Mental health and suicide prevention

LGBTQI people experience more mental illness and have more frequent suicidal thoughts than heterosexual cis people. RFSL works to ensure that the authorities, health care and society in general recognises this and carry out specific efforts to improve the situation for LGBTQI people.

This is what RFSL does

RFSL works actively to promote the mental health of LGBTQI people and address the issue of  suicide prevention for LGBTQI people. Influence work is a central part where we raise awareness about this need through dialogue and meetings with authorities, politicians and other decision-makers. RFSL also receives operating grants from the Public Health Agency to work with suicide prevention and mental health. RFSL can in various ways complement other efforts that are being made because we meet LGBTQI people in a variety of contexts.

An important part is to raise awareness within RFSL about suicide prevention and to promote mental health. Staff, elected representatives, volunteers and others active within RFSL may need more knowledge about how to work but also about where one’s responsibility ends. Within the framework of this, we have therefore produced the material We are better together which is a guide to how RFSL’s branches can work to prevent suicide and to promote mental health for LGBTQI people in general and trans people in particular.

RFSL also provides support specifically for transgender people via the website transformering.se and the support email linked to the page. RFSL also cooperates with other organizations and participates in national network meetings for suicide prevention. Mental health is also highlighted within RFSL’s trainings. Last but not least, RFSL conducts a number of concrete health-promoting activities and activities, both nationally and through our branches. RFSL offers community, safer meeting places and support calls. This takes place, among other things, in the form of various discussion groups, the Newcomers network, RFSL Support Service and counseling.

What do we know about the mental health of LGBTQI people?

There is a lot of research, among other things a registry study from the National Board of Health and Welfare showed that the incidence of risk use or addiction as well as the incidence of depression and anxiety disorders is higher among people in same-sex marriages compared to people in opposite-sex marriages (National Board of Health and Welfare, 2016). The Public Health Agency’s report on the health of transgender people showed that 40 percent of young transgender people have tried to take their own lives at some point and that 57 percent have had suicidal thoughts in the past year (Public Health Agency, 2015). A survey from the National Board of Health and Welfare (2020) also showed that the population of trans people to a large extent has one or more psychiatric diagnoses.

A possible explanation for the widespread mental illness among LGBTQI people is the theory of minority stress. As part of a minority group, you can feel great stress/strain from being made invisible, questioned, harassed and discriminated against, from constantly having to come out and explain yourself, and from feeling fear and worry about being exposed in various ways. One can also adopt the negative view of LGBTQI people from those around you, i.e. internalized LGBTQI-phobia. All this affects mental health negatively.

It is important to remember that not all LGBTQI people experience mental illness or have suicidal thoughts. However, it is much more common among LGBTQI people than the general population, and there is much to be done in the area of mental health and suicide prevention for LGBTQI people. Targeted interventions are necessary, especially for transgender and bisexual women who are the two groups with the highest rates of ill health.

In order to get the funding, all actors were asked to make a current situation analysis and write a plan of action regarding what measures would be taken locally and regionally. One of the target areas in the agreement between the government and SKL was to focus on vulnerable groups. LGBTQ people are mentioned as an important target group for these efforts.

RFSL has read the plans of action that were sent in during the fall of 2016, and that are to form the basis of the work in 2017, to see if the LGBTQ perspective has been integrated and what measures are planned to support LGBTQ people’s mental health.

Survey of the regions’ efforts for mental health

The mental health initiative from the government is intended to strengthen the work of municipalities, county councils and regions with mental health locally based on local conditions. SEK 780 million was set aside for this purpose, which Sweden’s municipalities and county councils (SKL) have been allocated for the work locally and regionally.

Requirements for an action plan

In order to get a share of the money, all the actors would do a current situation analysis and write an action plan about what efforts should be made locally and regionally. One of the target areas in the agreement between the government and SKL was to focus on vulnerable groups, where LGBTQI people are mentioned as an important target group to reach with the efforts.

