Guest: Dr. Delaney Skerrett
Presenter: Wayne Bucklar
Guest Bio: Dr Delaney Skerrett is a Research Fellow and Clinical Interviewer at the Australian Institute for Suicide Research and Prevention (AISRAP). His background is in psychology and language policy and he is a provisionally registered psychologist. Delaney’s research at AISRAP has focused on predictive factors for suicide mortality in lesbian, gay, bisexual, transgender, and intersex (LGBTI) populations in Australia, the first research of its kind in the country. He is a member of the mindOUT! National LGBTI Mental Health Promotion Framework task group. Delaney has also been the coordinator of an evaluation of the Expanded Horizons psychosocial program for LGBTI youth and a social-emotional wellbeing project with Aboriginal and Torres Strait Islander youth for Headspace.
Segment overview: For our Health Academy Series today, Dr. Delaney Skerrett from the Australian Institute for Suicide Research and Prevention at Griffith University is here to share his research on the non-fatal suicidal behaviors in lesbian, gay, bisexual, transgender, and intersex populations in Australia. He believes that studies are needed to collect data on the prevalence of suicidal behaviours in living LGBTI people, the pathways to these behaviours, and the barriers to help-seeking in these groups. Dr. Skerrett proposes a model including those factors thought to be central to the suicidal process in LGBTI people to be designed and tested.
Health Professional Radio
Wayne Bucklar: You’re listening to the Health Academy on Health Professional Radio, our regular listen into what’s happening in the world of research in academia. Today my guest is Dr. Delaney Skerrett. Delaney is a research fellow and clinical interviewer from the Australian Institute for Suicide Research and Prevention at Griffith University in Australia. Delaney, Welcome to Health Professional Radio.
Dr. Delaney Skerrett: Thank you very much, thanks for having me.
W: Now Delaney, give us a little insight into your research here. What have you been working on?
S: Okay, well we’ve just actually finished a study that responded by Beyond Blue and that was to look at fatal suicidal behaviors so that’s death by suicide in LGBT people in Australia. There’s been quite a bit of research done in the area of non-fatal behaviors with people who thought about suicide or suicide attempts in LGBT people in Australia, this is the first large scale project that have ever been done in the area of actual suicide deaths in LGBT people in Australia. So that’s what I’ve been working on for the past couple of years and as I say a project that we’ve done just got thru to completion.
W: Now I guess the obvious question for me here is if you’re dealing with fatal suicides, what’s the research methodology? How do you go about doing that?
S: So there were two components to it. So the first part was looking at the “QSR” which is the Queensland Suicide Register so that’s a database of all suicides that have occurred in Queensland since 1990 and it is maintained by the institute that I work at here at Griffith University. And so it’s basically compiled some information that provided by the Queensland Police Service and the Coroner, as I said those that occurred in Queensland and so we had a look at 10 years records of data out of the registered to see how many of the cases in there that we’ve identified being LGBT or even LGBTI. And the problem there is that data about sexuality or gender are not routinely collected on death by suicide and so it’s not like there’s a box that’s ticked that says so you know this person, identified as gay or they were transgender. We just had to look for information with new cases to try and identify from many people as we could that were LGBT. And so that was the first component, we looked at 10 years’ worth of data there. Out of that, we only – and I’m saying ‘only’ meaning that the common – we were able to find 35 cases which would appear to be low given that you know in 10 years of time in Queensland, you have around 6,000 suicides so it would seem to be a case of under reporting, that you’ve expected to be more than that with LGBT people, but as I said the data are routinely collected. But we were still able to look at those cases and to see if there were any difference to the non-LGBT cases. So that was the first thing that we did and then the second was interviewing people who knew an LGBT person that had died by suicide so someone that was close to them that identified them as LGBT and that is called that particular type of interview is called a psychological autopsy. So it goes thru basically the life of the person that have died and to find out all the factors that might have been related to the suicide death in that person. And in that part of the study, we compared the people who have died by suicide with living LGBT people. So the first component we compared to the suicide death cases of LGBT people with non-LGBT people from the register and compared the factors related, and the second part we compared LGBT people who have died with living LGBT people.
W: Now Delaney, were there results that came out of this that you’re able to share with us?
