Suicidality, self-efficacy and mental health help-seeking in lesbian, gay, bisexual and transgender adults in Taiwan: A cross-sectional study

J Clin Nurs. 2021 Aug;30(15-16):2270-2278. doi: 10.1111/jocn.15680. Epub 2021 Apr 25.

Abstract

Aim and objectives: The study aimed to investigate the associations of suicide risk, self-efficacy and mental health help-seeking among the lesbian, gay, bisexual and transgender (LGBT).

Background: The LGBT individuals were found to have higher risk of suicide. However, mental health promotion and suicide prevention strategies were lacking in this population.

Design: A cross-sectional survey with two-group comparison.

Methods: The LGBT group was recruited through snowballing method, which was then age-matched with the comparison group as the reference. The questionnaire contained demographics, self-rated health, suicide risk assessment and help-seeking indicators including formal (e.g. medical or psychiatric services) and informal (e.g. family or friends) help sought. Chi-square tests, t-tests, two-way ANOVA and multivariable regression were performed to test the differences between two groups. The methods followed STROBE criteria.

Results: The LGBT group had a significantly higher prevalence of lifetime/recent suicide ideation, prior suicide attempts and mental distress or depressive symptoms. Their self-rated health and health-related self-efficacy were poorer than those of the comparison group and were associated with increased suicide risk levels. Among the 27.1% of LGBT who intended to seek help for depression, one in five visited psychiatric services. The LGBT were 2-4 times more likely than the comparison group to disclose their distress or seek informal help. However, psychiatric and medical service contacts were relatively low for suicide high-risk individuals in the LGBT group.

Conclusions: The LGBT individuals had a lower level of self-efficacy and higher suicidal risks than the general public. Healthcare professionals and the public should be aware of their informal help-seeking signals such as disclosure of suicide ideation to friends/relatives and connect them to proper mental health resources for further assessment.

Relevance to clinical practice: The LGBT with suicide risks require early detection and proper referrals by first-line nurses to promote suicide prevention in this population.

Keywords: LGBT; help-seeking behaviour; mental health promotion; nursing; suicide risk assessment.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Humans
  • Mental Health
  • Self Efficacy
  • Sexual and Gender Minorities*
  • Suicide Prevention*
  • Taiwan
  • Transgender Persons*