Influences of Suicide Ideation for Gender and Sexual Minority Youth Accessing a Warmline

Background

Gender and sexual minority youth (GSMY) are at higher risk for suicide ideation, suicidal intention, and suicidal attempts compared to heterosexual counterparts. This risk can be attributed to a variety of risk factors and demographic differences across this diverse population. Minority stress—the experience of social rejection or discrimination against a minoritized identity—is a well-established theory to understand the risk of suicide ideation (SI). However, social network factors and Interpersonal Theory of Suicide (ITS) subdomains of thwarted belonging and perceived burdensome may influence the total risk of SI. This analysis will assess the relationship between minority stress and suicide ideation, as moderated by social network variables, and mediated by ITS.

Methods

This is a secondary data analysis of a 2017 dataset was collected by researchers over 18-months from a GSMY suicide warmline (24-hour non-clinically staffed support line) service provider located in the United States. The sample ranged from 12-24 with a final n=459. The survey assessed the experiences of GSMY who accessed the warmline about their experiences of minority stress, social networks, and mental health. The analysis examined the presence of minority stress, through the lifetime sum of the Sexual Minority Adolescent Stress Inventory, ITS through the Interpersonal Needs Questionaire-10, social network factors, while controlling for gender, sexuality, race, age, and urbanicity. Individuals’ overall risk of SI was measured by the Columbia Suicide Severity Rating Scale. SI was examined through a moderated mediation model assessing if minority stress is mediated by ITS and moderated by social network make-up.

Results

The sample was on average 17 (sd=3.128), predominantly white (63.47%), with four larger sexual orientation categories: gay (22.44%), lesbian (14.46%), bisexual (14.46%), or pansexual (15.68%), and majority cisgender (female 36.09%; male 24.77%). The majority of the sample endorsed suicide ideation (64.54%). The final model was significant F(18, 440)=31.33, p<.0001,. The results of the moderation analysis were not significant; however, there was one positive trend, the interaction term between ITS and the presence of one or more LGBTQIA+ individuals (β=0.08, p=0.053). Minority stress is fully mediated by ITS factors of thwarted belonging and perceived burdensomeness on CSSRS scores (Sobel = 5.073, p<.0001).

Discussion

Social networks are not seen to moderate the experience of minority stress, ITS, and total suicide ideation risk and support prior research that ITS may be a better predictor for suicidal ideation and possible intent for GSMY. While the initial research questions were rejected, full mediation of ITS on suicide ideation and a positive trend between LGBTQIA+ presence in the social network of GSMY were found. The trend indicates that with a larger sample, it may be possible that certain social networks moderate these relationships. Critically, the findings show that minority stress may only be a piece of the total suicidal risk factors for GSMY. These findings indicate that interventions aimed at experiences of perceived burdensomeness and thwarted belonging are indicated to better support GSMY at risk of suicide.