Effects of "It Gets Better" Suicide Prevention Videos on Youth Identifying as Lesbian, Gay, Bisexual, Transgender, Queer, or Other Sexual or Gender Minorities: A Randomized Controlled Trial.

The "It Gets Better" project (IGBP) features video narratives of lesbian, gay, bisexual, transgender, queer persons or persons with other sexual or gender minority identities (LGBTQ+) of overcoming coming-out-related difficulties. This is the first experimental study investigating effects of these videos. We conducted a double-blind randomized controlled trial on-site in Austria and online in German-language settings from January to November 2020 with LGBTQ+ youth (14-22 years;  = 483), randomized to an IGBP ( = 242) or control video ( = 241). Suicidal ideation (primary outcome), help-seeking intentions, hopelessness, mood, and sexual identity were assessed at baseline (T), postexposure (T), and 4-week follow-up (T). We assessed differences among gender identities, sexual orientations, with regard to depressive symptoms, and the role of identification. Data were analyzed with linear mixed models and mediation analysis. There was no overall effect on suicidal ideation, but nonbinary/transgender individuals experienced a small-sized improvement (T: mean change [MC] from baseline MC = -0.06 [95% confidence interval {CI} -0.16 to 0.05],  = 0.60; mean difference [MD] to controls MD = -0.42 [95% CI -0.79 to -0.06],  = 0.02,  = -0.10). An indirect preventive effect on suicidal ideation at T2 through the degree of identification with the protagonist in the video was observed. There was improvement in help-seeking intentions in the intervention group (T: MC = 0.25 [95% CI 0.15 to 0.35],  < 0.001; MD = 0.28 [95% CI 0.01 to 0.54],  < 0.05,  = 0.09). Video narratives featuring coping might have some potential to decrease suicidal ideation and encourage help-seeking among vulnerable youth identifying with videos, but effects are small and short-lived. German Clinical Trial Registry (DRKS00019913).