BACKGROUND: Prevalence rates of mental health disorders, non-suicidal self-injury and suicidality among Lesbian, Gay, Bisexual, Transgender, Queer and Asexual (LGBTQA+) higher education students are consistently higher than rates for heterosexual students. Nevertheless, in the United Kingdom, there remains limited prevalence data and evidence on the risk factors that confer increased risk of suicide among this population. The purpose of the present study was to investigate mental health disorders, childhood adversities, and recent stressors as risk factors for non-suicidal self-injury, and suicidality among LGBTQA + students.

METHODS: The Student Psychological Interventional Trial (SPIT) was conducted as part of the World Mental Health International College Student Initiative (WMH-ICS). First year undergraduate students aged 18-24 years were recruited (n = 1525), including LGBTQA + students (n = 190). Chi-squared test of independence was used to identify significant differences in lifetime prevalence rates between heterosexual and LGBTQA + students. Bivariate and multivariate logistic regression analyses examined the associations between mental health disorders, childhood adversities, recent stressors, non-suicidal self-injury, and suicidality among LGBTQA + students.

RESULTS: LGBTQA + students were significantly more likely to have experienced mental health difficulties, childhood adversities, recent stressors, non-suicidal self-injury, and suicidality than their heterosexual counterparts. One in four LGBTQA + students reported experiencing major depressive episode, and non-suicidal self-injury in their lifetime. LGBTQA + students also reported earlier onset of mental health disorders and suicidality, with much higher rates of interpersonal conflict, and probable post-traumatic stress disorder. Among LGBTQA + students, major depressive disorder, probable post-traumatic stress disorder, and non-suicidal self-injury were significantly associated with an increased likelihood of suicidal ideation and suicide plan. Childhood adversities, and recent stressors such as bullying were significantly associated with an increased likelihood of suicide attempt.

CONCLUSIONS: Our findings highlight the existing mental health disparities, childhood adversities, and recent stressors which may contribute to higher prevalence rates of non-suicidal self-injury, and suicidality among LGBTQA + students. The results emphasise the importance of early intervention, prevention, and treatment, focused on reducing the impact of childhood adversities and recent stressors such as bullying. In addressing these risk factors, educational settings may offer unique opportunities for the practice of inclusion, preventative care, and harm reduction for LGBTQA + students.