Experiences and Needs of Sexual and Gender Minority Young Adults with a History of Suicidal Ideation Regarding Formal and Informal Mental Healthcare

Abstract

Introduction Little is known about whether sexual and gender minority (SGM) youth and young adults with suicidal ideation receive adequate mental healthcare in the Netherlands. The aim of this study was to examine healthcare experiences and needs of SGM young adults and how formal and informal mental healthcare can be improved to support SGM youth with suicidal ideation. Methods In 2018 and 2019, qualitative interviews were conducted among (1) SGM young adults with a history of suicidal ideation (n = 23, age 18 to 35), (2) parents of SGM youth with suicidal ideation (n = 16), and (3) professionals and volunteers who work with SGM youth (n = 14). Thematic analysis was used for coding and analyzing the interviews. Results Analyses yielded several themes for all groups of participants. Similar themes related to addressing suicidal ideation and SGM issues were found across the three participant groups. Participants perceived a lack of knowledge among professionals regarding SGM issues and perceived that suicidal ideation was sometimes inadequately addressed. Participants expressed the need for training and information on addressing SGM issues and suicidal ideation for parents and professionals. Conclusions Formal mental healthcare is not yet affirmative of SGM identities. Informal and formal healthcare should be improved to address sexual orientation, gender identity, and suicidal ideation. Policy Implications Findings underpin the need for improving skills and knowledge of mental healthcare professionals to better support SGM youth with suicidal ideation. Parents would benefit from accessible information on SGM-related themes and suicidal ideation.

Caring for a friend or family member who has experienced suicidal behaviour: A systematic review and qualitative synthesis

“…Thirteen studies described the experience of contacting professionals to help manage suicidal behaviour (Buus et al, 2014 ; de Lange et al, 2021 ; Dransart & Guerry, 2017 ; Garcia‐Williams & McGee, 2016 ; Hellerova et al, 2022 ; Inscoe et al, 2021 ; Ngwane & van Der Wath, 2019 ; Nosek, 2008 ; Sellin et al, 2017 ; Talseth et al, 2001 ; Vandewalle et al, 2021 ; Wolk‐Wasserman, 1987a , 1987b ). Carers primarily desired help to establish their friend or family member's physical safety when they felt unprepared to manage suicidal behaviour (Dransart & Guerry, 2017 ; Garcia‐Williams & McGee, 2016 ; Sellin et al, 2017 ; Vandewalle et al, 2021 ; Wolk‐Wasserman, 1987a ).…”

“…Eight studies described the nature and value of effective communication with healthcare professionals (de Lange et al, 2021 ; Dransart & Guerry, 2017 ; Garcia‐Williams & McGee, 2016 ; Inscoe et al, 2021 ; Sellin et al, 2017 ; Talseth et al, 2001 ; Thapa et al, 2021 ; Vandewalle et al, 2021 ). Carers valued proactive information sharing: ‘…in the evening, at 19h, the psychiatrist calls me and then she tells me “you know, I have contacted your husband's GP…”.…”

“…This included long waiting times and a lack of hospital bed availability (Dransart & Guerry, 2017 ; Fu et al, 2021 ; Hellerova et al, 2022 ; Talseth et al, 2001 ; Vandewalle et al, 2021 ). Others described how treatment options were insufficient to meet the needs of a family affected by suicidal behaviour, due to staff misunderstanding the nature of the situation (de Lange et al, 2021 ; Wolk‐Wasserman, 1987a ) or because services were focused to a greater degree on physical health (Fu et al, 2021 ). Other barriers included lack of continuity in care, causing carers to repeat distressing details to multiple staff members (Dransart & Guerry, 2017 ), an absence of effective follow‐up care (Vandewalle et al, 2021 ) and the prohibitively expensive cost of private healthcare (Garcia‐Williams & McGee, 2016 ; Hellerova et al, 2022 ; Thapa et al, 2021 ).…”

“…This iterative process of experiential learning helped carers who were aware of suicidal behaviour 'to take the second step…being able to cope with the behaviour' (Nosek, 2008, p. 40). Nine studies highlighted professional assistance with interpersonal support strategies as a support need (de Lange et al, 2021;Doyle et al, 2021;Dransart & Guerry, 2017;Fu et al, 2021;Garcia-Williams & McGee, 2016;Nosek, 2008;Vandewalle et al, 2021;Wolk-Wasserman, 1987a):…”

Differences in risk for suicidal ideation and suicide attempts among sexual and gender minority young adults and the moderating role of social support.

“…Furthermore, studies also show that (mental) health care does not meet the needs of gender minority individuals in the Netherlands, Belgium, and the United States. For example, a lack of skills and knowledge regarding sexual and gender diversity exists among (mental) health professionals (de Lange, van Bergen et al, 2022; Motmans et al, 2017; Rees et al, 2021; Sonneveld & Bungener, 2022). In the United States, the health care system is different.…”