Understanding Suicidality among Sexual and Gender Minority Young Adults Experiencing Homelessness

Modified Project Summary/Abstract Section Up to 40% of young adults experiencing homelessness (YAEH) are sexual or gender minority individuals, despite sexual and gender minority young people making up around 7% of the general young person population. Currently, suicide is the leading cause of death among YAEH, followed by substance-use-related death. Suicidal ideation and attempts and substance use are particularly prevalent among sexual and gender minority YAEH. Adverse outcomes co-occur for YAEH, yet the relationship between co-occurring adversities is minimally understood among YAEH. Understanding the interplay of these factors with respect to suicide attempts and suicidal ideation is crucial for prevention interventions. The goal of this concurrent mixed-methods mental health disparities study is to develop models of co-occurring health adversity and social determinants of health with a focus on the syndemic of substance use, violence exposure, and mental health, and implications for suicidality among sexual and gender minority YAEH. With substantial work in young adult homelessness and suicide prevention, our team is uniquely positioned to complete the proposed study, which aligns with the training purposes of the F31 mechanism and institutional goals of the National Institute of Mental Health and focuses on a known mental health disparity. Aims 1 and 2 will use an existing dataset from the CDC Youth Violence Study, a comprehensive, psychosocial assessment of YAEH collected in Los Angeles, California. Aim 1 will use latent class analysis to identify classes of sexual and gender minority YAEH with distinct patterns of suicidality based on the syndemic of substance use, violence exposure, and mental health issues to inform tailored service needs. Aim 2 will entail conducting social network analysis to examine social network characteristics of sexual and gender minority YAEH and how social networks are associated with syndemic factors and suicidality risk. Aim 3 will be achieved through primary data collection using collaborative model building with sexual and gender minority YAEH (n=12) recruited through an established partnerships with community organizations and will apply collaborative model building to develop a causal loop diagram of the causes and consequences of suicidality among sexual and gender minority YAEH. No gender-affirming surgery or hormone-based interventions are provided as part of this research. This study will pave the way for the development and tailoring of targeted suicide prevention interventions for this vulnerable population. In addition, the PI will receive training in advanced quantitative skills, training in social network analysis, experience using collaborative model building to develop a causal loop diagram, and opportunities for professional development.