Administrators’ Perceptions of Family-Based Treatment Needs, Barriers, and Facilitators for LGBTQ+ Youth With Suicidal Ideation and Behavior

Abstract LGBTQ+ youth are at disproportionate risk for suicidal ideation and behavior (SIB). Family relationships within this population act as both a risk and protector factor for SIB, yet family-based treatments are rarely utilized at LGBTQ+ community centers. Prior research has explored the perceptions of LGBTQ+ youth, caregivers, and treatment providers on the use of family based treatment. Notably, no research has explored perceptions of another key stakeholder group: administrators. The present study used semi-structured interviews with administrators ( N = 10) supporting LGBTQ+ community centers regarding implementation of family-based services for LGBTQ+ youth with SIB. Semi-structured interviews explored (1) the needs of LGBTQ+ youth, (2) where a program that includes family-based interventions should be housed, and (3) how a program could be sustained. Interviews were transcribed and analyzed using thematic analysis. Results include nine needs, nine barriers, and 12 facilitators of family-based services for LGBTQ+ youth with SIB. Administrators generally found family-based services to be important, beneficial, and needed. They described missing, necessary factors (needs), existing barriers to implementation, and existing facilitative factors. Administrators generally described a need for additional education on affirmative practice, professionals to examine their own biases, and an improvement in standardization of care. They identified implementation barriers related to youth rejection from caregivers, lack of affirming healthcare, and logistical concerns. Lastly, they described inner-agency collaboration, family interventions, youth driven care, and resources for clinicians as facilitative implementation factors.