Grant: Catalyst Grant: Moving Upstream - Structural Determinants of Health-POR Approach

Suicide deeply impacts Two-Spirit, lesbian, gay, bisexual, transgender, and queer (2S/LGBTQ+) communities. Complicating this, in 2027, medical assistance in dying (MAID) in Canada will be available to those with mental illness as the sole underlying condition (MAID-MI). Rates of mental illness are disproportionately high for 2S/LGBTQ+ people, and many may be eligible for MAID-MI. The legalization of MAID-MI must carefully be handled since the mishandling of suicide prevention efforts alongside an increase in MAID accessibility could have detrimental impacts. Yet, little research examines how 2S/LGBTQ+ people in Canada engage with crisis suicide prevention services or their perspectives on MAID-MI. In order to improve services that can reduce mortality and prepare for the impact of MAID-MI on suicide prevention efforts, research must begin from patient perspectives. Our objectives are to: 1) identify the factors impacting access to, and delivery of, crisis services for 2S/LGBTQ+ people; 2) understand and assess the anticipated impact of MAID-MI on decision-making processes and crisis service provision for 2S/LGBTQ+ people. Our research team, along with a patient advisory council and community collaborators, will conduct a two-part, patient-oriented, qualitative study. In Part 1, we will analyze recent interview data that explored 2S/LGBTQ+ people's access to mental health care in Atlantic Canada and their perspectives on MAID-MI. In Part 2, we will interview two new participant groups: i) 2S/LGBTQ+ Canadians who experience suicidality; ii) community members/peer workers who support 2S/LGBTQ+ people experiencing mental health crisis and suicidality. This research will offer insights into the relationship between suicide prevention and MAID-MI for 2S/LGBTQ+ people, recommendations for safely integrating and/or drawing boundaries between suicide prevention and MAID-MI, and structural and policy suggestions developed alongside policy leaders and community partners.