1. Strategies for Suicide Prevention Amongst LGBTQ High School Students
Alison Lance, BS, School Psychologist in Training
Shanter H Alexander, Ed.S, CAS, NCSP

2. Color Cards
Who is here today?

3. NASP Model

4. NASP Position Statement (2011) Lesbian, Gay, Bisexual, Transgender, and Questioning Youth
“NASP believes that school psychologists are ethically obligated to ensure that all students have an equal opportunity for the development and expression of their personal identity in a school climate that is safe, accepting, and respectful of all persons and free from discrimination, harassment, violence, and abuse. To achieve this goal, education and advocacy must be used to reduce discrimination and harassment against LGBTQ youth by students and staff and promote positive social-emotional and educational development.”

5. Youth and Young Adult Suicide
Suicide is the 2nd leading cause of death for youth and young adults ages 15–24 in the United States.
Over 4,800 youths and young adults ages 15–24 commit suicide/year.
About 1 out of every 13 high school students attempts suicide each year.
Individuals in the LGBTQ community are up to 7x more likely to attempt suicide.
Centers for Disease Control and Prevention, YRBS, 2014

6. Most importantly, suicide can often be prevented.
Suicide is a major public health issue, meaning:
Suicide affects large numbers of people.
Prevention is based on research that is mostly related to risk factors.
Most importantly, suicide can often be prevented.

7. Session Objectives
Use correct terminology for suicidal behavior and LGBTQ issues.
Describe research related to suicidal behavior among LGBTQ youth.
Discuss risk and protective factors for suicidal behavior in LGBTQ youth.
Assess the cultural competence of schools in relation to LGBT youth, and plan next steps for increasing LGBTQ cultural competence.
Describe strategies to reduce suicidal behavior among LGBTQ youth.

8. What causes suicide? Individual, family, and social? Mental illness?
Depression and anxiety
There are other risk factors associated with suicide, including:
Previous suicide attempt(s)
Firearm ownership
Isolation
Hopelessness
Impulsivity and recklessness
Family discord and dysfunction
On-going exposure to negative events such as abuse/neglect or bullying/peer victimization.

10. Terms – Suicidology Suicide death Attempted suicide Suicidal ideation
Suicidal behavior
Terms – Suicidology

11. Suicidal Ideation in LGBTQ youth
LGBTQ youth are 1½ to 3 times more likely to report suicidal ideation than non-LGB youth.
48% of LGBTQ youth ages said suicidal thoughts were clearly or at least somewhat related to their sexual orientation.

12. Suicide Attempts in LGBTQ Youth
LGBTQ youth are 2 to 7 times more likely to have said they attempted suicide than non-LGB youth.
LGBTQ youth attempts may be more serious, based on some initial findings about:
Intent to end their lives
Lethality
Suicide Prevention Resource Center, 2008
Kann et al., 2011

13. Suicide Death among LGBTQ Youth
There is no reliable or official way to determine rates of suicide deaths in people who are LGBTQ because death reports and certificates do not usually include the person’s sexual orientation.
Compared to non-LGB youth:
LGB youth have higher rates of suicide attempts.
LGB youth suicide attempts may be more serious.

14. Suicide Behavior and Transgender Youth
Did you know that…
46% of transgender youth under the age of 26 will attempt suicide
AND
59% self-harm on a regular basis?

15. Risk and Protective Factors
Being LGBTQ is not itself a risk factor for suicidal behavior
BUT
social stigma and discrimination
unsafe schools and bullying
are associated with mood, anxiety, and substance use disorders, and
suicidal behavior.

16. Rural vs. Urban
In general, rural LGBTQ students tend to find faculty or staff less supportive and feel less connected to their schools than suburban and urban students.
Rural LGBTQ youth might be at particularly high risk due to lower levels of support and fewer resources in rural schools and communities.
Ballard et al., 2017

17. Protective Factors Family connectedness Family acceptance Safe schools
Caring adult
High self-esteem
Positive role models
Kosciw et al., 2014

18. Risk Factors Gender nonconformity
Internal conflict about sexual orientation
Early coming out
Low family connectedness
Lack of adult caring
Unsafe school
Family rejection
Victimization
Bullying
Stigma and discrimination
perceived burdensomeness
feeling that one doesn’t belong
Baams et al., 2015 and Kosciw et al., 2014

19. Game Plan
What can you do?

20. School Policies
Check your school or agency anti-discrimination policies for both sexual orientation and gender identity.
Explicitly including LGBTQ issues gives legitimacy to LGBTQ concerns.
(NASP, 2011).

