Transformational-Visual Intervention for Exposure With Suicide (Transformational-VIEWS): Postvention as Suicide Prevention for Racially Diverse Sexual and Gender Minority Young Adult Suicide Loss Survivors

Suicide is a leading cause of death among youth ages 15-25. Each suicide leaves behind survivors of suicide loss (SSL); friends, family, classmates, or peers who are deeply impacted. Without proper postvention (i.e., support provided after a suicide death), SSL often struggle with grief, shame, guilt, and stigma, or negative judgments based on their identities and experiences. SSL are at higher risk of depression, posttraumatic stress, suicidal thinking, and self-harm behaviors such as suicide attempts. Youth-aged SSL are especially vulnerable, yet their experiences remain understudied. Furthermore, LGBTQ+ youth those identifying as lesbian, gay, bisexual, transgender, queer, or outside of heterosexual/cisgender identities are more likely to lose someone to suicide and face greater suicide risks. Nearly half of LGBTQ+ youth seriously considered suicide, and almost one third attempted suicide in the past year. Compared to heterosexual/cisgender peers, LGBTQ+ youth are 2-5 times more likely to feel depressed or attempt suicide. Discrimination, stigma, and harmful anti-LGBTQ+ policies further increase this vulnerability, making targeted postvention supports essential.

Suicide postvention is suicide prevention; however, most suicide postvention research has focused on White, heterosexual, cisgender females, while suicide rates are rising among LGBTQ+ youth and youth of color. In 2020, suicide deaths briefly declined among White youth, but suicidal thoughts and attempts increased among youth of color. This highlights the urgent need to study diverse LGBTQ+ SSL and design supports that meet their unique needs.

This study will use the Transformational Visual Intervention for Exposure With Suicide (Transformational VIEWS) to understand the impacts of suicide loss in racially diverse LGBTQ+ SSL and inform postvention supports. We will also assess whether Transformational-VIEWS is acceptable, helpful, and feasible. Based off our initial group, we hypothesize that Transformational-VIEWS will be well-received by at least 75% of group participants, and that personal resilience will increase after the intervention while suicide risk decreases. Transformational-VIEWS is a group based program using artmaking, writing, and discussion to support racially diverse LGBTQ+ SSL ages 18- 25.

We will enroll 32 youth who lost a loved one or peer to suicide between ages 10-24. Groups of 5-10 participants will meet for two sessions, 3 hours each, within two weeks. Before and after the group, participants will complete surveys measuring intervention targets such as suicide loss stigma, suicidal thinking, connectedness, and resilience. Participants will also join focus groups to share feedback on what worked and what could be improved. Based on this feedback, Transformational-VIEWS will be updated and tested again to strengthen its impact and appeal to LGBTQ+ SSL.

Youth participants will be recruited through suicide prevention networks, LGBTQ+ centers, and community partners across Missouri. A steering committee composed of community members, researchers, and people with suicide lived experience will guide the program to ensure it is relevant, supportive, and safe. By focusing on racially diverse LGBTQ+ youth who experienced suicide loss, this project aims to fill critical gaps in suicide research. The ultimate goal is to reduce stigma, build resilience, and help young people heal after losing someone to suicide