Not long ago, an aging gay man in his 70’s shared with me his grief over the death of his cherished partner, who died as a result of HIV/AIDS in the 1990’s. Although his partner died almost twenty years ago, he was now experiencing intense feelings of loss. He said, “I couldn’t deal with his death back then. There were so many friends who died. No one was prepared to handle so many deaths. I shut down, drank, and stumbled through the next decade.” He continued, “It’s bad enough now to be old, but to be ugly too is unbearable. I think about him all the time and want to join him. I know I can kill myself. Why am I still here?”
Sadly, this man’s story is not unique. While reasons vary, in terms of suicidal ideation, the disturbing thought is that older LGTB adults are vulnerable to suicidal behavior. In the 2013 citywide survey on the needs of the LGBT older population in San Francisco, 15% of the participants in the study reported that they had seriously considered suicide in the last 12 months.
Having created the Center for Elderly Suicide Prevention and Grief Related Services, and maintaining the 24-hour Friendship Line crisis intervention service for older adults and younger disabled adults, I am, and continue to be, intensely concerned about preventing death by suicide. As an older gay man myself, I am aware of the unique issues related to my sexual orientation.
As a presenter and participant at the LGBTQ Suicide Prevention Conference held in March at San Francisco State University, I learned that progress has been made, especially in terms of programs designed to support the younger LGBTQ population. Unfortunately, we still have little data that accurately reflects the number of deaths by suicide for the adult and older adult LGBT population. Few studies identify best practices for LGBT suicide prevention services.
In the meantime, how can we respond to this urgent public health problem? First, we have to increase our awareness about suicide death in the LGBT community by encouraging researchers to investigate the risks and protective factors associated with LGBT older adults. Second, we need to understand the challenges that older LGBT people of differing racial and ethnic backgrounds face as they age. Third, we must find ways to deal with disparity in our health care systems and our long-term care institutions when LGBT individuals need these services. Fourth, we must challenge prejudice and discrimination that exist in many segments of the LGBT community as well as in the heterosexual community. Such problems include ageism, racism, gender discrimination, homophobia, biphobia, and transphobia. These are just some of the internalized and externalized beliefs that harm all of us.
Through early intervention and prevention, we can hopefully identify the grief, depression, substance abuse, loneliness and other factors that contribute to suicide risk and suicide death. If we are going to reduce suicidal ideation and suicide death in the older LGBT community, we will need to insist that health, mental health, and other city-wide services do all they can to advocate for nondiscrimination and protection for LGBT people.
We can help that older gay man who finds himself isolated from a community in which he, in his youth, found love and acceptance. We can reach out to him, and others like him, to connect and to remind him that he is still a vital part of our community, our history and our legacy. Connections are what bind us to life and offer us the support we need to manage the heartbreaks that occurred in our pasts so that we can face the uncertainties in our futures.
Patrick Arbore, Ed.D., is Founder and Director of the Center for Elderly Suicide Prevention & Grief Related Services, a program of the Institute on Aging. The 24-hour Friendship Line’s number is 800-971-0016.
• Openhouse: 415-296-8995 openhouse-sf.org/
• Family Caregiver
• Institute on Aging: 415-750-4111, www.ioaging.org/
• National Resource
Center on LGBT Aging
• Project Open Hand
San Francisco: Nutrition
• SAGE: 212-741-2247
• Shanti Project, Inc: HIV Services and Life Threatening Illnesses, 415-674-4700
Alzheimer’s Association Programs and Services:
• 24/7 Helpline: 1-800-272-3900, www.alz.org/norcal/; Online Community: www.alzheimersblog.org/lgbt-forum
• Memory Clinic, Kaiser
Permanente Santa Clara Medical Center: 408-530-6900, mydoctor.kaiserpermanente.org/ncal/facilities/region/santaclara/area_master/departments/memoryclinic/index.jsp