Applying a Behavioral Fit Analysis with Sexual Minority Youth at Risk for Suicide

Background Suicide is the second leading cause of death among youth ages 15–24. Sexual minority (SM) youth are at higher risk for suicidal thoughts, behavior, and non-suicidal self- injury than their heterosexual peers. Part of understanding this disparity includes accounting for the role of social drivers of health. The increased risk of suicide and self-harm for SM youth is driven by experiences of minority stress and discrimination that is embedded in society. Recognizing the impact of these factors is essential to inform the delivery of evidence-based interventions for SM youth who are receiving care for suicide prevention.Objective To describe the process for developing a behavioral fit analysis when working with SM youth who are at risk for suicide, with an emphasis on the role of social drivers of health that may overlap with SM identity as it contributes to suicide risk.Method A brief review of the literature is provided on the topics of minority stress and existing screening and assessment approaches for suicidal youth. The benefits of a behavioral fit analysis are described and how this supplements existing evidence-based tools. A fictional case example is included to illustrate the direct application of this organizational framework.Results A case example of a fictional SM youth is provided with an accompanying fit analysis and treatment plan. Implications for generalization to clinical practice are described, complemented with resources and suggestions for clinicians.Conclusions The use of a behavioral fit analysis balances a nomothetic and idiographic approach to a case conceptualization for SM youth at risk for suicide and incorporates the impact of social drivers of health on the use of evidence-based treatments.