Trans and Gender-Diverse peoples' experiences of crisis helpline services

Demographics and Use of an Addiction Helpline for Concerned Significant Others: Observational Study

BACKGROUND

Concerned significant others (CSOs) play a significant role in supporting individuals with substance use disorders. There is a lack of tailored support services for these CSOs, despite their substantial contributions to the well-being of their loved ones (LOs). The emergence of helplines as a potential avenue for CSO support is outlined, culminating in the focus on the Partnership to End Addiction's helpline service, an innovative public health intervention aimed at aiding CSOs concerned about an LO's substance use.

OBJECTIVE

The article analyzes the demographics and use patterns of the Partnership to End Addiction's helpline service, highlighting the critical role of such services, and advocating for expanded, tailored support models.

METHODS

This observational study draws data from 8 data platforms spanning April 2011 to December 2021, encompassing 24,096 client records. Surveys were completed by helpline specialists during synchronous telephone calls or self-reported by CSOs before helpline engagement. Collected information encompasses demographics, interaction language, substance of concern, CSO-LO relationship, and the LO's "use state," that is, their location on the continuum of substance use.

RESULTS

CSOs primarily comprised women (13,980/18,373, 76.1%) seeking support for their children (1062/1542, 68.9%). LOs were mostly male (1090/1738, 62.7%), aged 18-25 years (2380/7208, 33%), with primary substance concerns being cannabis (5266/12,817, 40.9%), opioids (2445/12,817, 19%), and stimulants (1563/12,817, 12.1%). CSOs primarily sought aid for LOs struggling with substances who were not in treatment (1102/1753, 62.9%). The majority of CSOs were looking for support in English (14,738/17,920, 82.2%), while the rest (3182/17,920, 17.8%) preferred to communicate in Spanish. Spanish-speaking CSOs were significantly more likely to call about cannabis (n=963, 53.7% vs n=4026, 38.6%) and stimulants (n=304, 16.9% vs n=1185, 11.3%) than English-speaking CSOs (P<.001). On the other hand, English-speaking CSOs were more likely to be concerned about opioids than Spanish-speaking CSOs (n=2215, 21.3% vs n=94, 5.2%; P<.001).

CONCLUSIONS

The study illuminates the helpline's pioneering role in aiding CSOs grappling with an LO's substance use. It highlights helplines as crucial resources for CSOs, revealing key demographic, substance-related, and use-state trends. The dominant presence of women among users aligns with other helpline patterns and reflects traditional caregiving roles. While parents form a significant percentage of those reaching out, support is also sought by siblings, friends, and other family members, emphasizing the need for assistance for other members of an LO's social network. Spanish-speaking individuals' significant outreach underscores the necessity for bilingual support services. Substance concerns revolve around cannabis, opioids, and stimulants, influenced by age and language preferences. The helpline serves as an essential intermediary for CSOs, filling a gap between acute crisis intervention services and formalized health care and treatment services. Overall, the study highlights this helpline's crucial role in aiding CSOs with tailored, accessible support services.

Enhancing Equity on Crisis Lines: Understanding the Background, Practices and Learning Needs of Responders in Canada

Understanding the current state of equity, diversity, and inclusion (EDI) within the crisis line sector is essential to enhancing accessibility and acceptability of crisis line services for all. Through an intersectional lens, we examined 9-8-8 crisis line workers' personal and work demographics, training, resources, perceived competencies in supporting diverse populations. We conducted an electronic survey of crisis line responders and leadership in Canada. Data was analyzed using descriptive statistics, Fisher's test, and Mann-Whitney U/Kruskal-Wallis H tests. Open ended responses were analyzed using content analysis. 323 surveys were completed. Analysis revealed statistically significant associations between respondent demographics, training satisfaction, access to resources, and perceived competency in supporting diverse communities. Conclusion: The findings indicate the need for new approaches to recruitment and training in the crisis line sector to enhance the inclusivity of crisis services for all individuals seeking mental health support.

Romantic relationships buffer minority stress in transgender and non-binary adults: Effects on depressive symptoms and suicidality

BACKGROUND

Transgender and non-binary (TNB) individuals are at greater risk of mental health concerns relative to their cisgender peers due to experiences of minority stress. Thus, it is critically important to identify factors that may be protective and buffer the effects of minority stress. This study examined whether romantic relationship involvement and quality buffered effects of TNB minority stress on depressive symptoms and suicidal ideation.

METHODS

A large international sample (n = 1156) of TNB adults (n = 654 partnered; n = 502 single) reported on minority stress experiences, relationship status and quality, and mental health outcomes (i.e., depressive symptoms and suicidal ideation).

RESULTS

The effects of victimization and rejection on depressive symptoms and suicidal ideation were attenuated among partnered individuals. However, once relationship quality was considered, the buffering effects of relationship involvement applied only to those in more satisfying relationships; the stress-buffering effects were not observed among those in distressed relationships. Of particular importance, general interpersonal satisfaction did not act as a minority stress buffer, suggesting there may be unique stress-buffering effects of being in a satisfying romantic relationship on depressive symptoms and suicidal ideation.

LIMITATIONS

The cross-sectional nature of the current study precludes definitive conclusions regarding causation.

CONCLUSIONS

These findings suggest that romantic involvement may serve a stress-buffering role for TNB adults, but only when these relationships are satisfying. Our results have important theoretical and clinical implications, and further research is needed to investigate the utility of relationship interventions to buffer the effects of TNB minority stress on depressive symptoms and suicidality.

