The Continuum of Care for LGBTQ Youth is partnering with Spectrum Consulting Group, LLC on a unique community based pilot project designed to reduce suicide risk for lesbian, gay, bisexual, transgender and queer or questioning (LGBTQ) youth through age 24. 

Utah has the 5th highest rate of youth suicide in the country, with suicide now the leading cause of death for youth in the state. LGBTQ youth attempt suicide 4 times more often than their straight, cisgender peers; those children rejected by their parents have an 8 times great risk of suicide. One convenience sample indicates 62% of Utah LGBTQ youth report attempting suicide, almost all more than once, with virtually every child having lost at least one friend to death by suicide. Nationally, 86% of LGBT students report harassment at school, and 28% of LGBTQ youth stop going to school because of being bullied. Each episode of LGBTQ victimization, such as physical or verbal harassment or abuse, increases the likelihood of self-harming behavior by 2.5 times.

Utah has been the subject of national scrutiny of late, with anecdotal reports of many purportedly LGBTQ LDS identified suicides receiving national attention.  There is high interest in addressing LGBTQ suicide, particularly for youth from conservative religious backgrounds.  Therefore, this pilot project is intended for Provo, Utah, an area known for high LDS populations and great symbolic significance for communities tied to the LDS faith.  Provo is also a community with a great interest in LGBTQ suicide prevention. Community partners are readily available to assist with implementing programmatic elements, raise awareness, be trained and become trainers, as well as help to augment existing resources for at-risk youth and their families.

 

Goals and Objectives

  • This project is a multi-layered approach, using a broad array of community partners and points of contact for LGBT youth and their families to raise awareness, train, and provide resources for suicide prevention, including a combination of risk reduction and the promotion of protective factors. Goals for this project and their associated objectives are:

     

    1.   Raise awareness of risk of suicide for LGBTQ youth

    1a. Hold a Family Fireside event on LGBTQ youth and suicide risk

    1b. Hold a community awareness event on LGBTQ youth and suicide risk

     

    2.   Train points of contact for LGBTQ youth

    2a. Train youth serving organizations in LGBTQ suicide prevention and cultural competency

    2b. Distribute literature about LGBTQ youth and risks to youth serving organizations

     

    3.   Compile and provide resources for LGBTQ youth and their families

    3a. Vet, compile and distribute local, state and national resources for all

    LGBTQ youth points of contact

 

Strategy / Program Design 

Per SPRC community LGBTQ youth suicide recommendations, the ultimate goal of our project is to reduce risk factors and increase protective factors as much as possible, highlighting these components:

 

• Implement training for all staff members to effectively serve LGBTQ youth by including recognition and response to warning signs for suicide and the risk and protective factors for suicidal behavior in LGBTQ youth

 

• Assess and ensure that youth services and providers are inclusive, responsive to, and affirming of the needs of LGBTQ youth, and refer youth to these services and providers

 

• Support the development of peer-based support programs and include the topic of coping with stress and discrimination and integrate specific activities for LGBTQ youth• Incorporate program activities to support youth and their family members throughout the development of sexual orientation and gender identity, including awareness, identity, and disclosure. These programs must address young children and adolescents.

 

• Promote organizations that support LGBTQ youth, such as Gay-Straight Alliances and Parents, Families, and Friends of Lesbians & Gays (PFLAG)

 

• Make accurate information about LGBT issues and resources easily available

 

• Use an LGBT cultural competence model that enables individuals and agencies to work effectively with LGBT youth cultures

Curriculum

This project will use select materials from the Best Practices Registry, including:

 

Supportive Families, Healthy Children: Helping Families with Lesbian, Gay, Bisexual & Transgender (LGBT) Children

Awareness/Outreach, Family Acceptance Project, San Francisco State University

 

Trevor Lifeguard Workshop

Education & Training, The Trevor Project

 

Guidelines for School Based Suicide Prevention Programs

Guidelines & Protocols, American Association of Suicidology

 

Saving Our Lives: Transgender Suicide Myths, Reality and Help

Awareness/Outreach, Massachusetts Department of Public Health

 

Suicide Prevention among LGBT Youth: A Workshop for Professionals Who

Serve Youth

Education & Training, Suicide Prevention Resource Center

 

