Preventing Suicide Among Sexual and Gender Diverse Young Adults in Primary Care in Texas

Preventing Suicide among Sexual and Gender Diverse Young Adults in Primary Care in Texas Elizabeth Arnold, PhD, PI – University of Kentucky, Department of Psychiatry Phillip Schnarrs, PhD, Co-PI; and Lauren Gulbas, PhD, Co-I- Dell Medical/University of Texas at Austin Background and Significance. Sexual and gender diverse young adults (SGDYA) are at increased risk for suicidal ideation, suicide attempts, and death by suicide as compared to their peers. Despite unequivocal empirical evidence pointing to high rates of suicide risk among this group of youth, no suicide interventions focused on the specific needs of this population have been developed. It is important to understand whether evidence-based interventions, with appropriate adaptations, are effective in reducing suicide and other related outcomes. Primary care settings offer the opportunity to do screening for depression, a risk factor for suicide, and link youth to mental healthcare using brief suicide prevention interventions. Study Aims and Design. The long-term objective of this project is to reduce death by suicide in SGDYA. To do this, this project will compare adapted versions of two existing evidence-based suicide prevention interventions for use with SGDYA in primary care settings to be delivered via telehealth on our primary outcome of suicidal ideation in a cluster randomized trial (CRT; N=594). We will also examine secondary outcomes associated with suicide risk and explore the effects of sexual orientation, sex assigned at birth, sexual orientation and race/ethnicity on study outcomes. We will randomly assign primary care practices (N=34) in Texas to one of the two study interventions, STAT-Primary Care (STAT-PC) and Youth Nominated Support Team III (YST-III). The study interventions and all study activities will be done virtually by the study team. We will conduct study follow-up assessments at months 1, 3, 6, 9, and 12 with our primary endpoint at 6-months. Study Population. Our study population will be SGDYA aged 18-24 in Texas receiving care in primary care clinics. To be eligible, participants must report some suicide risk based on screening questions. Primary and Secondary Outcome. Our primary outcome is suicidal ideation. Secondary outcomes will include outcomes related to suicidal behavior: suicide attempts, deaths by suicide, psychiatric hospitalizations, depressive symptoms, social support, and internalized stigma.