Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan; The Michigan Institute for Data Science, University of Michigan, Ann Arbor, Michigan; Injury Prevention Center, University of Michigan, Ann Arbor, Michigan.
Department of Health Law, Policy & Management, School of Public Health, Boston University, Boston, Massachusetts.
Am J Prev Med. 2023 Aug;65(2):307-312. doi: 10.1016/j.amepre.2023.02.031. Epub 2023 Mar 7.
Despite being at the highest risk of suicide, American Indian/Alaskan Native (AIAN)-emerging adults are underrepresented in mental health research. There is great diversity in individual and community experiences and access within AIAN-identifying individuals, prompting the need for research on risk and protective factors of suicidality within AIAN-emerging adults.
Data from AIAN-identifying emerging adults (mean age = 24.4 years) collected between 2017 and 2020 (n=2,551) were drawn from the Healthy Minds Study, a national annual panel study on mental/behavioral health within higher education settings. Multivariate logistic regressions (conducted in 2022) were used to evaluate the risk and protective factors associated with suicidality (ideation, planning, attempt) by gender (male, female, trans/gender nonbinary).
Suicidal ideation rates were high; over 1 in 5 AIAN-emerging adults reported ideation, 1 in 10 reported planning, and 3% reported attempt in the previous year. AIANs identifying as a gender minority (trans/nonbinary) were 3 times more likely to report suicidality across event type. Across all gender identities, suicidality was significantly associated with nonsuicidal self-injury and self-perceived need for help; flourishing was predictive of lower odds of suicidality event for male- and female-identifying AIAN students.
Suicidality is high for AIAN college-attending students, particularly for gender minority-identifying students. Embracing a strength-based approach to highlight student awareness of mental health services is critical. Future research should examine the protective factors as well as community and structural factors that might provide meaningful support within and outside of university contexts for students facing individual, relational, or challenges within their communities.
尽管美国印第安人/阿拉斯加原住民(AIAN)-新兴成年人自杀风险最高,但他们在心理健康研究中代表性不足。在 AIAN 身份个体中,个人和社区的经历和获得存在巨大差异,这促使我们需要对 AIAN-新兴成年人的自杀意念的风险和保护因素进行研究。
本研究数据来自于 2017 年至 2020 年期间(n=2551)收集的 AIAN 身份的新兴成年人(平均年龄 24.4 岁),这些数据来自于健康思维研究(Healthy Minds Study),这是一项针对高等教育环境中心理/行为健康的全国年度面板研究。多变量逻辑回归(于 2022 年进行)用于评估与自杀意念(意念、计划、尝试)相关的风险和保护因素,并按性别(男性、女性、跨性别/非二元性别)进行分层。
自杀意念率较高;超过 1/5 的 AIAN 新兴成年人报告存在自杀意念,1/10 报告有自杀计划,3%报告在过去一年中有过自杀尝试。跨性别/非二元性别认同的 AIAN 更有可能报告各种自杀意念事件,其可能性是其他性别认同者的 3 倍。在所有性别认同者中,自杀意念与非自杀性自伤和自我感知的求助需求显著相关;对于男性和女性 AIAN 学生,蓬勃发展与自杀意念事件的较低可能性相关。
自杀意念在参加大学的 AIAN 学生中很高,特别是对跨性别身份的学生而言。采用以优势为基础的方法来提高学生对心理健康服务的认识至关重要。未来的研究应该探讨保护因素以及社区和结构性因素,以便为面临个人、关系或社区内挑战的学生在大学内外提供有意义的支持。