21. Make your support visible
Student who could identify with ONE adult staff member who supported the LGBTQ community felt safer at school.
LGBTQ students are more likely to feel comfortable talking with school staff about LGBTQ issues.
Kosciw, 2016

22. Review availability of information on LGBT youth issues
Check your school library, or add some books to your own collection.
Books for parents
Books about LGBTQ heroes (those in a protagonist role)
Biographies about LGBTQ individuals
Documentaries about LGBTQ individuals
Suicide Prevention Resource Center (2014)

23. Intervene
Interrupt a student who is using a derogatory term, and report it. The negative affects of bullying are positively correlated to suicidal ideation and suicide attempts.
In one study, only about 1/3 of students reported teachers intervening when they felt victimized at school.
Ballard, 2017, Camera, 2016 and Kosciw, 2016

24. Harassment & Assault
Verbal and physical harassment, and physical assault are addressed in research.
Harassment and assault occur frequently because of a youth’s sexual orientation, and gender expression.
Kosciw, 2016

25. Attend or Help Start a GSA
GSAs positively impact the school climate for LGBTQ students.
A better school climate is negatively correlated with suicidal thought, suicide plans, and suicide attempts of LGBTQ students
(Hatzenbuehler, Birkett, Van Wagenen & Meyer, 2014)

26. Inclusive Curriculums
Only 22.4% of LGBTQ students were taught positive representations about LGBT people, history, or events in their schools
17.9% had been taught negative content about LGBT topics.
Staff and (especially) students should be educated on:
Gender identity
Sexual orientation
Homophobia
Institutionalized discrimination
Kosciw, 2016

27. Gatekeeper Training Recognize someone at risk for suicide,
Intervene with those at risk; and,
Refer them to an appropriate resource.
Reduction of risk factors, increase in protective factors.

28. Gatekeeper Resources
Take a gatekeeper training (e.g., QPR, ASIST, Connect) to learn how to identify youth who may be having suicidal thoughts type%3Abpr_listing
Take a gatekeeper training from the Trevor Project that focuses on LGBT youth
Contact your state suicide prevention coalition to find gatekeeper training in your area type%3Abpr_listing
Encourage your local referral network to be trained in assessing and managing suicide risk

29. The 2015 National School Climate Survey, GLSEN https://www. glsen

30. The 2015 National School Climate Survey, GLSEN https://www. glsen

31. Crisis Line Resources Suicide Prevention Crisis Lines
National Suicide Prevention Lifeline
Phone: TALK (8255), available 24/7.
For Spanish, call
Online chat: 2 pm – 2 am
Trevor Lifeline: , available 24/7
TrevorText: Available only specific hours. Text “Trevor” to TrevorChat: Online only specific hours.
For hours, go to

32. References
Ballard, M. E., Jameson, J. P., & Martz, D. M. (2017). Sexual identity and risk behaviors among adolescents in rural appalachia. Journal of Rural Mental Health, 41(1), doi: Baams, L., Grossman, A. H., & Russell, S. T. (2015). Minority stress and mechanisms of risk for depression and suicidal ideation among lesbian, gay, and bisexual youth. Developmental Psychology, 51(5), doi: Centers for Disease Control and Prevention. (2014). Youth risk behavior surveillance - United States, Surveillance Summaries. MMWR, 63(4). Retrieved from Kosciw, J. G., Greytak, E. A., Palmer, N. A., & Boesen, M. J. (2014). The 2013 National School Climate Survey: The experiences of lesbian, gay, bisexual, and transgender youth in our nation’s schools. New York, NY: Gay, Lesbian, & Straight Education Network. National Association of School Psychologists. (2011). Lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth (Position Statement). Bethesda, MD: Author.

33. References
Suicide Prevention Resource Center (2014) Suicide Prevention among LGBT Youth: A Workshop for Professionals Who Serve Youth. Retrived on Oct 30. from programs/suicide-prevention-among-lgbt-youth-workshop-professionals-who-serve-youth-0