The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.
Aust N Z J Psychiatry. 2024 Feb;58(2):162-174. doi: 10.1177/00048674231202427. Epub 2023 Sep 29.
Mental ill-health, substance use and their co-occurrence among sexuality diverse young people during earlier adolescence is relatively understudied. The preventive utility of positive school climate for sexuality diverse adolescents' mental health is also unclear, as well as the role of teachers in conferring this benefit.
Using Wave 8 'B Cohort' data from the Longitudinal Study of Australian children ( = 3127, = 14.3), prevalence ratios and odds ratios were used to assess prevalence and disparities in mental ill-health and substance use, and multinomial logistic regression for co-occurring outcomes, among sexuality diverse adolescents relative to heterosexual peers. Logistic regression was used to assess associations between school climate and teacher self-efficacy with sexuality diverse adolescents' mental health.
Mental ill-health prevalence ranged from 22% (suicidal thoughts/behaviour) to 46% (probable depressive disorders) and substance use between 66% (cigarette use) and 97% (alcohol use). Sexuality diverse participants were significantly more likely to report self-harm and high levels of emotional symptoms in co-occurrence with cigarette, alcohol and/or cannabis use. For each 1-point increase in school climate scores as measured by the Psychological Sense of School Membership scale, there was 10% reduction in sexuality diverse adolescents reporting high levels of emotional symptoms, probable depressive disorder, self-harm thoughts/behaviour and suicidal thoughts/behaviour. For each 1-point increase in lower perceived (worse) teacher self-efficacy scores as measured by four bespoke teacher self-efficacy items, odds of sexuality diverse adolescent-reported suicidal thoughts/behaviour increased by 80%.
Mental ill-health, substance use and especially their co-occurrence, are highly prevalent and pose significant and inequitable health and well-being risks. Schools represent a potential site for focusing future prevention efforts and educating and training teachers on sexuality diversity is a promising pathway towards optimising these.
在青少年早期，性少数群体年轻人的心理健康问题、物质使用问题及其共病相对较少受到研究。积极的学校氛围对性少数群体青少年心理健康的预防效果尚不清楚，教师在带来这种益处方面的作用也不清楚。
利用澳大利亚儿童纵向研究的第 8 波“B 队列”数据（ = 3127， = 14.3），使用患病率比和优势比评估性少数群体青少年与异性恋同龄人相比，心理健康问题和物质使用的患病率和差异，使用多项逻辑回归评估共病结果。使用逻辑回归评估学校氛围和教师自我效能感与性少数群体青少年心理健康之间的关联。
心理健康问题的患病率从 22%（自杀意念/行为）到 46%（可能的抑郁障碍）不等，物质使用的患病率从 66%（吸烟）到 97%（饮酒）不等。性少数群体参与者更有可能报告自我伤害，并且更有可能同时出现与吸烟、饮酒和/或大麻使用相关的情绪症状高。在使用心理归属感量表测量的学校氛围得分每增加 1 分，报告情绪症状高、可能的抑郁障碍、自我伤害意念/行为和自杀意念/行为的性少数群体青少年减少 10%。在使用四个专门的教师自我效能感项目测量的感知（较差）教师自我效能感每增加 1 分，性少数群体青少年报告自杀意念/行为的几率增加 80%。
心理健康问题、物质使用问题，尤其是共病，非常普遍，会带来重大的、不平等的健康和福祉风险。学校是未来集中开展预防工作的潜在场所，对教师进行性多样性教育和培训是优化这一工作的有前途途径。
