Risk and protective factors for self-harm, suicidal thoughts, and suicide attempts in LGBTQ+ young people in the Republic of Ireland: the XXXX study (blinded for review)

Aims: This study aimed to provide an account of prevalence and the risk and protective correlates of self-harm, suicidal thoughts, and suicide attempt in Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ+) young people in the Republic of Ireland (RoI). Methods: Data from a national survey of 1,191 LGBTQ+ young people aged between 14 and 25 years were analysed. This self-report epidemiological survey assessed lifetime incidence of self-harm, suicidal thoughts, and suicide attempt. Information on sociodemographic characteristics, mental health (including depression, anxiety, and stress), alcohol and/or drug use, self-esteem and resilience, supportive family and friends, in-person abuse, online abuse and LGBTQ+ bullying in school was collected. Data were collected between 13 September-31 October 2022 via an online survey accessible to people who identified as LGBTQ+, were 14 years of age or over and living in the RoI. Results: The prevalence of lifetime self-harm, suicidal thoughts and suicide attempts were 68.5% (n=758/1106), 75.5% (n=831/1100) and 32.6% (n=339/1041) respectively. Some gendered differences were identified, with transgender and cisgender-women reporting higher rates of self-harm compared to cisgender-men. Similarly, participants who reported physical and neurodevelopmental disabilities had comparatively higher odds of self-harm, suicidal thoughts and suicide attempt compared to those without. In general, anxiety and depression, but not stress, and drug, but not alcohol use, were associated with increased odds of any suicide-related outcome explored. By contrast higher levels of self-esteem and resilience were associated with lower rates of self-harm, suicidal thoughts and suicide attempt. A lack of support of one’s LGBTQ+ identity from immediate family was further found to increase risk. Likewise, online and in-person identity abuse predicted higher rates of self-harm, suicidal thoughts and suicide attempts. No significant association between religion and any suicide-related outcome was identified. Conclusions: These findings highlight high rates of self-harm, suicidal thoughts, and suicide attempts experienced by LGBTQ+ young people in the RoI. Several risk correlates were identified including gender, anxiety and depression, drug use, and abuse, both online and in person. Although many of these factors may be regarded as ‘universal determinants’ of suicidality, these risks may be qualitatively different for LGBTQ+ young people. Support of one’s gender or sexual identity is a protective factor. Therefore, a combination of universal and tailored supports could help LGBTQ+ young people experiencing self-harm, suicidal thoughts and suicide attempt.