1 - (IOP 24) Barriers and Facilitators to Treatment for Sexual and Gender Minority Adolescents Who Are at Risk for Suicide: Recommendations for Mental Health Professionals

Objective: Sexual and gender minority adolescents (SGMA) are at elevated risk for suicide thoughts and behaviors (STB) and non-suicidal self-injury (NSSI) compared to their heterosexual and cisgender peers. Additionally, SGMA experience unique barriers when seeking mental health treatment, in part due to structural oppression that SGMA face (i.e., cisheterosexism), which can negatively impact SGMA’s access to and experiences with mental health treatment. There are also factors (i.e., social support) that may support SGMA with seeking mental health care. Extant research has broadly identified that SGMA encounter unique barriers and facilitators when accessing mental health treatment; however, there is limited research exploring these barriers and facilitators within the context of treatment for STB. The present qualitative study draws upon the lived experience of SGMA at risk for suicide to gain a deeper understanding of factors that help and hinder access to affirming mental health care to address their STB.

Methods: A sample of 18 SGMA, ages 13 to 19 years old (M = 16.8; SD = 1.89; 61% transgender or gender diverse; 61% plurisexual; 78% White and non-Hispanic/Latine), were recruited from clinical and community settings. All participants endorsed suicidal thoughts or behaviors in the past month or endorsed NSSI thoughts or behaviors in the past month and suicidal thoughts and behaviors in their lifetime. Through a semi-structured interview, participants were asked questions about their experiences related to barriers and facilitators to accessing treatment for STB and ideas for mental health professionals on how to improve treatment. Participant interviews were transcribed and coded using qualitative content analysis methods.

Results: Several themes emerged related to barriers and facilitators and regarding treatment recommendations from SGMA to mental health professionals. Within barriers to treatment, the following themes emerged: (1) shame (2) lack of parental involvement/support (3) structural barriers (e.g., transportation), (4) cultural barriers. Within facilitators to treatment, the following themes emerged: (1) parental support, (2) peer support, (3) structural facilitators (e.g., financial support). For recommendations to mental health professionals, the following themes emerged: (1) SGM-affirmative care (e.g., access to resources, interventions, acknowledgement and validation of oppression-based stress), (2) privacy and safety, (3) validating and direct therapeutic interventions.

Conclusion: These results provide rich insight into the lived experiences of SGMA, who have experienced and have sought treatment for STB, by centering their voices. These findings highlight unique barriers that SGMA face but also by uncover factors that may support SGMA when seeking treatment for STB. Additionally, our findings provide useful recommendations from SGMA to help guide mental health professionals in developing affirming interventions for SGMA who experience STB. These findings have significant implications for research and clinical interventions for SGMA at risk for suicide.