Available evidence affirms the effectiveness- of crisis helpline services in providing appropriate short-term intervention for many groups, but the unique needs of sexual minority adult callers may prevent them from deriving similar therapeutic benefit. Two hundred and forty-eight sexual minority adults from across Australia were asked about a previous personal crisis where they had accessed, or had considered accessing, a crisis helpline service. While most responses indicated some familiarity with available services, only 30% (n=75) of participants had accessed a helpline service during a time of crisis. Despite a low rate of service uptake, many of those who had used a service evaluated it positively. The low rate of overall engagement was attributed to a fear of being discriminated against by helpline workers or arose from a concern that they would have insufficient understanding of LGBT-specific concerns to be able to render meaningful support. For helpline services to increase service uptake among sexual minority adults, it is recommended that outreach efforts be undertaken to dispel the negative perceptions about such services by sexual minority persons.