 The above resources will be used to raise awareness, train points of contact for youth, as resources, and to promote wellness and reduce risk.  Given the short time frame there will be overlap between awareness and training efforts.  Resources will be compiled and vetted throughout the direction of the project and made available by the conclusion date of June 30, 2016.  Participants will be recruited through general advertising, through community partner groups, and through selective engagement.  For example, the Dragon Mamas group will assist with recruiting not only their own members and persons of interest, but also throughout their wards, workplaces and neighborhoods.  Every event and training will be achieved with cultural relevance firmly in mind, partnering at every turn with key stakeholders to ensure participant comfort and ease.  Existing school bullying prevention partners will be partnered with (Utah Bullying Coalition / Stand4Kind) to include LGBTQ materials and resources in a new school pilot, which will be concurrent with this pilot and share data collection and analysis.

Integrated

At each of the three intervention levels (universal, selective, and indicated), the intervention strategies implemented will be empirically supported activities in LGBTQ youth suicide prevention. The goals, objectives, and intervention design are based on several national best practices, and draws heavily from two best-practices reports (see logic model for links to reports):

Suicide Prevention Resource Center (2008). Suicide risk and prevention for lesbian, gay, bisexual, and transgender youth. Newton, MA: Education Development Center, Inc.

 

van der Feltz-Cornelis, C.M., et. al. (2011). Best practice elements of multilevel suicide prevention strategies: A review of systematic reviews. Boston, MA: Hogrefe Publishing.

 

Fidelity measures will be collected throughout the duration of the intervention, including training and presentation evaluations, and frequent interviews and communication with key stakeholders in this intervention (youth service providers, points-of-contact, families and youth served).

 

Intervention strategies for each focus population are based on identified needs of LGBTQ youth. This intervention aims to improve overall community climate for LGBTQ youth in the broadest sense (universal), target youth service providers as gatekeepers (selective), and engage LGBTQ youth and their families directly (indicated). The selective strategy, engaging gatekeepers, is based on recommendations from the US Center for Disease Control – “Gatekeepers—those who have contact with youth and are trained to recognize at-risk youth and refer them to services—as well as staff of screening programs and crisis lines, need to understand LGBT risk for suicidal behavior, know particular issues for these youth, and develop cultural effectiveness to serve them. Gatekeepers and staff need to be aware of LGBT- inclusive providers to use for referrals.” By intervening at all three levels, barriers in one intervention strategy can be addressed and balanced by strengths in other intervention levels.

 

Performance and Outcomes

 

Data will be collected at all levels and in all stages of this project. At the beginning of the project, we will work with local government organizations, systems, youth service providers, and clergy, to assess the extent of the problem of LGBTQ youth suicide. Because it is hard to  collect accurate data on LGBTQ status and death by suicide, numbers collected will be supplemented with qualitative interviews from community members with knowledge of this issue in Provo. Throughout the project, researchers will work with community members to improve methods for enumerating suicide attempts and ideation among LGBTQ youth. When possible, additional demographic information on youth will also be collected to assess which characteristics of youth are associated with higher rates of suicide attempt and completion (such as age, gender, race, etc.).

 

Process data will be collected at each stage of the intervention. Process output measures will include number in attendance at trainings and events, number of contacts made, meeting minutes, and number of trainings and events held. Outcome data will also be collected throughout, through methods including training evaluations and post-surveys, and records of Queer Straight Alliances in schools. Throughout the course of the intervention, researchers will develop instruments to assess community suicide awareness, LGBTQ cultural competency, school climate, and family acceptance.

 

Community Support and Collaboration

 

This project will seek to integrate with existing prevention services in Provo, LGBTQ community groups and organizations, youth homelessness services, juvenile justice and DCFS / foster care, faith communities, individual stakeholders and families will also be sought as collaborators and partners in executing this project.

 

In addition to existing partnerships, we will expand the network of prevention supports throughout health and wellness promotion, suicide prevention and youth surviving organizations, including schools and faith communities. 

 

The Provo Pilot Project has been completed, collected data is being reviewed and analyzed.  Please This email address is being protected from spambots. You need JavaScript enabled to view it.">email us for more information.


