Suicide Prevention Among LGB Adolescents: The Role of Schools

Introduction:Prevalence of suicidal ideation and attempts is more than 2 times higher for lesbian, gay and bisexual (LGB) adolescents than their heterosexual peers (Centers for Disease Control, 2011). The risk factors for LGB suicide (e.g., bullying and harassment, substance abuse, mental health problems, familial rejection) are better understood than the protective factors (Almeida et al., 2009; DAugelli et al., 2005; Eisenberg & Resnick, 2006; Russell & Joyner, 2001; Ryan, Huebner, Diaz, & Sanchez, 2009). It is important to understand school-based protective factors for LGB adolescents to inform intervention development, testing, and dissemination of preventive interventions in schools. This paper explores the extent to which theorized school-based protective factors (e.g., school connectedness) predict rates of suicidal ideation.

Methods: A comprehensive review of the literature identified theorized protective factors for suicide.  Logistic regression was used to analyze data from the 2011 California Healthy Kids Survey (CHKS) for a subgroup of LGB adolescents (n=300).  The 2011 CHKS data was a census of all 9^th and 11^th grade students across all San Francisco public high schools (n=17) yielding a 70% response rate. The sample of students who identified as LGB was ethnically diverse, [Asian (33%), Latino (30%), other races (22%), white (11%), African American (4%)] and almost equally split by gender and grade [45% female, 55% male; 46% 9^th grade, 49% 11^thgrade]. Multi-level models were used to control for school-effects.

Results: Bivariate results indicate that 59% of LGB adolescents in this sample were depressed and 30% considered suicide in the past 12 months. Logistic regression results indicate that school connectedness was significantly related to reduced suicidal ideation, for LGB adolescents [OR: .69 95% CI: (.51, .93)].  Females [OR: 2.4 95% CI: (1.39, 4.29)] and depressed students [OR: 4.1 95% CI: (2.4, 7.1)] had increased odds of considering suicide. There were no observed differences in outcomes by school.

Conclusions: Our analysis revealed that LGB adolescents’ connection to school may serve a protective role for suicidal ideation.  Interventions to increase LGB students’ sense of school connectedness may be effective for reducing LGB suicide ideation, and these interventions may need to be LGB specific.  Improving school climate for LGB youth, developing Gay/Straight Alliances, improving school supports, and developing anti-bullying policies have been suggested (Goodenow et al., 2006; Poteat et al., 2012).