The Impact of Positive School Climate on Suicidality and Mental Health Among LGBTQ Adolescents: A Systematic Review.
April J Ancheta, Jean-Marie Bruzzese, Tonda L Hughes
PMID 33287652WHAT IT FOUND
LGBTQ adolescents in schools with more positive climates reported fewer suicide-related thoughts and behaviors and fewer depressive symptoms across six cross-sectional studies.
The studies show a link, not proof that changing climate reduces suicide risk.
Key findings
01Five of six included studies found lower suicidality among LGBTQ adolescents in more positive school climates.
02All four studies examining depressive symptoms found fewer symptoms in more positive school climates.
03Evidence was stronger for suicidal thoughts than for suicide plans and attempts, and possibly more so for gay and bisexual male adolescents.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All included studies were cross-sectional, so they show association, not causation. Only six studies were included, and they used different school climate measures. This made comparison difficult. Most studies were from the United States and did not use probability sampling, so results may not apply to all schools. School climate and outcomes were mostly self-reported by students. One study used teacher and principal reports. Gender identity was poorly represented. Only two studies collected it, and no subgroup analyses for gender minorities were performed. Two studies had moderate risk of bias because confounding factors were not identified. Subgroup findings were inconsistent. One study found no effect for lesbian and bisexual females. Four studies were conducted before same-sex marriage legalization in the United States, so current social climate may differ. The review looked only at suicidality and depressive symptoms, not other mental health outcomes.
Declared interests
The authors declared no potential conflicts of interest.
The easy way to misread this
Do not read this review as proof that creating a more positive school climate lowers LGBTQ adolescents' suicide risk. The included studies were cross-sectional, so they show that positive climate and lower suicidality occurred together, not that one caused the other.