Finding out more about attempted suicide by LGBT adolescents

In 2016 the Swiss Confederation and the cantons developed an “Action plan for suicide prevention” in conjunction with the Swiss Health Promotion Foundation. The aim of this plan is to reduce the number of non-assisted suicides during (often transient) personal crises by 25 per cent by 2030 – a figure equivalent to roughly 300 premature deaths per year. The FOPH hopes not only to prevent suicides in general – an objective that focusses on the popu­lation at large – but also to target specific groups in which an elevated rate of suicidal actions can be observed.

LGBT adolescents, for example, have a substantially higher risk of suicidal behaviours than heterosexual teenagers (LGBT stands for lesbian/gay/bisexual/transgender). “This doesn’t mean, though, that these adolescents in and of themselves are burdened with problems and at risk of suicide,” says An­dreas Pfister from the University of Lucerne. “Suicidal behaviour is by no means common in gay and lesbian adolescents, and fortunately only affects a minority within the LGBT community.” The higher number of suicides is not directly related to sexual orientation but arises through indirect factors such as homophobia, bullying at school or lack of acceptance in the family.

Last year Pfister and his team carried out a pilot study as part of the implementation of the national action plan with financial support from the FOPH. This pilot study   examined the extent to which it is possible to perform a qualitative investigation of multiple aspects of attempted suicide in LGBT adolescents. To date very little research has been done into the exact processes and background that lead these young people to attempt suicide. There are also no international studies in this field.

One of the main considerations in establishing the feasibility of a study of this kind was the extent to which it is even possible to interview adolescents who have attempted suicide without inducing them to make a further attempt. The researchers also looked at the following questions in their pilot: What is the best way to design an interview situation of this kind? And is it possible to derive information from qualitative and problem-focussed interviews that will improve suicide prevention and help to better identify cries for help?

The team of social scientists working with Pfister talked to clinical experts, counselling and suicide prevention professionals and representatives of a number of LGBT organisations. In the course of this exchange the team developed measures designed to ensure the safety of the adolescents in the study. The researchers will be flanked continuously by a psychi­atric expert and trained to identify individuals at acute risk of suicide. The researchers also want to hand out the contact details of regional and nationwide crisis centres to every person interviewed, thus ensuring that they can obtain rapid assistance if needed.

In the pilot study, Pfister and his team developed interview guidelines that the researchers have already tested in interviews with two subjects. “We found that the processes leading to an attempted suicide are varied and complex,” Andreas Pfister says. “Attempted suicide is determined to a widely varying extent by stress factors relating to sexual identity or orientation.” Pfister and his team have concluded from the responses they have received so far that interviews of this kind are a suitable approach to finding out more about attempted suicide and the needs of those affected.

Pfister and the team have put together a research advisory board that will keep a constructively critical eye on the study that will now follow the pilot. Pfister submitted a proposal to the Swiss National Science Foundation in order to obtain funding for the study – and received approval in late March. The study is planned to start in October 2020.

Pfister, Andreas & Mikolasek, Michael (2019). Suizidversuche von LGBT-Jugendlichen und jungen Erwachsenen. Einschätzung der Machbarkeit einer qualitativen Untersuchung in der Schweiz