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Abstract
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INTRODUCTION: Disclosure of suicidal thoughts and behaviors (STBs) represents an opportunity to intervene before suicide mortality, representing a cornerstone for suicide prevention. Sexual minority (e.g., lesbian/gay, bisexual) people experience sharply elevated suicide risk, yet there is scant research on patterns of disclosure of STBs prior to suicide that might uncover missed opportunities for suicide prevention. Thus, we leveraged postmortem suicide data to evaluate associations among sexual orientation, sex, and disclosure of STBs in the month preceding death.
METHODS: Data on suicides from the 2013-2019 National Violent Death Reporting System (N=155,516) were classified for sexual orientation and denoted disclosure of STBs and to whom STBs were disclosed in the month preceding death. Logistic regression models stratified by sex and adjusted for sociodemographic covariates assessed associations among sexual orientation and STBs disclosure. Analyses were conducted from 10/22-02/23.
RESULTS: Among females, sexual minority decedents were 65% more likely to disclose STBs compared to heterosexual decedents (95% CI=37%-99%, p<0.001). No difference in STBs disclosure was observed between sexual minority and heterosexual men. Of decedents who disclosed STBs, one-in-five sexual minority decedents disclosed to a friend/colleague while fewer than 5% disclosed to a healthcare professional. Among sexual minority females, younger age, intimate partner problems, and physical health problems were positively associated with disclosing STBs.
CONCLUSIONS: These findings suggest that reducing suicide mortality in sexual minority populations will require considering contexts beyond the healthcare system including engaging peer networks. Gatekeeper training for suicide prevention may be an especially promising approach for reducing suicide among sexual minority women.
Language: en |