From isolation to inclusion: Understanding suicidality and school supports for LGB+ students in Japan.

Introduction: Youth suicide rates in Japan are among the highest globally, highlighting the urgent need for targeted prevention strategies. Within this context, schools can offer significant protective factors by shaping both identity development and mental health outcomes, but such protective effects have not examined in Japanese LGB+ populations. To address this research gap, this examined correlates of suicidal ideation and suicide attempts among LGB+ students in the past 12 months in Japanese educational settings. Methods: Multivariable logistic regression examined associations between recent suicidal ideation and suicide attempt and experiences of sexuality or gender-based harassment, exclusion, and school support structures among 2,095 LGB+ students aged 15-25 years in Japan from an anonymous online survey. Results: Results revealed high rates of suicidal ideation (32.3 %) and attempts (8.8 %) in the past 12 months. Sexuality and gender identity-based harassment, exclusion and hearing negative remarks about sexuality in educational settings were linked to higher suicidal ideation and suicide attempts. Supportive LGBT clubs and alliances and LGBT-inclusive anti-bullying policies at educational settings were associated with lower rates of suicidal ideation. Conclusion: The findings highlight the urgent need for school-based interventions to mitigate the elevated risk of suicidality among LGB+ youth in Japan. Establishing safe and supportive educational environments may help reduce the heightened suicide risk faced by this vulnerable population.