“We need all the support we can get”: a rapid qualitative analysis of cross-national LGBTQ+ perspectives on social support, mental health, and suicide prevention

Lesbian, gay, bisexual, transgender, queer and gender minority (LGBTQ+) individuals experience significant disparities in suicidal thoughts and behaviors. Responding to recent cross-national calls for solutions to LGBTQ+ suicide, the purpose of this study was to investigate perspectives of individuals with LGBTQ + and suicide lived experience in three domains: (1) improving mental health services, (2) seeking social support if experiencing suicidal thoughts and behaviors, and (3) defining support/family. A total of 748 LGBTQ+ participants in the United States (U.S.) and the United Kingdom (U.K.) completed a cross-sectional online survey. Using a rapid qualitative approach, we organized narrative responses with a rubric and applied primary codes in a matrix display. Summary tabulations captured the frequency of 29 codes mentioned by participants across the three domains. A heatmap visualization by subgroup summarized code application and respondent proportions, exploring variation by geographic location, LGBTQ+ outness, and gender. Recruitment channels, compensation, and missingness varied by country, limiting robust cross-country comparisons. Participants cited compassionate care (e.g., gender-affirming) and accessible appointments as primary needs for mental health resources. Subgroup analyses indicated a greater proportion of transgender participants discussed a need for compassionate care compared to cisgender participants. LGBTQ+ individuals frequently reported past suicide disclosure, or intent to disclose, to their close social ties. Unconditional love, regardless of family-of-origin connection, was a prominent definition of family across all participants. Supporting LGBTQ+ individuals’ mental health needs should consider relational and person-centered approaches to reduce suicide in the U.S. and U.K.