"Celebrate, uplift, resist!" : a mixed methods exploration of suicidality among queer and takatāpui people in Aotearoa New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Wellington, Aotearoa New Zealand

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In Aotearoa, a growing body of research has demonstrated a greater ‘risk’ for suicidal ideation, self-harm, and attempted suicide among people with diverse sexualities and genders, compared with cisgender-heterosexual counterparts. Few studies have investigated the applicability of explanatory theories of suicide with queer and takatāpui samples. Of those which have, the Interpersonal Theory of Suicide and the Minority Stress Model are commonly utilised, arguably attributing suicidal risk and resilience to one’s internalised processes in application. Alternatively, the Three-Step Theory of suicide and the Theory of Decompensation provide frameworks for understanding how social processes elicit and attenuate suicidality among queer and takatāpui people. The current mixed-methods research consisted of a survey examining the applicability of the Three-Step Theory, and a qualitative study, informed by the Theory of Decompensation, exploring queer and takatāpui people’s perspectives on suicide. In study one, the three steps were tested using survey data from 250 queer and takatāpui people. Step-one, discrimination and hopelessness were positively associated with suicidal ideation, but the interaction of these variables did not predict suicidal ideation. Step-two, among participants with high discrimination and hopelessness, social support was negatively associated with suicidal ideation when social support exceeded discrimination. Step-three, participants who previously attempted suicide (SI/SA subgroup) had greater self-harm behaviours than participants who experienced suicidal ideation but never attempted suicide (SI/- subgroup). Self-harm more precisely categorised SI/SA subgroup membership than SI/- subgroup membership. In study two, twenty queer and takatāpui people were interviewed to explore understandings of suicidality, discrimination, and resilience. Five themes were developed using a theory-driven approach to reflexive thematic analysis, underpinned by social constructionism and the Theory of Decompensation. These themes were “Not just this Amorphous Subject”, “You’re Removing the Responsibility from Society”, “Social Norms Require a Deviant Group”, “the Straw that Broke the Camel’s Back”, and Ethnicity and Resilience to Suicidality. The applicability of step-two and step-three processes were supported, and the influences of ideologies, intersectionality, and privilege on suicidality were discussed by participants. These findings are situated within literature on suicide and the two respective theories used. Implications for clinical practice are discussed in relation to processes of suicidality and co-appraisal of suicide risk assessment.
LGBTQ+ people, Suicidal behavior, New Zealand