Preventing Suicide in England identifies increased mental health needs and an increased risk of suicide in the lesbian, gay, bisexual and transgendered (LGBT) community. It promotes interventions and service developments aimed at improving the mental health of people in this group as well as in other communities. However, the evidence surrounding the mental health needs of people who identify themselves as LGBT—particularly in relation to suicide—are complex and very few new services are being considered by commissioners at a time of recession and reform within the NHS. This review discusses the context in which the policy was developed, and explores barriers to the implementation of the second area for action within the strategy, in relation to preventing suicide among LGBT people. The need for sustained change is identified, while recognising that service development and evaluation may prove difficult when people often choose not to disclose their sexuality to healthcare practitioners. The Stonewall Health Champion Programme is given as an example to support recommendations in policy, practice, research and commissioning.