Supportive model for the improvement of mental health and prevention of suicide among LGBTQ+ youth

Sexual Fluidity and Suicidal Thoughts and Behaviors in Early and Middle Adulthood: Evidence From the National Longitudinal Study of Adolescent to Adult Health

OBJECTIVE

The present study seeks to explore the relationship between sexual fluidity and suicidal thoughts (STs) and behaviors (STBs) among adults in early and middle adulthood.

METHODS

This study utilized data from Waves IV and V of the National Longitudinal Study of Adolescent to Adult Health (ADD Health). Participants were categorized into four groups: (1) heterosexual at both waves, (2) sexual minority (SM) at Wave IV but heterosexual at Wave V, (3) heterosexual at Wave IV and SM at Wave V, and (4) SM at Wave IV and Wave V.

RESULTS

Hierarchical logistic regression revealed that sexual fluidity between Waves IV and V was associated with STs. Those who were heterosexual-identifying at Wave IV but identified as an SM at Wave V were close to four times as likely to report STs at Wave V than were those who identified as heterosexual at both waves. Those who were an SM at Waves IV and V were almost twice as likely to report STs compared to those who were heterosexual at both waves. Additionally, χ2 results showed that suicide attempts (SAs) and sexual fluidity were associated. Similarly, SA prevalence was highest during periods in which participants identified as SMs.

CONCLUSIONS

Transitioning into a sexually minoritized status is associated with increased risk of STBs, whereas transitioning into a nonminoritized status was not.

The mental and behavioral health crisis in youth: Strategic solutions post COVID-19 pandemic: An American Academy of Nursing consensus paper

The COVID-19 pandemic wrought significant negative impacts on youth well-being, particularly among Black, Hispanic, American Indian, Alaska Native, and LGBTQ+ (Lesbian, gay, bisexual, transgender, queer or questioning) youth. The pandemic disrupted connections to family, school, and community, which are essential supports for youth mental health. Lessons learned from the pandemic suggest the role of stress and windows of opportunity to build resiliency. Drawing from a policy dialog on the youth mental health crisis conducted by 4 American Academy of Nursing Expert Panels, we present approaches to the current increase in youth mental health problems. Included is emerging literature on building youth resilience, particularly via re-establishing school and community connections. The role of families, schools, and community support is emphasized, particularly by creating a healing school environment and the pivotal role of school nurses. Recommendations include increased support for families, engaging the school nurse role, and developing school-based innovative programs to build connections and youth wellness.

The queers are all right: a content analysis of LGBTQIA + mental health on TikTok

The formation of online communities instils a sense of connectedness which can ameliorate the mental health concerns that result from minority stressors for lesbian, gay, queer, intersex, asexual, and other diverse genders/sexualities (LGBTQIA+). The aim of this study was to explore how LGBTQIA + people communicate social and mental health concerns on TikTok. It was anticipated that factors affecting mental health, such as minority stressors and community connectedness, would be addressed by the videos collected. Engagement statistics, demographics and content analysis were used to describe the 50 most-viewed videos across the top five related hashtags: #genderidentity, #lgbtqawareness, #sexualidentity, #lgbtmentalhealth, and #transmentalhealth. The content analysis indicates that TikTok is used as a way for members of the LGBTQIA + community to connect with each other and enhance feelings of community connectedness, which research shows may buffer the effects of minority stressors. Engagement with social media can be especially beneficial for those who may not be able to connect in the real-world. Further interactions, such as analysis of the comment section, should be investigated to develop a fuller understanding of how LGBTQIA + TikTok users respond to these contents.

Mixed-Methods Examination of Adolescent-Reported Barriers to Accessing Mental Health Services

PURPOSE

Many adolescents struggle to access the mental healthcare they need. To increase access to mental health services, we must have a clear understanding of the barriers adolescents face from their own perspectives. This online mixed-methods study aimed to enhance understanding of access barriers by centering the perspectives of diverse adolescents who had recently tried and failed to access mental health support.

METHODS

In this convergent parallel mixed-methods study, adolescents responded to a preintervention, open-ended question about barriers they have faced to accessing mental health services when they needed them and shared information about their background and depressive symptoms. Barriers were assessed using inductive, conventional content analysis. Quantitative analyses examined barrier differences across sociodemographic groups.

RESULTS

All adolescents (aged 11-17 years, 50% racially minoritized youth, 15% gender diverse youth, 64% LGBTQ + youth; 78% with clinically elevated depressive symptoms) reported at least one barrier to accessing mental health support, and 20% reported multiple barriers. Content analysis revealed 13 barrier categories, with parent-related barriers (three different categories) accounting for 32% of all barriers. The most common barrier categories related to personal and financial constraints. Asian adolescents, adolescents who were aged 17 years or more, and adolescents who reported uncertainty of their gender identity endorsed the numerically highest mean number of barriers to accessing mental health support.

DISCUSSION

High-symptom adolescents reported myriad barriers to accessing mental health support, with 32% of all barriers related to parents.

Stress and Depression Are Associated with Sexual Function and Satisfaction in Young Men Who Have Sex with Men

Prior research suggests that better mental health and higher relationship quality are associated with better sexual function and satisfaction. Such insights can inform intervention development for mental, relationship, and sexual health concerns. This study examined the interactions among these variables in a racially and ethnically diverse group of young men who have sex with men (YMSM) in serious relationships (N = 348). Data were drawn from wave 5 of a longitudinal cohort study. We examined cross-sectional associations between depression and stress (predictors) and sexual function, sexual satisfaction, and anal discomfort (outcomes) and to what extent these associations were moderated by relationship quality. Higher endorsement of depression and stress was associated with worse sexual functioning, lower sexual satisfaction, and more anal discomfort. We also found that fewer negative interactions, stronger commitment, and higher relationship satisfaction were associated with better sexual functioning and higher sexual satisfaction. Higher relationship satisfaction and commitment were found to attenuate the association between stress and sexual satisfaction. Contrary to expectations, higher relationship satisfaction also showed a trend toward exacerbating the association between depression and sexual functioning. These results suggest that, for YMSM, high relationship satisfaction and commitment may protect sexual satisfaction from being negatively impacted by high stress. However, YMSM in highly satisfying relationships may experience poor sexual functioning associated with depression as particularly distressing. This study addressed a major gap in the literature by focusing on mental, relationship, and sexual health in a diverse sample. Future research should examine a wider range of sexual functioning outcomes and include minority stress in study design.

Family Structure Diversity and Youth Health Care Access and Interactions With Health Care Providers

Using data from the 2019 National Survey of Children's Health, we evaluated family structure differences in youth health care access and experiences. We found youth living with their married biological/adoptive parents generally had greater health care access than youth living in structurally diverse families. Differences, however, varied based on which aspect of health care access was examined and the specific types of structurally diverse families youth were living in. Youth living in single-father and other relative-headed families showed the most consistent differences in health care access from youth living with their married biological/adoptive parents. In terms of health care experiences, youth living in several structurally diverse families were more likely to have had time alone with health care providers. Furthermore, there were differences in family-centered care, but the effect size and magnitude of the differences were small.