These criteria included: (i) a known statistical risk of suicide; (ii) actual numbers of suicides in the group were known; (iii) evidence exists on which to base preventative measures and; (iv) effective monitoring of preventive measures exist.

Lesbian, gay and bisexual (LGB) people were not included as a high risk group because they did not meet these criteria. For example, routine data collection and monitoring of the number of suicides in this group is not possible because sexual orientation is not recorded when the death is registered, nor at the inquest.

However, the concerns of organisations representing LGB groups were acknowledged that there was an accumulation of evidence which suggested that sexual orientation is a risk factor for self-harm and suicide. That is why NIMHE commissioned this literature review into the risks of suicide and self- harm amongst lesbian, gay and bisexual people.

This report sets out the results of this systematic review and adds to the growing evidence that suggests that LGB people are at greater risk of mental disorders and suicidal behaviour than heterosexual people. The challenge now is to promote the findings and conclusions of this review and to consider the implications for the work of the suicide prevention strategy. That is why LGB people  are now included as a specific group who have special needs under Goal Two of the Strategy (to promote the mental well-being of the wider population). This will send out a clear message to organisations working with LGB groups, including health and social care agencies, that actions need to be taken if we are to reduce the risk of suicide in this group of people.