(PS8-40) Effects of Sexual Minority Discrimination from Mental Healthcare Providers on Suicide-Relevant Risk Factors and Suicidal Ideation among Sexual Minority Undergraduates

Abstract Text: Sexual minority (SM) individuals experience chronic minority stressors related to their identity (Meyer, 2003). Such experiences are associated with negative health outcomes among SM people, including suicidal thoughts and behaviors (STBs; Meyer 2003, Plöderl et al., 2014). Discrimination in healthcare may particularly exacerbate health disparities among SM individuals, and healthcare discrimination is associated with past suicide attempts in SM individuals (Draheim et al., 2023). Thus, it is crucial to determine how health care discrimination may exacerbate STBs. No study to date has examined the effects of discrimination in mental health care on STBs, and what factors related to STBs are exacerbated by discrimination in healthcare. Relevant constructs may be perceived burdensomeness, which mediates the relationship between SM victimization and suicidal ideation (SI; Baams, Grossman, & Russell, 2015), and rejection sensitivity (RS), which indirectly relates to suicidal ideation through thwarted belongingness (Brown et al., 2019). The current study investigated a) whether distress from discriminatory experiences from both medical and mental health care providers relate to SI, and b) whether RS, thwarted belongingness (TB), and perceived burdensomeness (PB) explain this relationship. Participants were SM undergraduate students (n= 235) who completed self-report scales designed for this study measuring lifetime experiences of distress due to discrimination in medical and mental healthcare settings, with higher scores indicating higher distress. Participants also completed past 2-week SI, the Interpersonal Needs Questionnaire, which measures TB and PB, and the Rejection Sensitivity Questionnaire. Means among all variables of interest except medical healthcare discrimination distress were higher among those with SI compared to without SI, and all variables except for discrimination in medical healthcare settings were positively related to each other (p’s < .05) in bivariate correlations. A serial mediation analysis (Hayes, 2023) revealed discrimination distress was indirectly related to SI through RS and PB (b = .085; 95% confidence interval [CI]: lower = .026; upper = .194). Findings highlight the need for mental health clinicians to provide sensitive, supportive, and affirming care, and for clinician training to challenge negative attitudes and behaviors that may confer even subtle discrimination toward SM communities. Findings also highlight rejection sensitivity as a treatment target among SM individuals. This study contributes to the literature in that RS and PB may partially explain the pathway between SM minority stress and SI.