Suicide attempts in LGBTQ+ youth in Switzerland: Qualitative insights in school-based risk factors

Abstract Background Studies show that the LGBTQ+ population is particularly vulnerable to suicidal thoughts and behavior. This vulnerability is even more pronounced in the younger population. However, in Switzerland, qualitative studies on this topic are missing. Our study investigates the processual dynamics and background of suicide attempts of LGBTQ+ youths while looking into their subjective meaning. Here, behaviors of help-seeking are also from interest. In addition, the burdens and resources associated with being LGBTQ+ are explored. By better understanding the process of suicide attempts, we can identify relevant contexts of the respondents’ experiences and illustrate how to enhance suicide prevention strategies. We are referring here to the school context. Methods From 2021 until 2024, we interview LGBTQ+ youths in the German- and French-speaking parts of Switzerland who have tried to end their lives between the ages of 14 to 25 (max. three attempts). Applying a multi-perspective approach, we interview persons from their social environment if agreed. Recruitment is based on ‘theoretical sampling’. Data collection and analysis follow the grounded theory methodology. As of July 2022, the sample consists of 18 persons: 3 bisexual women, 1 lesbian woman, 2 gay men, 7 transgender persons, and 5 persons with fluid identities. Results Through preliminary analysis, the school context could be identified as one relevant burdening context in the respondents’ experience and suicide attempt process. In this respect, respondents experienced complicated social relationships: e.g., bullying, social exclusion, and pressure to conform. Moreover, the school environment was experienced by some as LGBTQ+ hostile. Conclusions Our current findings support the necessity to integrate schools as important stakeholders in suicide prevention but highlight a need for LGBTQ-specific and LGBTQ-sensitive orientations to suicide prevention strategies.


Background:
Studies show that the LGBTQ+ population is particularly vulnerable to suicidal thoughts and behavior. This vulnerability is even more pronounced in the younger population. However, in Switzerland, qualitative studies on this topic are missing. Our study investigates the processual dynamics and background of suicide attempts of LGBTQ+ youths while looking into their subjective meaning. Here, behaviors of helpseeking are also from interest. In addition, the burdens and resources associated with being LGBTQ+ are explored. By better understanding the process of suicide attempts, we can identify relevant contexts of the respondents' experiences and illustrate how to enhance suicide prevention strategies. We are referring here to the school context.

Methods:
From 2021 until 2024, we interview LGBTQ+ youths in the German-and French-speaking parts of Switzerland who have tried to end their lives between the ages of 14 to 25 (max. three attempts). Applying a multi-perspective approach, we interview persons from their social environment if agreed. Recruitment is based on 'theoretical sampling'. Data collection and analysis follow the grounded theory methodology. As of July 2022, the sample consists of 18 persons: 3 bisexual women, 1 lesbian woman, 2 gay men, 7 transgender persons, and 5 persons with fluid identities.

Results:
Through preliminary analysis, the school context could be identified as one relevant burdening context in the respondents' experience and suicide attempt process. In this respect, respondents experienced complicated social relationships: e.g., bullying, social exclusion, and pressure to conform. Moreover, the school environment was experienced by some as LGBTQ+ hostile.

Conclusions:
Our current findings support the necessity to integrate schools as important stakeholders in suicide prevention but highlight a need for LGBTQ-specific and LGBTQ-sensitive orientations to suicide prevention strategies.

Purpose:
Few researchers have explained disparities in mental health between sexual minority and heterosexual adolescents by focusing on structural forms of stigma as, for instance, heterosexist school or classroom norms. Addressing this gap, our paper aimed to study disparities in life satisfaction, psychosomatic complaints, and emotional problems between sexual minority and heterosexual adolescents and examine the moderating role of heterosexist norms in the classroom and school.

Methods:
We used data from the 2013 and 2017 Dutch Health and Behaviour in School-Aged Children (HBSC) study (N = 12,756; M age = 14.02; SD = 1.54). Separate multilevel analyses for life satisfaction, psychosomatic complaints, and emotional problems were conducted in which cross-level interaction effects between sexual attraction and school and classroom-level heterosexist norms were estimated. Results: Same-sex attracted, both-sex attracted, and adolescents unsure about their sexual attraction reported lower life satisfaction, more psychosomatic complaints (not for unsure adolescents), and more emotional problems than their other-sex attracted peers. Stronger school-level heterosexist norms were associated with higher life satisfaction and fewer psychosomatic complaints and fewer emotional problems. Stronger classroomlevel heterosexist norms were associated with less emotional problems. Few moderating effects of classroom and schoollevel heterosexist norms were found. Contrary to expectations, disparities in life satisfaction between same-sex attracted and other-sex attracted adolescents decreased when classroom-level heterosexist norms were stronger. Conclusions: Although our findings suggest pressing health disparities between heterosexual and sexual minority adolescents, heterosexist norms at the school-and classroom-level hardly contributed to these health disparities.

Background:
LGBTQ+ adolescents living with mental conditions are affected by stigma based on their health status, sexual orientation, and/or gender identity/expression (SOGIE), especially when navigating their learning environments. Our aim is to gain detailed insights into how LGBTQ+ adolescents living with mental conditions vision their learning environments so that they can feel safe and supported enough to freely disclose their SOGIE and health status, and hence thrive.
iii276 European Journal of Public Health, Volume 32 Supplement 3, 2022