Going off to college can be a fraught time for young people and access to mental health care and support can be crucial in making sure a student can adjust to the demands of college life.
New research from the nonprofit organization The Trevor Project takes a look at the impact access to mental health services can have on LGBTQIA+ college students and how that relates to suicide risk.
Experts say these findings underscore just how crucial it is that colleges and universities make mental health care accessible and inclusive to members of the LGBTQIA+ community on their campuses. Getting access to care that meets their needs can make a profoundly positive impact on these students’ lives.
This new research brief uses data from The Trevor Project’s 2022 National Survey on LGBTQ Youth Mental Health, which surveyed 33,993 LGBTQ youth online from September to December 2021.
Data from participants who stated they were enrolled in community or junior college, a 4-year university, or a graduate school were used for this brief.
The brief paints a pretty clear look at the state of LGBTQ students’ mental health on America’s college campuses. It shows that 33% of LGBTQ college students “seriously considered” suicide in the past year, while 7% actually reported a suicide attempt in the past year.
In zeroing in on which populations of students were most impacted by suicide and suicidal ideation, rates for those considering suicide were highest among LGBTQ students of color, at 35%, multi-sexual students, also at 35%, and transgender and nonbinary students at 39%.
The brief also reveals LGBTQ students of color, as well as transgender and nonbinary students, were at 9% when it came to reporting an attempted suicide in the past year. By comparison, their white LGBTQ peers were at 6%, and cisgender LGBQ students were at 4%.
With those statistics in mind, this new research brief pinpoints just how important access to mental health services is for LGBTQIA+ students, especially those who are most vulnerable and at risk for adverse mental health outcomes.
The Trevor Project reveals that those LGBTQ college students who had access to mental health care through their college or university displayed 84% lower odds of attempting suicide in the past year compared to those who did not have access to this kind of support.
What accounts for the reasons why an LGBTQ college kid might not have access to adequate mental health care?
The research brief shows that 33% cited they “did not feel comfortable” seeking this care in the first place, while 29% cited long waitlists, and 17% pointed to “privacy concerns” for why they either didn’t want to seek or were unable to seek mental health services at their school.
Those LGBTQ college students who did have access to LGBTQ-specific student services at college had 44% lower odds of attempting suicide in the past year, compared to those without access to this kind of support system.
They also found that 63% of LGBTQ students said their college had LGBTQ-specific services — think an LGBTQ center on campus, for instance.
LGBTQ students who didn’t have access to these kinds of community-centered services reported higher rates of suicide in the past year, at 41%, compared to 30% for those who did have access.
One positive statistic showed that 89% of the surveyed college students reported that their “college was accepting of LGBTQ people,” and that “this was associated with the availability of LGBTQ-specific student services,” the brief reads.
Myeshia Price, PhD, the Director of Research Science at The Trevor Project, said that the overall findings weren’t surprising to their team due to the fact they hypothesized that access to on-campus mental health and LGBTQ services would be a significant protective factor for LGBTQ youth.
“The data not only supported our hypothesis, the results were undeniably clear and will hopefully help inform colleges and universities as they work to make their campus more LGBTQ-inclusive,” Price told Healthline.
When it comes to this brief, one thing appears clear above all else — access to LGBTQ-affirming mental health resources is crucial for college campuses.
Dr. Jack Turban, assistant professor of child and adolescent psychiatry at The University of California San Francisco and Affiliate Faculty at the Philip R. Lee Institute for Health Policy Studies, told Healthline that for those LGBTQ young people who grow up in “non-affirming communities,” college might be the “first place where they find a supportive, accepting” environment.
“It may also be the first time they encounter a mental health professional who is affirming and accepting,” said Turban, who is unaffiliated with this research. “This can have a dramatic impact on improving mental health and reducing risk of suicidality.”
Dr. Natalia Ramos, MPH, an assistant clinical professor of psychiatry in the Division of Population Behavioral Health and a board certified child, adolescent, and adult psychiatrist at UCLA Health, explained that “young adulthood is a very stressful time.”
