Advancing Health Equity Among Older Men Who Have Sex With Men: A Multisectoral Collaboration

Dear Editor,

In an earlier published article, the authors have examined the impact of psychological well-being and suicide attempts among older men who have sex with men (OMSM; Chan et al., 2022). The link between suicide and OMSM is a novel idea. While the link between suicide and mental health disorders such as depression and alcohol use disorder is well established in high-income countries, many suicides happen impulsively in moments of crisis with a breakdown in the ability to deal with life stresses, such as chronic pain such as COVID-19 and illnesses, financial problems, and relationship break-up. Suicide at any stage of life is a tragedy for the individual, his or her family and friends, and the community.

OMSM belong to a marginalized group of people often referred to a family group called lesbians, gays, bisexuals, transgenders, queers, intersex, asexuals and other individuals with diverse sexualities and genders (LGBTQIA+). They are often discriminated against and suppressed by mainstream group (Blosnich et al., 2020). The risk factors such as psychiatric, physical and functional, and social domains operate in complex interactions against a background influenced by one’s culture, personality, traits, and even neurobiological make up. A 2002 study reported that 12% of urban gay and bisexual men had attempted suicide, a rate 3 times higher than the overall rate for American men (Paul et al., 2002). Almost half reported multiple attempts. By far, the strongest risk factor to suicide is a previous suicide attempt. One common theme that underlies most successful suicides is a sense of hopelessness. Although depression may seem hopeless, it is not because it is treatable. Suicides are preventable.

The World Health Organization (WHO) recommends the following key effective evidenced-based interventions: limiting access to the means of suicide, interacting with the media for responsible reporting of suicide, fostering socioemotional life skills in adolescents, and assessing and managing anyone who is affected by suicidal behaviors. These need to go together with the following foundational pillars: situation analysis, multisectoral collaboration, awareness raising, capacity building, financing, surveillance and monitoring, and evaluation (WHO, 2022). Corpuz (2021) proposed a multiagency and multisectoral approach to suicide. Multiple sectors of society, including the health sector and other sectors such as governmental and nongovernmental organizations, education, labor unions, business, justice, law, defense, politics, and the media, can leverage knowledge, expertise, and resources to provide assistance to OMSM and LGBTQIA+ who are experiencing depression. The key findings of Chan et al. (2022), therefore, lend support and a sense of urgency to need to focus on both interventions and policy changes that can mitigate the suicide rates among OMSM and LGBTQIA+.