Suicide Prevention for Sexual and Gender Minority Youth (Open Trial)
Condition: Suicide
MeSH terms: Suicide; Suicide Prevention
Study type: Interventional

Summary: 
      The overarching goal of this study is to develop a suicide prevention program for
      sexual-and-gender-minority youth and emerging adults. After development of the intervention
      program, an open phase trial will be conducted to test its feasibility, acceptability, and
      preliminary impact on three intervention targets.
    

Detailed description: 
      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 34. Moreover, U.S.
      representative data indicate increasing trends in suicide attempts and death by suicide. In
      addition to the immense psychological burden experienced by the family and friends of
      individuals who attempt and complete suicide, the costs of death by suicide and suicide
      attempts in 2013 were estimated at $93.5 billion.

      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). Extant research consistently notes substantial
      mental health disparities among SGMs in comparison to their heterosexual and cis-gender
      counterparts. In 2017, in the U.S., 23% of sexual minority youth reported one or more suicide
      attempts (in the past 12 months) vs. 5.4% of heterosexual youth. This disparity has also been
      noted in a meta-analysis of population-based longitudinal studies, with sexual minority
      adolescents and emerging adults reporting 2.26 increased odds of suicide attempts compared to
      their heterosexual counterparts. 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 history of one or 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 a patient navigation
      (PN) intervention for SGM youth/emerging adults designed to target mechanisms (i.e.,
      decreasing thwarted belongingness and increasing suicide-related coping skills) that
      theoretically underlie suicide. The proposed intervention will integrate a single-session,
      empirically supported, suicide prevention intervention (Safety Planning Intervention; SPI)
      with PN services (PN+SPI). The patient navigator will deliver the SPI and continue frequent
      contact for the purpose of providing motivational enhancement, problem-solving, reinforcing
      coping strategies, and connecting participants to social support and mental health resources
      (e.g., SGM-specific support groups within the community). This study will accomplish the
      following specific aims:

      Specific Aim 1: To adapt and test an integrated PN+SPI designed to reduce suicide attempts
      among SGM youth and emerging adults. In this open-phase trial (N = 30), within-person changes
      in thwarted belongingness and suicide-related coping skills will be tested. It is
      hypothesized that PN+SPI participants will display decreases in thwarted belongingness and
      increases in suicide-related coping skills. Feasibility and acceptability of the PN+ SPI
      intervention will also be assessed.
    

Intervention name(s): Safety Planning Intervention with Navigation Services
Intervention type(s): Behavioral
Intervention description(s): A patient navigation (PN) intervention for SGM youth/emerging adults designed to target mechanisms (i.e., decreasing thwarted belongingness and increasing suicide-related coping skills) that theoretically underlie suicide. The proposed intervention will integrate a single-session, empirically supported, suicide prevention intervention (Safety Planning Intervention; SPI) with PN services (PN+SPI). The patient navigator will deliver the SPI and continue frequent contact for the purpose of providing motivational enhancement, problem-solving, reinforcing coping strategies, and connecting participants to social support and mental health resources (e.g., SGM-specific support groups within the community).
Other intervention name(s): PN+SPI
Intervention model: Single Group Assignment
Intervention model description: A broad recruitment strategy will be used to recruit participants within the greater San Diego. Potential participants will be requested to contact study personnel via email or telephone. A trained member of the study team will contact each potential participant to explain the study, obtain verbal consent for pre-enrollment screening, and conduct the screening process. For those who meet screening criteria, a trained member of the study team will provide more information about the study and engage in an informed consent process at an in-person appointment. Following informed consent, participants will complete self-report questionnaires and clinician-based interviews in person. At baseline, 3-month, and 6-month follow-ups, participants will be asked to complete measures of suicidal coping and thwarted belongingness. At the 3- and 6-month follow-up, satisfaction with mental health services and satisfaction with interpersonal relationship with patient navigator will be assessed.
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Sexual and gender minority youth; Prevention; Patient Navigation; Safety Planning Intervention