“Students who face discrimination, marginalization, and stigma often find themselves experiencing higher rates of depression, anxiety, and suicidality as a result of these experiences,” said Ramos, who is also unaffiliated with The Trevor Project’s research.
“Improved access to quality mental health services benefits all students. Students with increased stressors and traumatic experiences, including some LGBTQ students, clearly benefit from receiving supportive and therapeutic mental health services from well-trained professionals,” she said. “We know that having access to good quality care greatly decreases the risk of suicide and other adverse mental health outcomes. When youth get the support they need to thrive, they tend to do just that.”
Price pointed to the finding from the larger 2022 national survey this data came from that showed 82% of LGBTQ youth wanted mental health care in the past year, but 60% who wanted it, weren’t able to get it.
As a result of this, a college campus mental health service or an LGBTQ center at school might be the only available resource to these young people. This could be due to considerations over a student’s culture, safety, or financial instability.
“It’s imperative that schools offer a safe and supportive space for LGBTQ young people who might not have access to affirming care elsewhere,” Price added.
Ramos pointed to the importance LGBTQ-specific care makes for a queer young person looking for mental health care.
Ramos explained that care that is specific to the LGBTQ community encompasses services that “accept variety in gender identities and sexual orientations.”
If an LGBTQ student finds a provider who is well-versed in areas of concern specific to that young person’s identity and community, it can make all the difference, she added.
Turban spotlighted “the minority stress framework ” which states that one’s surrounding social environment can have a huge impact on mental health. He said that LGBTQ-centric resource centers “send a strong message” to students that they “are in a community that accepts and values them.”
“Our research has found time and time again that when LGBTQ young people feel affirmed and accepted for who they are, their odds of considering or attempting suicide can significantly decrease,” Price added.
On the flip side, Ramos explained that anti-LGBTQ services, or care that isn’t inclusive, “can further hurt and stress already vulnerable students.”
“Imagine seeking help during a vulnerable time and being treated disrespectfully or with confusion, or even being told that your identity is not valid,” Ramos added. “It’s very damaging.”
What if a college doesn’t have LGBTQ services but wants to augment its existing mental health programs to be more inclusive of these students’ needs?
“While it is helpful to have LGBTQ mental health experts on campus, all mental health professionals can play a pivotal role in supporting LGBTQ students on their campus. Well-trained therapists and psychiatrists can listen actively, meet someone where they’re at, and engage the student in strategies that address areas of challenge and foster resilience,” Ramos said. “You don’t have to be specifically an expert in LGBTQ areas to engage openly.”
Turban added that the new research brief shows many LGBTQ students on college campuses don’t connect with mental health services “because they fear they will be judged” by a provider due to their LGBTQ identity.
He said that if a campus center has “outreach materials” that explicitly show the university or college’s mental health services “welcome, respect, and affirm the full range of LGBTQ experiences,” then students seeking these resources will feel more at ease.
“In truth, intersectionality suggests that even things that are not specifically for LGBTQ students should be affirming and inclusive of LGBTQ students. Doing so would mean purposeful training in the understanding of LGBTQ identities for staff and faculty, as well as practical steps to take such as requesting and respecting pronouns and chosen names in those spaces, having gender-neutral bathrooms, and inclusive dorm and locker room policies,” Price explained.
“At the end of the day, allowing the space and opportunity for LGBTQ students to express themselves openly without fear of discrimination and victimization is free,” Price added.
When it comes to the barriers to care that LGBTQ students face at college, Ramos said it is yet another sign of flaws in the larger American mental health system, which is “underfunded, overloaded, and undervalued.”
What’s true for the country at large, is true on college campuses. She said we need to build a larger workforce of mental health professionals nationwide who are “trained to care for diverse patients.”