 

 

 

 

Starting soon:  Suicide Prevention Project with LGBTQ Youth from Plural Communities and with Youth Experiencing Homelessness

 

1.  Target Population(s)

 

According to some estimates, there are about 5,000 youth who experience homelessness in Utah during any given year. Youth from plural families are over-represented among youth experiencing homelessness, as are LGBTQ youth. Many of these youth are living “off the grid,” meaning they are not accessing community supports and services. Suicide rates for these youth are high, with some estimates of attempt rates for LGBTQ homeless youth as high as 62% (National Recommended Best Practices for Serving LGBT Homeless Youth, 2009).

 

Throughout the Wasatch Front, youth experiencing homelessness live in street family camps. These youth are unknown and unnoticed by most. Street families are generally 10-20 youth living together as a tribe, supporting and looking out for each other. Unlike many of their homeless youth peers, these “off the grid” youth have been severely traumatized, and are not trusting enough of adults and systems to access services at shelters or drop-in centers. These youth are struggling to meet their basic needs, and are often battling severe mental illnesses.

 

Though there is a dearth of research on suicide among youth in plural families and youth from plural communities, this at-risk group is known to struggle with poor economic, emotional, and mental health outcomes. Given the current instability of the FLDS community, many teens are leaving or being removed from the group. These youth are alone without the support of their community of origin, and need support to transition to a new life, and building connections and developing resiliency and self-efficacy. 

 

This intervention will target both off-grid youth, and youth transitioning out of plural communities, with a focus on LGBTQ youth within these groups. The target population for the intervention are youth and transition age young adults, age 14-23. Because the group targeted by this intervention is specific, the geographic scope of the project will be broad, encompassing camps of off-grid youth throughout the Wasatch Front, youth experiencing homelessness in rural areas without access to services, and youth coming from plural family communities 

 

2. Goals and Objectives

 

The overarching goal of this project is to reduce suicide among youth experiencing homeless and youth from plural families. This will be accomplished through interventions targeting increasing self-efficacy, and building supportive connections. Because best practices do not exist for these populations, the first goal is to gather more information on what is working effectively in other communities throughout the US. This project seeks to improve data collection and statistics on suicide for off-grid youth, and to identify and pilot empirically supported interventions with off-grid youth populations.

The goals and strategies for this project are: 

 

  • Identify promising strategies for suicide prevention and resiliency promoting interventions with off-grid youth
  • Review the academic literature for evaluations of suicide prevention and resiliency promoting interventions with off-grid youth
  • Identify and engage youth service organizations and experts nationwide who have been involved with suicide prevention among off-grid youth
  • Interview national experts on effective strategies they have implemented for suicide prevention and promoting resiliency among off-grid youth
  • Establish protocol and curricula based on information gained in 1a-1c 
  • Build trusting relationships with off-grid homeless youth and youth from plural communities
  • Work with existing service providers and individuals who are part of off-grid and plural communities to gain insight into the specific mental health and suicide prevention needs of these populations and build rapport with key stakeholders
  • Begin street outreach efforts, engaging camps of off-grid youth and youth from plural communities by providing basic needs items (donated food, water, clothing, and other supplies) and listening to their needs and perceptions
  • Implement direct intervention with off-grid homeless youth and youth from plural communities
  • Implement support groups and empowerment opportunities (see strategy 1d) in street camps and other areas hidden youth feel comfortable and safe engaging
  • Connect youth in need to existing resources and programs that can provide additional support

  • Provide resources and information to families in plural communities to prevent youth homelessness and suicide
  • Make connections and build rapport with plural families throughout Utah, listening to their experiences and perceptions
  • Compile and offer best practices materials to plural families, including Family Acceptance Project materials, and Dragon Mamas Stories
  • Act as a point-of-contact for plural families with LGBTQ children, offering support and referrals when needed
  • Create a model that can be implemented in other communities
  • Collect process and outcomes data throughout all project components
  • Write up a model, including a report of pre- and post- measures, as a guide enabling other communities to implement this project with their hidden youth populations 

3. Strategy/Program Design

  

It is critical when working with off-grid youth to build trust and rapport before implementing any type of intervention. Because these youth have often experienced a great deal of trauma, the following procedure will guide our approach to working with youth in camps or on the street: 

 

Develop protocol and strategies in locating and mapping (keeping track) of homeless youth and areas of congregation. This includes truck stops and city parks where youth are known to experience sexual exploitation, as well as canyon areas, “off the grid” locations, and areas within the immediate vicinity

Develop protocol for approaching and engaging youth in many settings, including: LGBTQ, entrenched (hard to reach) and “off the grid” youth

