Suicide Prevention for Sexual and Gender Minority Youth

PROJECT SUMMARY
Suicide is the 10th leading cause of death among all U.S. citizens and is the 2nd leading cause of death among
youth and emerging adults between the ages of 15 and 29. One group that is particularly vulnerable to suicide
is sexual and gender minorities (SGMs). SGM is an umbrella term used to describe individuals who identify as
non-exclusively heterosexual (e.g., gay, lesbian, bisexual) and/or as transgender/non-binary (e.g., identify as a
gender different from their birth sex). Indeed, recent U.S. representative findings from 2017 underscore striking
disparities in suicidality between sexual minority and heterosexual adolescents, with 23% of sexual minority
youth reporting one or more suicide attempts (in the past 12 months) vs. 5.4% of heterosexual youth. Prevalence
of lifetime suicide attempts among gender minorities is also substantially elevated compared to the general
population, with 45% of 18-24-year-old transgender individuals reporting a history of one more suicide attempts.
Despite these substantial health disparities in suicide among SGM youth/emerging adults, no known suicide
prevention programs exist for this highly vulnerable population. Given this crucial gap in the literature, the
proposed study will adapt and test an innovative intervention that integrates patient navigation with the Safety
Planning Intervention (PN+SPI) for SGM youth/emerging adults designed to target mechanisms (e.g., reductions
in thwarted belongingness and increases in suicide-related coping skills) that theoretically underlie suicide. If the
PN+SPI intervention displays a clinically meaningful effect on the purported targets (i.e., reductions in thwarted
belongingness and increases in suicide-related coping skills) during the open-phase trial (R61 phase) and is
feasible and acceptable, we will subsequently move to the R33 phase. In the R33 phase, we will conduct a pilot
randomized controlled trial of the PN+SPI by comparing it to SPI alone to assess feasibility, acceptability, and
preliminary efficacy. During the randomized controlled trial, in which we will sample 170 youth and emerging
adult SGMs, we will also evaluate the mechanisms of action of the PN+SPI intervention through longitudinal
analysis. The proposed project has substantial public health significance as SGMs are one of the most vulnerable
groups for suicidality globally. Given the brevity of the PN+SPI intervention and its emphasis on safety planning
and accessing community resources, the PN+SPI intervention has high potential for wide dissemination and
public health impact.

Grant Number: 5R33MH120236-05
NIH Institute/Center: NIH
Principal Investigator: Aaron Blashill