Barriers and risk factors associated with non-treatment-seeking for suicidality onset during the COVID-19 pandemic among young adults

Psychiatry Res. 2024 Oct:340:116095. doi: 10.1016/j.psychres.2024.116095. Epub 2024 Jul 23.

Abstract

Introduction: Researchers predict long-term increases in suicide deaths following the COVID-19 pandemic. Little is known about risk factors for suicidal ideation (SI) and suicidal attempts (SA) or treatment barriers and promoters during the pandemic. We examine these factors in a young adult sample.

Methods: Analyses used a 2022 cross-sectional survey dataset (N = 1,956). Logistic regression identified factors associated with pandemic suicidality (i.e., SI, SA). Non-treatment seekers reported barriers to seeking treatment. Logistic regression identified promotive factors associated with treatment-seeking.

Results: 28.6 % of our sample developed suicidality during the pandemic, of whom 49.6 % did not seek treatment. Asian race and sexual minority status were strongly associated with increased odds of pandemic suicidality. Among SI non-treatment-seekers, barriers were primarily attitudinal (e.g., "symptoms are not serious enough for treatment"); among non-treatment-seekers with SA, barriers were mostly structural (e.g., insufficient funds). Previous depression treatment was strongly associated with increased odds of treatment-seeking.

Conclusion: Asian American individuals were at increased risk for pandemic suicidality, which may reflect interpersonal risks related to COVID-19-related anti-Asian racism. Our findings point to a "foot-in-the-door" effect: past treatment-seeking was positively associated with future treatment-seeking. To promote this effect and decrease barriers, we suggest integrated mental health screening and referrals in primary care.

Keywords: COVID-19 pandemic; Suicidal ideation; Suicide; Suicide attempts; Treatment barriers; Treatment seeking.

MeSH terms

  • Adolescent
  • Adult
  • Asian / psychology
  • Asian / statistics & numerical data
  • COVID-19* / epidemiology
  • COVID-19* / psychology
  • Cross-Sectional Studies
  • Female
  • Health Services Accessibility
  • Humans
  • Male
  • Patient Acceptance of Health Care* / psychology
  • Patient Acceptance of Health Care* / statistics & numerical data
  • Risk Factors
  • Sexual and Gender Minorities / psychology
  • Sexual and Gender Minorities / statistics & numerical data
  • Suicidal Ideation*
  • Suicide, Attempted* / psychology
  • Suicide, Attempted* / statistics & numerical data
  • Young Adult