b'|Suicide Prevention Workplan - Los Angleles |43 |44 Sexual Orientation and Gender IdentityHomeless IndividualsLesbian, gay, bisexual, transgender, queer, and questioning people may be at increased risk for suicide."Homeless" is a term that includes individuals who are unsheltered and living on the streets as well as those Currently, it is difcult to evaluate risk for suicide among LGBTQ people because sexual orientation andwho are at imminent risk of losing housing or living in places not meant for human habitation. It also includes gender identity are not reported in death records. Healthcare settings, such as hospitals and emergencypeople living in shelters or other temporary programs; families with children or unaccompanied youth departments, also do not report sexual orientation and gender identity of people seen for suicide-relateddened as unstably housed; and those eeing or attempting to ee domestic violence and without services, making it even more difcult to evaluate suicidal behavior among this vulnerable group. Self-reportalternative resources for housing (48).surveys of suicidal behavior are the primary source of data. One survey of youth in primary care estimatedPeople falling within any of these categories of homelessness are undergoing intense physical, emotional, that 20 percent of lesbian, gay, and bisexual youth have attempted suicide.Suicide risk also is elevatedsocial, economic and cultural stressors. These stressors can be logically linked to risk factors for suicide.among transgender people. One study showed that 40 percent of transgender people attempted suicide at least once in their lifetime, with 92 percent of those making the attempt before the age of 25. StudiesA 2018 JAMA article (49) reported on mortality among unsheltered homeless adults in Boston. While the indicate that as many as 50 percent of transgender and gender non-conforming youth have attemptedndings are geographically limited, the results carry weight because they are from a 10-year study. Mortality suicide. Rejection of sexual orientation and gender identity by family and caregivers may signicantlywas 10 times higher among unsheltered homeless than the general population, and 3 times higher than increase risk for suicide among LGBT youth, highlighting the need to include familybased interventions insheltered homeless adults. The most common causes of death were disease (heart disease, cancer), suicide prevention efforts. (Information courtesy of Striving for Zero: Californias Strategic Plan for Suicidealcohol use disorder, and chronic liver disease. Suicide accounted for fewer than 5 of the 134 deaths over Prevention (6).) the 10-year period. Recommendations from the report included increasing accessibility of addiction treatment and recovery services, and establishing clinical outreach teams to establish and maintain medical An analysis of the California Healthy Kids Survey for school year 2017/18 found that a much highercare (as well as behavioral health care) for unsheltered homeless individuals.proportion of 9th and 11th grade students who identied as lesbian, gay or bisexual (as well as female or from a military family) had seriously considered suicide in the past 12 months. Other sources have reported that suicide rates among homeless populations are estimated at 9 times that of the U.S. general population, and that more than half of homeless individuals have had thoughts of suicide. Among those experiencing homelessness, transitional age youth (ages 18-24), LGBTQ individuals, and Los Angeles County School Risk Factor Comparison by District for School Year 2017-2018. ethnic minorities have elevated risk (50).Suicide Ideation Risk Factors Over one quarter of those who are sheltered and homeless, and nearly 35% of those who are unsheltered and homeless have a severe mental illness. Among those who are chronically homeless, one third have LA County School District Comparison, 2017-2018 mental health conditions and about half have co-occurring substance abuse problems. The majority have During the past 12 months, did you ever seriously consider attempting suicide?\x1f(Below percentages indicate yes to this question)experienced lifetime mental health and substance abuse problems. This population is also primarily male GenderSexual Orientation and middle aged (35-44 years old), and disproportionately consists of people of color, particularly African FemaleGay/Lesbian/Bisexual Americans and Latinos. There is a signicant relationship between incarceration and homelessness: 15.3% of inmates have been homeless within a year of incarceration, and 20% of those incarcerated who also have a mental illness were homeless. Finally, about 45% of homeless veterans also have a mental illness, and 70% have a substance abuse problem. Finally, a substantial portion of the homeless population are also 9th Grade 29%25% 25%23%24% 9th Grade 74%37% 55%47%52% veterans who tend to be single males, older than their non-veteran peers, and more likely to have a disabilityGlendoraClaremontNorwalk-La Mirada Paramount Santa Monica-MalibuGlendoraClaremontNorwalk-La Mirada Paramount Santa Monica-Malibu11th Grade 26%30% 20%22%18% 11th Grade 57%54% 31%37%35% (51, 52).The homeless population is a distinct cultural group with specic challenges and needs compared to Parent/Guardian Military Status Free/Reduced Mealpopulations with stable housing, with implications for access to services and supports. Little is known about In Military Free/reduced-price meal eligible suicide prevention specically for homeless populations; what we know works to reduce suicide risk was not developed within the context of the specic challenges and ongoing stressors of homelessness. Many people experiencing homelessness have additional challenges including a history of trauma, legal problems, 9th Grade 24%48% 17%33% 9th Grade 34%23% 19%16%24% and chronic health conditions. While counseling can make a life and death difference for a stably housedGlendoraClaremontNorwalk-La Mirada Paramount Santa Monica-MalibuGlendoraClaremontNorwalk-La Mirada Paramount Santa Monica-Malibu11th Grade 11th Grade 30%29% 17%17%16% person, an individual without the resources to meet their most basic needs is likely to require a different level of support to address their risk that must include efforts to secure housing, food, and medical care. Data not available LA County Average: 15%The five school districts listed had among the greatest proportion of students who answered yes when asked about suicide ideation for the 2017-18 survey Los Angeles Suicide Ideation County average: 2015-2017Source: CalSCHLS http://calschls.org'