGBTQ students enrolling to schools and develop their careers. It is important to note that, most LGBTQ youth are unlikely to develop suicidal behaviors if they are in a school with antibullying policies that include sexual orientation. Such policies ensure that every student is treated equally whether by

a fellow student or teacher regardless of sexual orientation. Therefore, there will be reduced suicidal cases in schools with protective school climate.

The Suicide Prevention Resource Centre is an organization that advocates for the fulfillment of the needs of the LGBTQ community. To accomplish their goals, the Centre have identified various programs which promote suicide prevention and offer support to reach out to the majority of the LGBTQ community. Some of the support that SPRC provides for different prevention programs include; training in general life skills, connecting the LGBTQ youth to with various supportive adults and encouraging family connectedness by conducting awareness programs to the entire community. Besides, the Centers offer insights on how to cope with stigma and discrimination while at the same time appreciating the gift of life.

Recommendations for suicide prevention programs

· Encourage specialized focus on the LGBTQ population under intervention plans and programs developed for the entire communities.
· Support educational programs which aim the teachers and supporting staff in schools. This will ensure that all the teachers and other employees will handle all the students equally regardless of their sexual orientation.
· Develop community programs which incorporate the input of the LGBTQ population. When the LGBTQ community is involved in community service programs, they will feel appreciated by the community and able to demonstrate their capabilities regardless their orientation.
· Conduct regular evaluations of various suicide prevention programs. This will aim at reviewing the activities conducted towards achieving their goals and how their efforts are influencing the suicidal rates among the LGBT community.

Policy changes

Various institutional policies contribute to discrimination of the LGBTQ population such as heterosexism in religious institutions, constitutional laws prohibiting same-sex marriage and

health insurance coverage to heterosexual couples only. Policy changes in both private and public institutions will form a comprehensive strategy towards reducing the suicide rates in the LGBT community.
According to Hass et al. (2011), most LGBT organizations have given their leadership responsibility in campaigning for policy and legislative adjustments to support LGBTQ protective rights against violence, bullying, and physical assault. In addition, laws to be applied in discriminatory cases in settings such as military, marriage, employment and housing.

The Suicide Prevention Resource Center, (2008), suggests that adoption of cultural competence among various institutions will ensure that every person is accommodated regardless of sexual orientation. Cultural competence comprises behaviors, attitudes, and policies which will ensure that various institutions and professional perform their responsibilities in different cross-cultural situations.

Recommendations

· LGBTQ organization to strongly advocate for the adoption of antibullying policies as part of school safety initiatives. Such policies will not only guide the students but the teachers and other staff as well. This will ensure that a comfortable learning environment is restored for all students regardless the sexual orientation and gender identity.
· Campaign for policy changes both at federal and state levels to ensure that laws and regulations promote diversity. Such policies will ensure issues like harassment by law enforcers will no longer be reported. Besides, policies such as the marriage act to be reviewed by appreciating the LGBTQ dynamics.
· Non-discriminatory policies should be promoted. These include, unlimited access to mental health professionals and other primary care physicians with revised health insurance coverage terms accommodating homosexuals.
· Development of awareness programs aiming at demonstrating the extent of suicide rates and how the religious institutions are contributing to the elevating rates.

Through this, the religious leaders will be able to understand the need to change their mindset towards homosexuals and offer them support and encouragement of the value of life.

Conclusion

Various studies have demonstrated that suicidal rates in the LGBTQ community are higher than the heterosexuals. With the knowledge of different risk factors contributing to suicidal deaths, the state, and national stakeholders have the responsibility of offering support to various LGBTQ organizations advocating for the fulfillment of both health and personal needs of the LGBTQ people. Support can, therefore, be provided through funding of research aiming at raising awareness of the problem or rather development and testing of various intervention methods to help prevent suicide cases. Until the general population reduces heterosexism, the LGBTQ organization will continue advocating for policy changes and ensure that the LGBTQ live happy and healthy.

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