Support reduces depression and suicidal thoughts among young people
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Support reduces depression and suicidal thoughts among young people

A new study from Children’s Hospital of Philadelphia (CHOP) researchers found that LGBTQ+ youth were more likely to experience depression and suicidal ideation and attempts than non-LGBTQ+ youth, but the prevalence of these mental health symptoms was significantly lower when LGBTQ+ youth reported support from their parents. These findings underscore the critical role families play in helping these youth lead healthier lives. The findings were recently published in JAMA Pediatrics.

Previous research has shown that the prevalence of depression and anxiety among LGBTQ+ teens is 58% and 73%, respectively, and nearly half of these young people have seriously considered suicide in 2022. Importantly, previous research has shown that the higher rates of mental health problems among LGBTQ+ youth are not due to identity per se, but rather to the fear, shame, discrimination, and victimization that youth face from society because of their identity.

Much evidence suggests the important role that a supportive family plays, but these previous findings were based on nonclinical samples. In this study, researchers wanted to accurately measure the impact of family support because these findings can help guide important discussions between adolescents, their families, and pediatricians during routine clinical visits.

“Brief screenings are incredibly valuable to clinicians because they give patients the opportunity to report what they’re experiencing and help facilitate better discussions during visits,” said study author Dr. Joey Whelihan, a fellow in adolescent medicine at CHOP and a member of the PolicyLab at CHOP. “This is critical for LGBTQ+ youth because it provides a safe and comfortable environment for them to discuss mental health issues and gives pediatricians the opportunity to develop appropriate mental health interventions.”

In this study, researchers used the Teen Health Questionnaire, developed and piloted by the Possibilities Project (TPP), which consists of pediatricians, Clinical Futures researchers, and technology experts from CHOP. Using evidence-based screening tools, this pre-visit questionnaire helps promote discussion of some of the topics focused on adolescents, identifies which adolescents may benefit from further intervention, and expedites the visit to focus on key topics. The study population included 60,226 adolescents aged 13 to 19 years who completed the questionnaire between February 2022 and May 2023. Of these, 9,936 were LGBTQ+ (16.4%), 15,387 (25.5%) were Black, and 30,296 (50.0%) were assigned female at birth.

The study found that LGBTQ+ youth had higher mean depression scores on the Patient Health Questionnaire-9 Modified for Teens (PHQ-9-M) than non-LGBTQ+ youth (5 vs. 1) and significantly higher rates of suicidal ideation compared to their peers (15.8% vs. 3.4%) and were more likely to attempt suicide. While most youth reported support from parents and caregivers, fewer LGBTQ+ youth reported parental support, including discussion of strengths and listening to feelings. However, LGBTQ+ youth who reported parental support reported lower rates of depression and suicidal ideation and significantly lower rates of suicide attempts.

Support reduces depression and suicidal thoughts among young people
“This study builds on what we know about the prevalence of depression and suicide among LGBTQ+ youth. As pediatric health systems, we need more action to train pediatricians to provide affirming care and increase funding for nurse navigators and social workers to facilitate more frequent follow-up care for youth with depression,” said senior author Sarah M. Wood, MD, MSHP, an adolescent medicine specialist and Clinical Futures Fellow at CHOP. “However, this study clearly demonstrates how important a supportive family can be in improving the mental health of these adolescents. Health systems should strongly consider integrating family-based interventions as an important factor in achieving health equity for LGBTQ+ youth.”

The study was supported by grant P30 AI045008 from the Penn Center for AIDS Research, Career Development Award K23MH119976 from the National Institute of Mental Health, and the Possibilities Project of Children’s Hospital of Philadelphia.

DelFerro et al., “The Role of Family Support in Moderating Mental Health Outcomes of LGBTQ+ Youth in Primary Care,” JAMA Pediatr. Online July 1, 2024. DOI: 10.1001/jamapediatrics.2024.1956.

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