Background: Suicide rates are particularly concerning among equity deserving populations, including 2SLGBTQIA+ and ethnoculturally diverse communities in Canada. Bisexual women, for instance, have the highest rates of suicidal ideation at 49.9%, compared to 28.1% for lesbian and 11.9% for heterosexual women (Stinchcombe & Hammond, 2021). Ethnocultural barriers, such as isolation and racial discrimination, further increase the risk of suicidality, especially among long-term immigrants and people of color (Coimbra et al., 2022; Stick et al., 2021). Crisis helplines are crucial for reducing suicidal ideation, with 45-48% of individuals reporting improved coping after using these services (Gould et al., 2019; Côté & Mishara, 2022). However, gaps remain in providing gender-affirming and culturally responsive care, which is critical for 2SLGBTQIA+ and ethnoculturally diverse individuals. U.S. research highlights that many 2SLGBTQIA+ populations will contact crisis lines they know are sexually and gender affirming, while immigrants avoid services over concerns about cultural insensitivity (Alvarez et al., 2022; Goldbach et al., 2019). Studies indicate that between 45% and 48% of individuals who contact helplines report feeling better equipped to cope after using the service (Côté & Mishara, 2022). However, a gap remains in providing gender-affirming and culturally responsive care, which is critical for 2SLGBTQIA+ and ethnoculturally diverse individuals. Despite the growing recognition of the importance of inclusive helpline services, Canada’s helplines largely fail to meet the specific needs of diverse populations. This reflects a significant gap in both service provision and research on how helplines can be better equipped to support marginalized populations.
Methods: This study, grounded in Queer Theory, Socioculturally Attuned Theory, and Critical Race Theory, sought to address this gap by exploring how crisis helplines can be transformed to better support 2SLGBTQIA+ and ethnoculturally diverse callers in Canada. Through semi-structured interviews, 17 frontline responders with experience supporting sexually and gender diverse callers, and six with experience supporting ethnoculturally diverse populations, were interviewed to identify service needs and pathways for transforming crisis support.
Results: Voices of the crisis responders revealed the following themes: identifying callers/texters from equity deserving communities, the role of effective training in empowering responders to offer supportive care, navigating systemic challenges, and building connections.
Discussion: Recommendations for culturally and gender-affirming care will include tailored training, collaborative care models, addressing the political climate, and targeted supports. These findings will be of value to crisis responders, community advocates, policymakers, and trainers aiming to create more inclusive and effective crisis support systems.