● Discrimination, victimization, or violence at school, work, and when accessing health care: 77%. ● Harassment or bullying at school (any level): 50 to 54%. ● Discrimination or harassment at work: 50 to 59%. ● Refusal of treatment by doctor or health-care provider: 60%. ● Physical or sexual violence: ○ At work: 64 to 65%. ○ At school: 63 to 78%. ● Discrimination, victimization or violence by law enforcement: 58%. ● Disrespect or harassment by law enforcement officers: 57 to 61%. ● Physical or sexual violence by law enforcement officers: 60 to 70%. ● Homelessness: 69%. The CDC 2020 analysis showed an exceptionally high prevalence of lifetime suicide attempts reported by NTDS respondents across all demographics and experiences. Analysis of other demographic variables among sexual minority youth found prevalence of suicide attempts was highest among those who are younger (45% among ages 18 to 24 years), multiracial (54 %), American Indian or Alaska Native (56%), have lower levels of educational attainment (48 to 49% among those with a high school diploma or less), and have lower annual household income (54% among those with less than $10,000 per year). Prevalence of suicide attempts is elevated among those who disclose to everyone that they are transgender or gender non- conforming (50%) and among those who report that others can tell that they are transgender or gender non-conforming, even though they do not self-disclose, either: all of the time (42%) or most of the time (45%). Rate of suicide attempts are also higher among respondents who are HIV-positive (51%) and respondents with disabilities (55 to 65%). In addition, 65% of respondents with a mental health condition that substantially affects a major life activity reported attempting suicide. Suicide is one of the leading causes of death in postpartum parents; findings suggest that it is the seventh-leading cause of maternal death within six months of delivery. Identifying modifiable factors related to suicide risk in mothers after delivery is a public health priority (Sit et al., 2015). An analysis by Sit et al. (2015) included 628 depressed mothers, who were diagnosed with depression at four to six weeks postpartum. Of the depressed mothers, 496 (79%) “never” had thoughts of self-harm, 98 (15.6%) “hardly ever,” and 34 (5.4%) “sometimes” or “quite often.” Because parents with postpartum depression can present with frequent thoughts of self-harm and a high level of clinical complexity, conducting a detailed safety assessment, which includes evaluation of childhood abuse history and current symptoms of sleep disturbance and anxiety, is a key component in the management of depressed mothers. Major depression, bipolar disorders, alcohol and substance use disorders, schizophrenia, and anxiety disorders contribute to the increased risk for suicide and suicidal behaviors in this population. In the postpartum period, women with a psychiatric disorder, substance use disorder, or both were at significantly increased risk for suicide attempts by 27-, 6- and 11-fold, respectively (Sit et al., 2015). Of mothers who died from suicide in the first six months after childbirth, the primary diagnoses were severe depression in 21% of decedents, substance use disorders in 31%, and psychosis in 38%. The inadequate assessment of risk or illness severity, combined with low rates of seeking mental health treatment and 15% of postpartum women indicating major mood disorders, likely compounds the risk for suicide in postpartum women. Beyond risk to parents themselves, parental suicidality can undermine
14.5% had seriously considered suicide, 12.1% were planning suicide, and 6.4% had made an attempt in the past year. Students identifying as bisexual had the highest risk for suicide with 46% reporting they had considered suicide in the past year. Girls identifying as bisexual had the highest rates with 48.5% saying they had considered suicide. More than 40% of the girls who identify as lesbian said they seriously considered suicide in the past year, compared to 19.6% of their female heterosexual peers. In the group of boys who identify as gay, 25.5% had considered suicide in the past year. Transgender teens were not included in this survey, but other research has shown high rates for suicide risk among transgender youth. The prevalence of suicide attempts among respondents to the National Transgender Discrimination Survey (NTDS), conducted by the National Gay and Lesbian Task Force and National Center for Transgender Equality, is 41%, which vastly exceeds the 4.6% of the overall U.S. population who report a lifetime suicide attempt, and is also higher than the 10 to 20% of LGBTQIA adults who report ever attempting suicide (Turban, Beckwith, Reisner, et al., 2019). The specific aims of the analysis were to identify the key characteristics and experiences associated with lifetime suicide attempts in the NTDS sample as a whole, and to examine how lifetime suicide attempts vary among different groups of transgender (trans) and gender non- conforming people. Key findings of this report include the following: Suicide attempts among trans men (46%) and trans women (42%) were slightly higher than the full sample (41%); people who identify as cross- dressers assigned male at birth have the lowest reported prevalence of suicide attempts (21%) among gender- diverse identity groups. Respondents who experienced rejection by family and friends, discrimination, victimization, or violence had elevated prevalence of suicide attempts, such as those who experienced the following: ● Family choosing not to speak/spend time with them: 57%. Postpartum parents Of all mental health problems, depression accounts for the greatest burden of disease and is estimated to become the second-leading cause of global disability (WHO, 2018). Perinatal depression is defined as depression experienced during pregnancy or the postnatal period up to one year after delivery. Some estimates have suggested that 7.4 to 20% of women experience depression at some stage during pregnancy, with the rate of postpartum depression estimated to be as high as 22% of all women who deliver a child. Perinatal depression is a distinct class with special recommendations for identification and clinical management (Littlewood et al., 2016), and although most research has been done in women, perinatal depression can affect any parent, including parents from non-binary gender backgrounds, same sex marriages, and other diverse family backgrounds (Malmquist & Nieminen, in press). Perinatal depression has been linked with various adverse outcomes, including suicidal behavior (Enatescu, Craina, Gluhovschi, Giurgi-Oncu, Hogea, et al., 2020). Evidence suggests an association between prenatal depression and adverse neonatal outcomes, including poor self-reported health, substance and alcohol abuse, and inadequate usage of antenatal care services. It is well-established that postnatal depression can affect the parents, parent-baby interactions, and the entire family unit. Postnatal depression can also cause longer-term emotional and cognitive implications in the baby’s development, especially when the depression occurs in the baby’s first year. Although perinatal depression is well-recognized as a mental health condition with potentially devastating effects, it often goes undetected. Healthcare professionals detect fewer than half of all cases in standard clinical practice (Littlewood et al, 2016).
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