Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy

Thursday, October 31, 2024

National Trends and Disparities in Suicidal Ideation, Attempts, and Health Care Utilization Among U.S. Adults

Samples, H., Cruz, N., Corr, A., & Akkas, F. (2024).
Psychiatric services (Washington, D.C.)
Advance online publication.

Abstract

Objective: Recent trends in U.S. suicide rates underscore a need for research on the risk for suicidality. The authors aimed to estimate national trends in suicidal ideation, suicide attempts, and health care utilization by using data from the 2015-2019 National Survey on Drug Use and Health.

Methods: Logistic regression was used to estimate the adjusted odds of past-year suicidal ideation and, among individuals with ideation, past-year suicide attempts, with separate interaction models estimating time trends by sex, age, and race-ethnicity. Time trends were further examined with logistic regression to estimate annual prevalence, overall and by sociodemographic, behavioral, and clinical characteristics. Logistic regression was used to estimate past-year general and mental health care utilization among adults with suicidal ideation. Analyses were survey weighted.

Results: Overall, 4.3% (N=13,195) of adults (N=214,505) reported suicidal ideation, and 13.0% (N=2,009) of those with ideation reported suicide attempts. Increases in prevalence of suicidal ideation, from 4.0% in 2015 to 4.9% in 2019, were significantly higher for young adults ages 18-25 years (p=0.001) than for older adults. Decreases in prevalence of suicide attempts among White adults (by 32.9%) were offset by increases among adults reporting Black (by 48.0%) and multiracial or other (by 82.3%) race-ethnicity. Less than half of adults with suicidal ideation (47.8%) received past-year mental health care, with significantly lower receipt for nearly all minoritized racial-ethnic groups, compared with White adults.

Conclusions: Widening racial-ethnic disparities in suicide attempts and lower mental health care utilization for minoritized groups underscore the importance of developing and implementing equity-focused, evidence-based suicide prevention strategies across health care settings.

Here are some thoughts: 

A recent study analyzed data from the National Survey on Drug Use and Health (2015-2019) to estimate national trends in suicidal ideation, attempts, and healthcare utilization among U.S. adults. The study found that suicidal ideation increased significantly from 4.0% in 2015 to 4.9% in 2019, with young adults (18-25) showing the highest increase. This age group demonstrated a 21.7% increase in suicidal ideation over the study period.

The prevalence of suicide attempts decreased among White adults by 32.9%, but increased among Black adults by 48.0% and multiracial/other adults by 82.3%. These findings highlight widening racial-ethnic disparities in suicide risk. Additionally, less than half of adults with suicidal ideation received mental health care, with significantly lower utilization among minority groups.

The study identified risk factors for suicidal ideation and attempts, including younger age, unemployment, LGBTQ+ orientation, and sedative/tranquilizer use disorder. These findings emphasize the importance of accounting for a range of factors in surveillance and prevention activities. Notably, age had one of the strongest associations with both ideation and attempts.

The study's results underscore the urgent need for equity-focused, evidence-based suicide prevention strategies. This includes addressing racial-ethnic disparities in suicide risk and healthcare utilization, increasing access to mental health care, particularly for young adults and minority groups, and reducing barriers to mental health care. Implementing suicide prevention interventions in general healthcare settings is also critical.

The study acknowledges limitations, including sampling limitations (e.g., unhoused, institutionalized individuals), potential underreporting of sensitive topics, and observational data limitations. Despite these limitations, the study provides valuable insights into trends in suicidal ideation, attempts, and healthcare utilization, highlighting the need for targeted interventions to address growing suicide risk.