“Beyond this, campuses can dedicate specific funding to mental health services just like they do physical health services and decrease barriers to accessing care, such as making centers easy to reach, creating ‘warm lines’ for students to call around the clock, and creating faculty and peer outreach teams that engage with students in various campus spaces like classrooms and dorms,” Ramos added.
Turban said the long waitlists the research brief points to have been a long-held problem, and he echoed Ramos’s concern that we don’t have enough providers to meet the great demand for mental health services that emerged since the COVID-19 pandemic began. He said this calls for “high-level structural changes” that will “fundamentally reshape the mental health workforce.”
This provider shortage is compounded by the fact that relatively few mental health professionals are trained in meeting the needs of LGBTQ youth. The number of providers trained to support and care for trans and nonbinary youth is even smaller still.
“Psychiatry unfortunately also has a tarnished history when it comes to LGBTQ people. In the past, the profession has inappropriately stigmatized and pathologized LGBTQ people. Many young people are understandably hesitant to reach out to mental health services for this reason,” Turban said. “It can go a long way when university mental health services send out emails, put up flyers, etc. explicitly emphasizing that they are affirming safe spaces for LGBTQ people to seek support.”
These pervading barriers make a serious problem continually worse.
When asked what accounts for the high suicide risk among LGBTQ youth, including college students, Price said these young people are “not inherently prone to suicide risk” becauseof their identities — “they are placed at a higher risk because of how they are mistreated and stigmatized in society.”
Price explained that these students face stressors that their straight, cisgender peers “simply never have to worry about.”
These include bullying, discrimination, family rejection, and threats of or actual experiences of physical harm tied directly to their gender identity or sexual orientation. All of this can increase suicide risk.
Ramos said by the time LGBTQ youth reaches college, they have faced an ever-growing wave of these stigmas and discrimination — both at home and at school. Given that college is marked by a “time of intense transition and pressure” for these young people to begin with, it all adds up in a way that can be particularly difficult for one’s mental health.
Within the LGBTQ community, this is especially true for students of color as well as those who are multiuser, trans, or nonbinary.
Turban said vulnerable groups like trans students and students of color face intersectional experiences of stigma — something for which not many providers are trained to offer support.
“First, it can be hard to study differences among sub-groups within LGBTQ communities. Keep in mind that everyone has complex identities when it comes to gender, sexuality, and other personal traits like ethnicity, race, religion, etc.,” Ramos said.
“Generally speaking, people who encounter more stigma, rejection, and marginalization are more likely to have higher rates of low mood and suicidality. Over time, humans internalize messages they are given by those around them, by society,” she added.
Making all of this worse is the current media and political landscape in the United States have made for an inhospitable, dangerous climate for LGBTQ young people, Turban added.
If an LGBTQ college student reads this, resonates with the survey, and doesn’t feel particularly safe or supported on their campus, what can they do?
“First, I would tell the young person that things may be really, really tough right now and, even though it’s hard to imagine, circumstances may change with a little time,” Ramos said. “I would want them to know that they are valued and valid and important. Sometimes hanging in longer brings different circumstances, especially if you can find even one person or space where you feel supported.”
She said she would encourage LGBTQ young people to explore options for mental health care on campus or outside school “within the local community and online.”
Telehealth has made it easier to connect with providers outside one’s immediate location. As a result, you might be able to work with someone licensed in your state virtually, Ramos explained.
Make sure you look at online directories of psychiatrists and therapists and “definitely ask trusted peers and faculty to see if anyone might have a good lead for you,” she added.
Seeking out activities with like-minded people that are supportive and safe can also be a great help for one’s overall mental health.
Turban added that if you are feeling like you need immediate support or assistance, or need help pinpointing resources, The Trevor Project’s own 24/7 crisis services can be a great help.
Price said the nonprofit will continue to look at the realities of LGBTQ youth at college and ways to support their needs. What is important for an LGBTQ college student to know is there are pathways for help and support — community is out there.
OUR BRANDS