'It feels meaningful': How informal mental health caregivers in an LGBTQ community interpret their work and their role

Many members of lesbian, gay, bisexual, trans and gender diverse, and queer (LGBTQ) communities provide informal mental health support to peers. This type of support is valuable for people who receive it - even helping to prevent suicide. It is also meaningful to those who provide it. In this article, we focus on how LGBTQ people derive meaning from their experiences of supporting peers. In-depth interviews with 25 LGBTQ people in Melbourne, Australia, indicate that those providing informal mental health support to fellow community members recognise their roles as meaningful in three main ways: in terms of self, relationships and communities. Recognising the meanings that LGBTQ caregivers derive from helping fellow community members provides useful information service providers and policymakers seeking to better address mental distress in LGBTQ communities and support caregivers. It is useful to understand this meaningful work in an LGBTQ context as caregiving that challenges gendered and heteronormative assumptions about what care is, and who provides it.

'Is it worth potentially dealing with someone who won't get it?': LGBTQA+ university students' perspectives on mental health care

LGBTQA+ university students have unique mental health needs and high rates of mental distress compared to their cisgender heterosexual peers; however, it is likely that many LGBTQA+ individuals remain untreated or receive inappropriate or insensitive care. The aim of this study was to explore the experiences and preferences in mental health care of LGBTQA+ university students in Aotearoa New Zealand. Twenty-eight young adults participated across 12 focus groups or interviews in which they were asked about their experiences and preferences. We used thematic analysis to identify patterns of meaning in the data. Researchers developed three themes of I can do this on my own, but others should seek help; you have to be lucky to access mental health care; and 'therapists just need to be a bit more like up with the programme'. The results of this study mirror those found in more general studies of LGBTQA+ mental healthcare experiences, however, also adds to considerations for university campus healthcare services. The findings of this study should be considered by all mental health providers working with LGBTQA+ young adult university students.

Demographic and psychosocial factors associated with recent suicidal ideation and suicide attempts among trans and gender diverse people in Australia

INTRODUCTION

Correlates of suicidal ideation and suicide attempts among a large cross-section of trans and gender diverse populations in Australia were examined.

METHODS

A national survey was conducted that included 1466 trans and gender diverse participants aged 18+ years. Multivariable regressions identified factors associated with recent suicidal ideation and suicide attempts.

RESULTS

Overall, 62.4% reported suicidal ideation and 9.5% suicide attempt in the past 12 months. The likelihood of suicidal ideation was higher for younger participants or those who felt treated unfairly or socially excluded due to their gender identity in the past 12 months. It was lower for those with a postgraduate degree, who felt accepted by family or work, or who felt their gender identity was respected when accessing a mainstream medical clinic in the past 12 months. The likelihood of suicide attempts was greater for those aged younger or who had recently experienced sexual harassment based on their sexual orientation or gender identity, and lower for those who were non-binary.

CONCLUSION

Urgent attention for suicide prevention is necessary for trans and gender diverse communities. These findings point to a range of risk and protective factors, which may help inform the targeting and design of suicide prevention strategies.

Gender differences in use of suicide crisis hotlines: a scoping review of current literature

Purpose

Little is known about the gender profile of callers to crisis hotlines, despite distinct gender differences in suicide risk and behavior. The authors assessed current knowledge of the role of caller gender in the use of crisis hotlines for suicide, specifically whether there are differences in frequency, reason for call and caller outcomes by gender.

Design/methodology/approach

The authors conducted a scoping literature review of peer-reviewed studies published since 2000 in Medline, PubMed and PsychInfo, examining a total of 18 articles based on 16 studies.

Findings

Overall, women represent a higher percentage of calls to crisis hotlines worldwide, despite men having higher rates of suicide. Primary reasons for calling hotlines were the same for men and women, regardless of geography or culture. When gender differences in reason for call were reported, they were consistent with literature documenting gender differences in the prevalence of risk factors for suicide, including higher rates of substance use among men and higher instances of domestic violence/abuse among women.

Research limitations/implications

There was variability in the studies the authors examined. This review was limited to research on crisis telephone hotlines and did not include text or chat services. Due to data reporting, the findings are constrained to reporting on a male/female gender binary.

Originality/value

Findings on gender differences in crisis line use suggest a need for continued research in this area to determine how to best meet the needs of callers of all genders.

The Nature and Impact of Informal Mental Health Support in an LGBTQ Context: Exploring Peer Roles and Their Challenges

BACKGROUND

Research shows that LGBTQ communities experience high levels of suicidality and mental ill health. They also face significant barriers to accessing adequate mental health treatment in service settings. In response to these factors, it is likely that LGBTQ community members turn to their peers for informal mental health-related support. Such support, however, is largely undefined, the extent of it poorly understood and its impacts on those who perform it underexplored.

METHODS

We explored the nature and impact of informal mental health-related support provided by peers in LGBTQ communities in Melbourne, Australia. Drawing on semi-structured in-depth interviews with 25 LGBTQ adults in 2020, we explored how and why peers provided mental health support to friends, partners, housemates and even strangers and the impact this had on them.

RESULTS

We found that participants performed support roles as extensions of their existing relationships. We demonstrate that the support roles of the safe friend, housemate and partner, among others, represent everyday relationships stretched-even to breaking point-to incorporate informal mental health support. Each of these support roles is distinct, but they can all potentially result in similar impacts on those performing them. One of the more significant of these is burnout.

CONCLUSIONS

LGBTQ community members face a diverse range of challenges when they support peers with their mental health. Informal peer-support roles are a significant responsibility for those performing them. LGBTQ community members stepping up to support others should be better supported to help manage their roles and the impacts of performing them.

POLICY IMPLICATIONS

Findings can contribute to policy that not only addresses high levels of mental ill health in LGBTQ communities, but also seeks to help peers in support roles to prevent them from being negatively impacted.