Suicidality Among Sexual or Gender Minority College Students With a Schizophrenia Spectrum Disorder

Background: Suicide is a leading cause of death among individuals with a schizophrenia spectrum disorder (SSD). Individuals who identify with a sexual and/or gender minority (SGM) identity are also at increased risk for suicidal thinking and behavior. Aims: To explore the association between SGM status and suicidality among university students with an SSD. Method: We used the 2019-2020 Healthy Minds survey data to explore the relationship between SGM status and past-year suicidal ideation, plan, and attempt among individuals with SSDs using bivariate and multivariable analyses. Results: Of 134 students with SSDs, 47.5% endorsed a sexual minority identity and 18.7% endorsed a gender minority identity. Gender minority individuals had 3.98 the odds of suicidal ideation compared to cisgender individuals (95% CI 1.16-13.60, p = .0277). There was no association between sexual minority identity and suicidal ideation. Limitations: This work was limited to a cross-sectional assessment using self-report survey data from a predominantly non-Latino White college student cohort, resulting in a small sample size and limited generalizability. Conclusion: The intersectionality of having a gender minority identity and an SSD may confer a heightened risk of suicidal ideation among young adults. University campuses and first-episode psychosis programs should consider targeted suicide prevention efforts in this population.