Treatment Recommendations and Barriers to Care for Suicidal LGBTQ Youth: A Quality Improvement Study

Abstract

ABSTRACT Lesbian, Gay, Bisexual, Transgender, and Queer or Questioning (LGBTQ) youth are at elevated risk for suicide. Despite this, there is limited information on how to optimize care for suicidal LGBTQ youth. Qualitative interviews were conducted with LGBTQ youth with a history of mental health treatment to identify treatment recommendations and barriers to care for this vulnerable population through the lens of a quality improvement approach. Individual qualitative interviews (n=20) and focus groups (n=21 participants) were conducted. Key findings included the critical role of receiving emotional support from caregivers related to LGBTQ identity, youth’s concern about whether it was safe to share LGBTQ identity with a mental health provider due to uncertainty about how this information would be received, the use of self-report measures early in care for self-disclosure, using clear symbols such as the rainbow pride flag indicating support for the LGBTQ community, and the importance of confidentiality in terms of both suicidality and LGBTQ identity. Youth also described being unaware of existing mental health resources designed for LGBTQ youth and emphasized the importance of educating youth directly on the availability of these resources. These findings underscore the importance of attending to the role of the family in supporting suicidal LGBTQ youth and designing clinic spaces where these youth feel comfortable seeking services. This study is one of the first to elicit direct feedback from LGBTQ youth themselves to inform quality improvement of suicide-prevention care for this population.