Suicidality, self-efficacy and mental health help-seeking in lesbian, gay, bisexual and transgender adults in Taiwan: A cross-sectional study.

Abstract

The study aimed to investigate the associations of suicide risk, self-efficacy and mental health help-seeking among the lesbian, gay, bisexual and transgender (LGBT). The LGBT individuals were found to have higher risk of suicide. However, mental health promotion and suicide prevention strategies were lacking in this population. A cross-sectional survey with two-group comparison. The LGBT group was recruited through snowballing method, which was then age-matched with the comparison group as the reference. The questionnaire contained demographics, self-rated health, suicide risk assessment and help-seeking indicators including formal (e.g. medical or psychiatric services) and informal (e.g. family or friends) help sought. Chi-square tests, t-tests, two-way ANOVA and multivariable regression were performed to test the differences between two groups. The methods followed STROBE criteria. The LGBT group had a significantly higher prevalence of lifetime/recent suicide ideation, prior suicide attempts and mental distress or depressive symptoms. Their self-rated health and health-related self-efficacy were poorer than those of the comparison group and were associated with increased suicide risk levels. Among the 27.1% of LGBT who intended to seek help for depression, one in five visited psychiatric services. The LGBT were 2-4 times more likely than the comparison group to disclose their distress or seek informal help. However, psychiatric and medical service contacts were relatively low for suicide high-risk individuals in the LGBT group. The LGBT individuals had a lower level of self-efficacy and higher suicidal risks than the general public. Healthcare professionals and the public should be aware of their informal help-seeking signals such as disclosure of suicide ideation to friends/relatives and connect them to proper mental health resources for further assessment. The LGBT with suicide risks require early detection and proper referrals by first-line nurses to promote suicide prevention in this population.