RFSL has gone through the action plans that were sent in during the fall of 2016 to form the basis for the work in 2017, to see if the LGBTQI perspective has been included and what initiatives are planned to improve the mental health of LGBTQI people.

11 regions completely lack LGBTQI efforts

It turned out that only 12 out of 21 regional analyzes received contain writings about LGBTQI. The is does not mentioned at all in the analysis of the situation regarding mental health locally. 10 out of 21 action plans mention LGBTQI in their action plans, but only one of the action plans (Stockholm’s) mentions several specific measures to be taken to improve the mental health of LGBTQI people.

However, we know that some of the regions that do not mention LGBTQI are actually making efforts for the health of LGBTQI people, but that this has clearly not been communicated between different units and that there is a lack of an overall approach to the efforts being made regionally and locally.

It is worrying that as many as 11 regions completely lack efforts to improve the mental health of LGBTQI people. The agreement is clear that LGBTQI people are a vulnerable group that needs specific interventions.

Education dominates efforts

The efforts planned within the framework of the mental health initiative are for the most part training for professionals in LGBTQI issues and approach. This is an important effort to improve healthcare and other functions within municipalities, county councils and regions, so RFSL views this positively. However, it becomes problematic when education becomes the only measure to improve the mental health of LGBTQI people.

These efforts are needed

LGBTQI people who are mentally ill have special needs that need to be taken into account and preventive measures are needed to avoid LGBTQI people developing mental illness. For example, we would like to see that each county council has an elaborate plan for what people seeking gender-affirming care should look like, how a referral should be written and what psychological support is provided in the home county council during and after gender-affirming treatment.

We also want there to be counseling support for trans people and relatives of trans people in every county council/region, and that every county council/region has a BUP reception with a special LGBT focus to which LGBT youth are referred.

RFSL has written an order list for municipalities, county councils and regions with proposals for measures to improve the mental health of LGBTQI people locally, which we hope that those who write the action plans in the future will use to better include the needs of LGBTQI people .

Link to RFSL’s survey in its entirety ( pdf , opens in new window)

Link to RFSL’s order list for municipalities and county councils/regions ( pdf , opens in new window)

It was clear that only 12 out of the 21 regional analyses about mental health locally mentioned LGBTQ. The rest didn’t mention the group at all. 10 out of 21 plans of action mention LGBTQ in their analyses, but only one of the action plans (Stockholm’s) mention many specific efforts that are to be made to improve LGBTQ people’s mental health.

However, we do know that some of the regions that don’t mention LGBTQ actually make efforts to improve LGBTQ people’s health, but this has obviously not been communicated between different divisions. Thus, there’s a lack of a holistic approach when it comes to the efforts that are made regionally and locally.

It’s worrisome that as many as 11 regions completely lack efforts to improve LGBTQ people’s mental health. The agreement is clear in that LGBTQ people are a vulnerable group that needs specific attention.

Education dominates the efforts

The measures that are planned within the framework of the mental health effort are for the most part education for people who work with LGBTQ issues. RFSL feels that this is an important effort to better healthcare and other functions within municipalities, county councils and regions. But it’s problematic when education becomes the only measure in improving LGBTQ people’s mental health.

These efforts are needed

LGBTQ people with poor mental health have specific needs and there is a need for preventative measures to keep LGBTQ people from developing mental ill health. For example, we would like to see that every county council had a plan for how people that seek gender affirming care should be treated, how a referral should be written and what psychological support should be given in the home county council during and after a gender affirming treatment.

We also want there to be counseling support for trans people and the family of trans people in every county council/region, and that every county council/region should have a BUP centre with a special LGBTQ profile that LGBTQ youth can be referred to.

RFSL has written a list of suggestions of measures to improve LGBTQ people’s mental health locally. We hope that those who write the plans of action in the future will consult this list to better be able to include LGBTQ people’s needs.

Link to RFSL’s mapping in its entirety (in Swedish, pdf, opens in new tab)

Link to RFSL’s list of suggestions to municipalities and county councils/regions (in Swedish, pdf, opens in new tab)