Assemble and train outreach team

Implement outreach program: 1) Approaching youth, building initial relationship, 2) Engaging youth, strengthening relationship by offering emergency assistance and supplies, informing them of community resources and drop-in center services 3) Implement our resiliency building, strengths-based suicide prevention curriculum

 

Curriculum 

 

The curriculum for these interventions will be created during the first three months of the funding period, following interviews with national experts working with off-grid youth. The interventions will focus on building resiliency, positive youth development, and educating youth in suicide prevention. The curricula will draw from best practices with related populations, including:

 

Preventing Mental, Emotional, and Behavioral Disorders in Young People

National Research Council

 

Trevor Lifeguard Workshop

The Trevor Project

 

Saving Our Lives: Transgender Suicide Myths, Reality and Help

Massachusetts Department of Public Health

 

Suicide Prevention among LGBT Youth: A Workshop for Professionals Who Serve Youth

Suicide Prevention Resource Center

 

Supportive Families, Healthy Children: Helping Families with Lesbian, Gay, Bisexual & Transgender (LGBT) Children

Awareness/Outreach

Family Acceptance Project, San Francisco State University

 

This curriculum will focus on development of positive connections and increasing self-efficacy. The intervention will address the empirically supported protective factors listed in Preventing Mental, Emotional, and Behavioral Disorders in Young People: safety,opportunities to take part in decision-making and to take leadership roles, opportunties to form healthy and positive connections with peers, opportunities to develop positive social values and contribute to the community, and increased self-efficacy, 

 

Integrated 

 

At each of the three intervention levels, the intervention strategies implemented will be empirically supported activities in youth suicide prevention. The intervention design will be based on best practices with at-risk youth, and information gained from our interviews with experts nationwide about models of suicide prevention for off-grid youth. Because LGBTQ youth are over-represented among the “hidden” youth we are targeting with this project, we will draw from the following best practices: 

 

Suicide Prevention Resource Center (2008). Suicide risk and prevention for lesbian, gay, bisexual, and transgender youth. Newton, MA: Education Development Center, Inc. 

 

van der Feltz-Cornelis, C.M., et. al. (2011). Best practice elements of multilevel suicide prevention strategies: A review of systematic reviews. Boston, MA: Hogrefe Publishing.

 

Fidelity measures will be collected throughout the duration of the intervention, including 

records of interviews and national expert contacts, conversations with parents in plural communities, and records of interaction with off-grid youth before the intervention begins.

 

4. Performance and Outcomes

 

Data will be collected at all levels and in all stages of this project. At the beginning of the project, we will create and implement a mapping system for identifying and engaging with youth. In addition to tracking camps and areas where homeless youth congregate, we will take case-notes (qualitative data) after interactions with a youth or street family. 

 

Pre- and post-data will be collected with all youth participating in the intervention. These measures will collect information regarding: self efficacy, risk and protective factors for suicide, suicide ideation, and content knowledge of the concepts being taught. 

 

Process data will be collected at each stage of the intervention. Process output measures will include number of contacts with national experts, contacts with parents in plural families, and contact made with off-grid youth. 

 

Community Support and Collaboration

 

This project will be a collaboration between Spectrum Consulting Group and two youth serving non-profit organizations: Operation Shine America, who focus on homeless, off-the-grid youth, and Cherish Families, an organization dedicated to improving outcomes for people from plural families and communities. 

 

Street outreach will be accomplished through collaboration with Operation Shine America, a national advocacy, education, and outreach organization for homeless youth. Cai Noble, founding Director of Operation Shine America, has been working with LGBTQ street youth using a trauma-based street outreach approach for five years. She has developed a system for approaching and engaging street youth, and will be expanding this system for the proposed project. In addition to visiting youth in camps and known homeless groups, we will directly contact youth who are living between truck stops, a subset of homeless youth known in the youth homelessness community as “road rats” or “lounge lizards.” Cai and the street outreach team will approach youth and offer basic needs items and support. Through this interaction, street outreach will seek to build trusting relationships and prepare youth to engage in our resiliency building, suicide prevention program. 

 

Cherish Families serves plural families throughout Utah through providing education, outreach, and resources. Currently, Cherish Famllies offers victim advocacy services, peer mentoring, cultural competency training, education and outreach, and community advocacy.