4 - (OP4) What Remains Unsaid: Outness and Help-seeking Among LGBTQ+ Veterans at Risk of Suicide

Disclosing suicidal thoughts and behaviors is an important first step to receiving evidence-based treatments for suicide risk (Fulginiti et al., 2016). LGBTQ+ Veterans are at increased risk for suicide. Additionally, LGBTQ+ Veterans may encounter barriers to suicide-related disclosure, such as navigating decisions about revealing or concealing aspects of their identity. This study explored the associations between identity outness, minority stress, and intentions to seek help for suicidal thoughts.

A sample of 99 LGBTQ+ Veterans who had experienced suicidal thoughts and/or behaviors within the past 12 months were recruited via social media and completed self-reports about 1) identity-related variables (internalized stigma, discrimination, positive LGBTQ+ identity, outness) and 2) help-seeking intentions for suicide-related concerns (total; formal, professional sources; informal, non-professional sources; no one). Analyses included exploratory Pearson correlations for key variables and regression models for each of the four help-seeking outcomes (total, formal, informal, no one) with facets of outness (disclosure and concealment) as predictors entered simultaneously.

Exploratory correlational analyses demonstrated that greater positive LGBTQ+ identity was associated with greater help-seeking intentions, both overall (r = .224, p = .026) and from informal sources (r = .231, p = .021), but not from formal sources (r = .166, p = .1). Greater LGBTQ+ identity concealment was significantly associated with greater likelihood of not seeking help from anyone (r = .237, p = .014). Ordinal logistic regression revealed that greater identity concealment remained associated with greater likelihood of not seeking help from anyone when controlling for identity disclosure (B = 0.162, SE 0.0667, 95% CI [.031, .293], p = 0.015). The overall model was statistically significant (χ² = 6.321, p = .042), indicating the predictors jointly predicted higher levels of not seeking help from anyone. Models for the other outcomes were not significant.

These findings suggest that among LGBTQ+ Veterans at risk of suicide, those with positive LGBTQ+ identity are more likely to intend to seek help for suicidal thoughts and behaviors, while those who conceal their LGBTQ+ identity—even if they may also disclose identity elsewhere—are more likely not to seek help from anyone. Findings highlight the importance of considering LGBTQ+ identity concealment, creating spaces where LGBTQ+ Veterans are comfortable disclosing their identity, and examining how these factors play a role when tailoring CBT and suicide prevention efforts to this population.