(PS9-B28) Mental Health Outcomes and Suicide Risk in Transgender Youth in a Suicide Prevention Intensive Outpatient Program

Transgender and non-binary (TGNB) youth are at increased risk for suicidal thoughts and behaviors (Connolly et al., 2016; Grossman et al., 2007; Hatchell et al., 2021; Olson et al., 2015). Identifying effective methods of suicide prevention and treatment of suicidal ideation is imperative to address the disparities in suicidal thoughts and behaviors in TGNB youth. Research regarding the outcomes of TGNB youth accessing a suicide prevention intensive outpatient program (IOP) is limited. This study aimed to identify a) the prevalence rate of TGNB youth accessing care as well as differences between TGNB and cisgender youth in b) baseline and exit depressive symptoms as measured by the QIDS c) suicidal behavior in month prior to intake and lifetime as measured by the Columbia Suicide Severity Rating Scale and during IOP as measured by clinician reported suicide attempts and admissions to the emergency room or inpatient, d) suicidal ideation and propensity at baseline and exit as measured by the Concise Health Risk Tracking (CHRT), and e) emotion regulation as measured by the Difficulties in Emotion Regulation Scale (DERS). A total of 88 youth completed intake and treatment at a suicide prevention intensive outpatient program (IOP) following a suicide attempt or suicidal ideation. The program implements a Dialectical Behavioral Therapy and Cognitive Behavioral Therapy model. Of the 88 youth, 65.9% identified as cisgender (48.9% = F, 17% = M), 29.5% identified within the transgender/non-binary umbrella including transgender, non-binary, genderfluid, questioning/not sure, and other TGNB identities, and two youth declined to answer and were excluded from analysis (N = 86). About 43% of the total sample (N = 88) consisted of youth self-reporting LGB+ identities (N = 38), 11.4% were not sure, 38.6% were heterosexual/straight and 4.5% declined to say. Youth completed self-report and clinical interview measures at intake and treatment exit. Youth gender identity and sexual orientation were self-reported in a REDCap survey. TGNB youth (N = 26) were compared to cisgender/non-transgender youth (N = 58). At intake and exit, TGNB youth had significantly greater reported depressive symptoms, higher rates of propensity for suicidal ideation, and difficulty in emotion regulation. At intake, TGNB youth were significantly more likely to endorse non-suicidal self-injury (NSSI) in the previous month and lifetime. Conversely, TGNB and cisgender youth did not differ at exit in terms of NSSI, frequency of inpatient or emergency department admissions, or suicide attempts during IOP.  TGNB youth experience comparable benefit to cisgender youth after completion of the IOP. Additionally, TGNB youth demonstrate greater symptom severity on intake which, though they may be receiving the same degree of improvement as cisgender youth, may be contributing to the differences in exit symptom severity. Furthermore, the disproportionate amount of TGNB youth accessing this suicide prevention program elucidates the mental health disparities in this population to a degree above evidenced prevalence. These results suggest treatment efficacy in extenuating depressive, suicidal, and emotion dysregulation symptom severity.