Sexual and gender minority (SGM) youth are disproportionately affected by suicide-related thoughts and behaviors relative to their heterosexual and/or non-transgender peers. Theory and empirical evidence suggest that there are unique factors that contribute to this elevated risk, with distinguishable differences among SGM subgroups. Although SGM youth suicide prevention research is in its nascence, initial findings indicate that interventions, which focus on family support and acceptance may be beneficial. It is critical that we develop and test tailored interventions for SGM youth at risk for suicide, with specific attention to subgroup differences and reductions in suicide-related thoughts and behaviors as outcomes.

To ameliorate the public health problem of adolescent suicide, it is imperative to go beyond simply establishing which factors increase risk. Multiple factors often interact in such a way that escalates suicide risk, and some combinations may be particularly perilous. Therefore, it is essential to examine the sequence and interplay of these various contributors to understand how they interact to confer risk. To enhance our understanding of this process, we used qualitative in-depth interviews with 20 psychiatrically hospitalized adolescents who had recently made a suicide attempt to investigate the factors that contributed to their attempts. In this qualitative analysis we 1) identified 16 separate factors that contributed to their suicide attempts, and 2) focused on the sequence and interplay between these factors in order to better understand why adolescents attempt suicide, with specific attention to which factors facilitated the transition from suicide ideation to action. Findings demonstrated that the strain caused by historical, sociocultural, and interpersonal factors alone was not enough to result in adolescents attempting suicide. For all but two participants, it was the interaction of intrapersonal factors that appeared to distort cognitions and/or elevate emotions to the point where they became intolerable and suicide became a viable option. These intrapersonal factors appeared to be the catalyst in the process from suicide ideation to action. Our findings suggest the need for specific strategies that address cognitive distortions, emotion dysregulation, and feelings of invalidation and entrapment as potential targets for interventions and prevention practices with adolescents at risk for suicide.

Aim: To investigate the function and progression of non-suicidal self-injury (NSSI) and its relationship with suicide attempts. Method: Qualitative in-depth interviews were conducted with 15 adolescents psychiatrically hospitalized following a suicide attempt who reported NSSI. Applied thematic analysis was used to identify and examine themes from the interview data. Results: Thematic analysis revealed that the primary function of NSSI was relief from emotional pain, though the function often changed over time. NSSI was often not directly related to patients’ suicide attempts, yet risk of suicidal behavior seemed to increase once NSSI lost its effectiveness, and suicide became the only option. Conclusion: Clinicians need to understand and monitor the functions of NSSI, and its relationship with suicidality, to prevent suicide attempts among adolescents.