Sexual and gender identity and note-leaving among adult suicide decedents in the USA

Holly P. O'Rourke, Chanler D. Hilley, Emily Lowell, Connor M. Sheehan

Research output: Contribution to journalArticlepeer-review


Background Suicide is one of the leading causes of preventable death in the USA, representing a critical public health threat. Suicide risks differ for different populations. In particular, the sexual and gender minority (SGM) population remains at increased risk for suicide. One of the circumstances that may differ for SGM and non-SGM individuals is the propensity to leave a suicide note. Information regarding note-leaving may be helpful in informing suicide prevention and intervention. Aims This study documents the differences in note-leaving in SGM individuals compared with non-SGM individuals, using recent data from the National Violent Death Reporting System (N = 98 515) and accounting for important covariates. Method We fit a logistic regression model with SGM status and covariates predicting note-leaving in suicide. Results SGM decedents were 1.508 times more likely to leave a note than their non-SGM counterparts, controlling for demographic, mental health and substance use covariates. Conclusions These findings highlight the importance of tailoring suicide prevention and intervention efforts to meet the needs of SGM populations.

Original languageEnglish (US)
Article numbere6
JournalBJPsych Open
Issue number1
StatePublished - Jan 21 2023


  • Gender and sexual minority (SGM)
  • National Violent Death Reporting System (NVDRS)
  • note-leaving
  • suicide

ASJC Scopus subject areas

  • Psychiatry and Mental health


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