How do sexual and gender minority people acquire the capability for suicide? Voices from survivors of near-fatal suicide attempts

Clark, Kirsty A.; Salway, Travis; McConocha, Erin M.; Pachankis, John E.

doi:10.1016/j.ssmqr.2022.100044

Cited by 23 publications

(22 citation statements)

References 61 publications

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“…Our finding is consistent with other research linking structural stigma to suicidal ideation among SGM people in the US and internationally [ 13 , 15 , 54 ]. For instance, a qualitative study of SGM people who had attempted suicide found that recurrent exposure to anti-SGM structural stigma was a source of emotional pain that lowered thresholds for suicidal action [ 7 ]. SGM participants who lived in communities with higher anti-SGM structural stigma experienced loneliness and fear of rejection.…”

Section: Discussionmentioning

confidence: 99%

“…SGM participants who lived in communities with higher anti-SGM structural stigma experienced loneliness and fear of rejection. This pain contributed to suicide attempts as a way to escape the pervasive anti-SGM social norms they experienced in their communities [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Stigma associated with having a sexual orientation or gender identity that falls outside the cisgender/heterosexual normative culture contributes to increased suicidality in this population [ 7 ]. One form of this stigma, structural stigma, can take the form of discriminatory laws and policies and is detrimental to the health and well-being of SGM people globally [ 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Moderating Effect of Community and Individual Resilience on Structural Stigma and Suicidal Ideation among Sexual and Gender Minority Adults in the United States

Pharr

Chien

Gakh

et al. 2022

IJERPH

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Background: Structural stigma in the form of discriminatory laws and policies impacts the mental health of sexual and gender minorities, especially with regard to suicidality. However, this relationship could be moderated by resilience. The past two years has brought anti-SGM legislation, particularly transgender sports bans, at the state level in the United States into focus. This study aims to understand if the relationship between familiarity with transgender sports bans (proposed or enacted) and suicidality was moderated by individual or community resilience. Methods: This was a cross-sectional study of survey data collected from a national sample of 1033 SGM adults in the United States between 28 January and 7 February 2022. Univariate and multivariate moderation analyses were used. Results: In the univariate analyses and the final model, community resilience moderated the relationship between structural stigma and suicidality (p = 0.0002); however, individual resilience did not (p = 0.0664). Conclusion: Interventions to bolster community resilience may attenuate the negative mental health impacts of structural stigma and are warranted, along with concerted efforts to minimize structural stigma in the form of discriminatory laws and policies targeting people who are SGM.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Moderating Effect of Community and Individual Resilience on Structural Stigma and Suicidal Ideation among Sexual and Gender Minority Adults in the United States

Pharr

Chien

Gakh

et al. 2022

IJERPH

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“…The interviewer (KAC) utilized an interview guide that included open-ended questions regarding the recent suicide attempt (e.g., method, preparation, and intent) as well participants’ perceptions of how their SGM identity shaped their mental health and suicidality-related factors, such as belonging and perceived burdensomeness. The interview guide focused discussion on a recent near-fatal suicide attempt and factors that contributed to acquired capability for suicide, described in Clark et al (2022). Most participants discussed their perspectives on mental health help-seeking and their previous mental health care experiences prior to and following their near-fatal suicide attempt during the interviews, but probing questions were not specifically written to elicit these conversations.…”

Section: Methodsmentioning

confidence: 99%

Previous mental health care and help-seeking experiences: Perspectives from sexual and gender minority survivors of near-fatal suicide attempts.

Holt¹,

Botelho²,

Wolford‐Clevenger³

et al. 2024

Psychological Services

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Sexual and gender minority (SGM) populations face heightened risk of suicide compared to their heterosexual and cisgender counterparts, and a previous suicide attempt is among the strongest predictors of suicide mortality. Despite this increased risk, limited research has explored mental health help-seeking behavior and previous mental health care experiences of SGM individuals among the highest risk for suicide-individuals with a recent, near-fatal suicide attempt. This study presents thematic analysis results of interviews with 22 SGM individuals who reported at least one near-fatal suicide attempt in the past 18 months. Identified themes were (a) factors that affect help-seeking for SGM individuals with a recent, near-fatal suicide attempt, including previous mental health care experiences, support systems, and structural barriers and facilitators; (b) hospitalization is not a one-size fits all solution; and (c) recommendations for improving care for this population. Findings demonstrate that anti-SGM stigma may magnify existing barriers to mental health care across all socioecological levels. Notably, participants cited a fear of loss of autonomy from inpatient hospitalization and previous discriminatory experiences when seeking mental health care as hampering helpseeking. Given increased risk for suicide mortality, this patient population is a necessary stakeholder in suicide prevention and intervention development and policy discussions affecting mental health care. Impact StatementSexual and gender minority (SGM) individuals with recent, near-fatal suicide attempts described that previous mental health care experiences, their support systems, structural factors, and their attitudes toward inpatient hospitalization can affect their future help-seeking behavior, particularly during a mental health crisis. Participants shared recommendations for improving care for other SGM individuals at high risk for suicide. These findings can inform efforts to improve the availability and quality of mental health care and suicide prevention for SGM populations.

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“…In this way, social networks are themselves foundational to suicide prevention science. Starting with Durkheim's anchoring work linking density of social ties and suicide mortality rates (Durkheim, 1897), the importance of social networks has now been replicated in multiple populations, methodological approaches, and suicide-related outcomes (Bearman & Moody, 2004;Cero & Witte, 2020;Clark et al, 2022;Pescosolido & Georgianna, 1989;Santini et al, 2015;Wyman et al, 2019;Xiao & Lindsey, 2022). In work using more modern research methods, experimental manipulations of social ties have been shown to affect the development of subsequent suicidal ideation (Joiner, 2003) and interventions that enhance social network bonds shown to reduce risk of ideation, attempts, and even mortality (King et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Social network structure as a suicide prevention target

Cero¹,

Choudhury²,

Wyman³

2023

Preprint

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Introduction: The structure of relationships in a social network affects the suicide risk of the people embedded within it. Although current interventions often modify the social perceptions (e.g., perceived support, sense of belonging) for people at elevated risk, few seek to directly modify the structure of their surrounding social networks. We show social network structure is a worthwhile intervention target in its own right.Methods: A simple model illustrates the potential of interventions to modify social structure. The effect of these basic structural interventions on suicide risk is simulated and evaluated. Its results are briefly compared to emerging empirical findings for real network interventions.Results: Even an intentionally simplified intervention on social network structure (i.e., random addition of social connections) is likely to be both effective and safe. Specifically, this illustrative intervention had a high probability of reducing the overall suicide risk, without increasing the risk of those who were healthy at baseline. It also frequently resolved stable, high risk clusters of people at elevated risk. These illustrative results are generally consistent with emerging evidence from real social network interventions for suicide.Conclusion: Social network structure is a neglected, but valuable intervention target for suicide prevention.

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How do sexual and gender minority people acquire the capability for suicide? Voices from survivors of near-fatal suicide attempts

Cited by 23 publications

References 61 publications

Moderating Effect of Community and Individual Resilience on Structural Stigma and Suicidal Ideation among Sexual and Gender Minority Adults in the United States

Moderating Effect of Community and Individual Resilience on Structural Stigma and Suicidal Ideation among Sexual and Gender Minority Adults in the United States

Previous mental health care and help-seeking experiences: Perspectives from sexual and gender minority survivors of near-fatal suicide attempts.

Social network structure as a suicide prevention target

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