S: Sure. So in the first component where we compared LGBT people with non-LGBT, the most significant finding there in terms when I say significant I mean in terms of “statistical significance” that the difference was the largest. And in fact the … suicide cases was in terms of relationship conflict so that in the case of LGBT people who were, there is a much greater incidence of there being conflicts in relationships in the period leading up to the suicide. There was also a higher incidence of depression in the case of LGBT people there, but certainly the strongest result that we found where this is the largest within issues surrounding relationships. And in the second component, there we as well as comparing the living people with the people that died we’re actually also mapped out the lives of the people that have died to see if there were certain patterns that were re-occurring and one thing that was very striking was that issue of relationship problems particularly in the older suicides. And when I say older, they tended to sort of clustering into two age groups, there was the younger people that had died which were tended to be sort of late teens and into their 20’s and then the older group were people late 30’s early 40’s. And in that older group, what was very striking there was that incidence of relationship conflicts in the period leading to the suicide death. So that confirmed the findings that we had from the Queensland Suicide Register components as well. In terms of the differences between the living LGBT people and the ones that have died in the second component, there were certainly differences in relation to mental health as we found in the issue with depression in the first component comparing the LGBT people with non-LGBT. So for example, on of there being a current case of major depression disorder in the LGBT people that died were 23 times higher than they were in living LGBT people when I interviewed them so certainly, greater incidence of that and anxiety disorders were higher and also use of supplements so alcohol dependence as well as abuse such as also substance use. I mean drugs other than alcohol and substance dependence was also higher. I was just gonna mention one of the thing, not surprisingly there was a difference in terms of the incidence of HIV or AIDS when we compared LGBT cases with non-LGBT cases of suicide but what was interesting when we compared the LGBT suicide deaths with living LGBT people, there was a higher incidence of HIV-AIDS in the people that have died but it wasn’t statistically significant…
S: compared with the living LGBT people. So it didn’t actually emerge the risk factor statistically speaking there.
W: Now you did mention a number earlier from your register work. What was the number that you ended up with when you went into the interviewing process?
S: So total we did 27 interviews and then for each interview with a lot, you know with someone that knew an LGBT person, we did 3 interviews with living LGBT people that would match by age, and gender or identified gender, so that’s a total of 81 controlled interviews and 27 psychological … interviews.
W: And that’s a significant piece of research to do. Has your research finished now?
S: That particular component has finished, or that particular project responded by Beyond Blue. There’s certainly an outstanding need for more research into suicide behavior in LGBT people in Australia and even though I said earlier on in the interview that there’s been a significant amount of research done to the non-fatal behaviors, there is still a need for more research with living LGBT people about suicide behaviors, and reports of suicide attempt because we need to understand better that trajectory, that pathway that leads to the development of suicidal behaviors in LGBT people. To understand how it’s different or how it might be different to an LGBT people and of course when you’re able to actually speak to people who are alive and you’re able to get the information first hand from them, then you know the data tend to be more liable in that case. So it’s always a limitation of doing research on the fatal behaviors, is that you’re interviewing people that need knew the person, second handed information in a way in that sense. So it would certainly be good to be able to do more research, large scale research with living LGBT people to understand that purposes of that leads to suicidal behaviors in new data.
W: And are you planning to undertake that research now?
S: There was a plan where we’re looking for funding for that but at this point, we haven’t been successful in being able to get that funding. So obviously in academic work, the funding does need to be able to come so someone has to come to pay for it and it’s something that we’ve been looking at but as I say at the moment the funding is being limited or at least for that particular project we haven’t been successful in getting anything.
W: And if it is funded, do you anticipate what the benefits might be at that further research? Is it research that you’ll expect will have some real world impacts or will it be an academic knowledge outcome?
S: Certainly it has immediate term application to the real world in being able to inform intervention strategies for psychological behaviors in LGBT people and also prevention so what we’re looking at there are ways in which we can, if we understand better pathways and to get through to suicide behaviors in LGBT people. And how and might be different and what’s specific about them, we can set up ways in order to prevent those behaviors from occurring or let’s say if they’re already occurring what are the best types of intervention that we can have. So we already do understand a bit better ways that perhaps we can prevent suicidal behaviors from the research that we’ve done, at least we can see that one of the other issues that emerged in the second component when we compared those who have died with living LGBT people, there was a insignificantly higher incidence of internalized homophobia and internalized shame in the people that have died. And the lack of acceptance from family, particularly in the younger group (we have put up the groups from…older and younger.) So we know that it’s still an issue even though society believes it’s more accepting nowadays around sexuality and gender but this is still leading to suicide based on the results of this research. So that has implications for prevention, it means that we still need to work on having a society that’s more tolerant and has less stigma around diversity in sexuality and gender. That’s an immediate implication that comes from research like this. And then with the further research from where we’re able to further and better understand the pathways to this sort of kind of behavior by doing research with living people, then we can also tailor an intervention strategy more effectively for those people by understanding what it is that they’re going through, what are the things that have led to that but also to understand what might be the barriers to help with LGBT people. Another issue that emerges from this type of research that LGBT people and not just from the research that we have done, but other research out there and particularly in Australian context that one of the reasons that LGBT people might not be seeking help for mental health problems and issues around suicidal behaviors is either the experience or the belief that the mainstream mental health services are not going to be inclusive of … sexuality and gender. So those are the kinds of things that can be informed by doing both a large scale research with living people.
W: Well we certainly hope that having completed a significant study to date that the funding goes become available for you to complete that work and continue your research. Delaney, it’s been a pleasure having you on today and thank you for your time. I understand that there’s further information available online at www.griffith.edu.au/aisrap A I S R A P.
S: Yes, that’s right. That’s the website for the institute there.
W: You’ve been listening to the Health Academy with Wayne Bucklar on Health Professional Radio. If you just tuned in and you’d like to hear more, there’s a transcript of my interview with Dr. Delaney Skerrett on our website and also in SoundCloud and YouTube for an audio achieve. Our website is www.hpr.fm. You’re listening to Health Professional Radio.