The Roles of Parental Mental Health and Help-Seeking: Utilizing a Family Systems Approach to Upstream Suicide Prevention for Sexual Minority Youth

Project Summary
Before leaving high school, approximately 1 in 4 sexual minority adolescents will attempt to end their
own life; a rate that is nearly four times higher than their heterosexual peers. Social determinants in
the family context through parental acceptance or rejection is a major, consistent risk factor. Despite
progress in social acceptance of sexual minorities, in 2015 the Pew Research Council noted that 40%
of parents reported they would be upset or somewhat upset if their child came out as sexual minority.
Parental acceptance is a crucial upstream determinant for sexual minority adolescents’ wellness, but
remarkably scant research has focused on how parents get to acceptance; a vital unanswered
question impeding intervention development. The stall in research is partially due to the hard-to-reach
nature of the hidden population of parents of sexual minorities. The goal of this sequential
explanatory mixed methods project is to explore parents’ mental health and help-seeking behaviors
after their child comes out as sexual minority. With substantial work in social determinants of sexual
minority suicide prevention, our team is uniquely positioned to complete the proposed exploratory
study, which aligns with the developmental purposes of the R21 mechanism and responds directly to
the Notice of Special Interest in Research on Family Support and Rejection in the Health and Well-
Being of SGM Populations (NOT-OD-23-166). We aim to (1) compare four strategies to recruit
parents of sexual minorities to a brief, online survey about their mental health and help-seeking when
their child came out; (2) describe parents’ mental health after their child’s coming out and the help-
seeking resources parents sought for their mental health to navigate their child’s coming out; and (3)
explore pathways, facilitators, and barriers to parents’ help-seeking for individual-level and family-
level health needs after their child came out, including resources they wished they had and
suggestions to improve help-seeking resources. For Aim 1, we will examine the effectiveness of 4
strategies to recruit parents of sexual minority adolescents to complete an online survey to explore
mental health (e.g., depressive symptoms, ambiguous loss) and help-seeking behaviors when their
child came out. For Aim 2, we will use the survey data from Aim 1 to examine correlates of mental
health symptomology, overall help-seeking behaviors, and among specific forms of formal (e.g.,
medical professional) vs. informal (e.g., pastoral professional) help-seeking behaviors. For Aim 3, we
will use semi-structured interviews to deeply explore parents’ experiences around their mental health
and help-seeking behaviors when their child came out to them. Using a family systems perspective to
explore the help-seeking needs of parents of sexual minorities opens new avenues for upstream
prevention and implementation studies to address health disparities for sexual minorities.

Grant Number: 5R21MD019829-02
NIH Institute/Center: NIH
Principal Investigator: John Blosnich