Examining differences in suicidality between and within mental health disorders and sexual identity among adults in the United States

David Adzrago; Ikponmwosa Osaghae; Nnenna Ananaba; Sylvia Ayieko; Pierre Fwelo; Nnabuchi Anikpezie; Donna Cherry; David Adzrago; Ikponmwosa Osaghae; Nnenna Ananaba; Sylvia Ayieko; Pierre Fwelo; Nnabuchi Anikpezie; Donna Cherry

doi:10.3934/publichealth.2021051

AIMS Public Health

2021, Volume 8, Issue 4: 636-654. doi: 10.3934/publichealth.2021051

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Research article

Examining differences in suicidality between and within mental health disorders and sexual identity among adults in the United States

1.
Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, Houston, Texas, USA
2.
Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston School, Houston, Texas, USA
3.
Department of Population Health Science, The University of Mississippi Medical Center, Jackson, Mississippi, USA
4.
Department of Social Work, East Tennessee State University, Johnson City, Tennessee, USA

Received: 09 July 2021 Accepted: 06 September 2021 Published: 18 September 2021

Background
Suicide is a leading but preventable cause of death and is preceded by domains of thoughts, plans, and attempts. We assessed the prevalence of suicidality domains and determined the association of suicidality domains with sexual identity, mental health disorder symptoms, and sociodemographic characteristics.

Methods
We used the 2019 National Survey on Drug Use and Health (NSDUH) data to perform weighted multivariable logistic regression and margins analyses to examine between and within-group differences in suicidality by sexual identity among adults aged ≥ 18 years.

Results
About 4.89%, 1.37%, and 0.56% of the population experienced suicidal thoughts, plans, and attempts, respectively. Those aged 18–25 years old had a higher odds of suicidality compared to those aged 26 years or older. Compared to those who reported having no alcohol use dependence, illicit drug use dependence, and major depressive episodes (MDEs), those who reported alcohol use dependence, illicit drug use dependence, and MDE had higher odds of suicidal thoughts, plans, and attempts. Between all sexual identity groups, bisexuals who experienced MDEs had the highest probability of having suicidal thoughts while lesbians and gays who experienced MDE showed a higher probability of suicidal plans and attempts compared to heterosexuals. Within each sexual identity group, the probability of having suicidal thoughts, suicidal plans, and suicidal attempts was higher for those who had experienced MDEs compared to those who had not experienced MDEs.

Conclusion
Substance use disorder and MDE symptoms were associated with increased suicidality, especially among young adults and sexual minority people. This disparity underscores the need for tailored interventions and policies to enhance the provision of prompt mental health screening, diagnosis, and linkage to care for mental health services, particularly among the most vulnerable in the population.
- suicidality,
- sexual identity,
- mental health disorder,
- substance use disorder
Citation: David Adzrago, Ikponmwosa Osaghae, Nnenna Ananaba, Sylvia Ayieko, Pierre Fwelo, Nnabuchi Anikpezie, Donna Cherry. Examining differences in suicidality between and within mental health disorders and sexual identity among adults in the United States[J]. AIMS Public Health, 2021, 8(4): 636-654. doi: 10.3934/publichealth.2021051

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Abstract

Background

Suicide is a leading but preventable cause of death and is preceded by domains of thoughts, plans, and attempts. We assessed the prevalence of suicidality domains and determined the association of suicidality domains with sexual identity, mental health disorder symptoms, and sociodemographic characteristics.

Methods

We used the 2019 National Survey on Drug Use and Health (NSDUH) data to perform weighted multivariable logistic regression and margins analyses to examine between and within-group differences in suicidality by sexual identity among adults aged ≥ 18 years.

Results

About 4.89%, 1.37%, and 0.56% of the population experienced suicidal thoughts, plans, and attempts, respectively. Those aged 18–25 years old had a higher odds of suicidality compared to those aged 26 years or older. Compared to those who reported having no alcohol use dependence, illicit drug use dependence, and major depressive episodes (MDEs), those who reported alcohol use dependence, illicit drug use dependence, and MDE had higher odds of suicidal thoughts, plans, and attempts. Between all sexual identity groups, bisexuals who experienced MDEs had the highest probability of having suicidal thoughts while lesbians and gays who experienced MDE showed a higher probability of suicidal plans and attempts compared to heterosexuals. Within each sexual identity group, the probability of having suicidal thoughts, suicidal plans, and suicidal attempts was higher for those who had experienced MDEs compared to those who had not experienced MDEs.

Conclusion

Substance use disorder and MDE symptoms were associated with increased suicidality, especially among young adults and sexual minority people. This disparity underscores the need for tailored interventions and policies to enhance the provision of prompt mental health screening, diagnosis, and linkage to care for mental health services, particularly among the most vulnerable in the population.

Acknowledgments

We would like to thank the Substance Abuse and Mental Health Services Administration (SAMHSA) and RTI International for conducting NSDUH and making the data publicly available.

Conflict of interest

The authors declare no conflict of interest.

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