Substance Use Disorders and Poverty as Prospective Predictors of Adult First-Time Suicide Ideation or Attempt in the United States

Thompson, Ronald G.; Alonzo, Dana; Hu, Mei‐Chen; Hasin, Deborah S.

doi:10.1007/s10597-016-0045-z

Cited by 21 publications

(7 citation statements)

References 71 publications

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“…Demographic characteristics, measured identically across surveys, included sex (male or female), age (18-29, 30-44, or ≥45 years), educational level (less than high school, high school, or some college or more), race/ethnicity (non-Hispanic white vs nonwhite [non-Hispanic black, Hispanic, Asian or Pacific Islander, or Native American]), marital status (unmarried; married or living as married; or widowed, separated, or divorced), urbanicity (in metropolitan statistical areas or other), region (Northeast, Midwest, South, or West, coded according to US Census definitions based on the location of participants’ residences), and federal poverty level (<100% [below poverty level], 100%-200%, and >200%). Federal poverty level was determined by family income and size and by federal poverty guidelines …”

Section: Methodsmentioning

confidence: 99%

Changes in US Lifetime Heroin Use and Heroin Use Disorder

et al. 2017

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The prevalence of heroin use and heroin use disorder increased significantly, with greater increases among white individuals. The nonmedical use of prescription opioids preceding heroin use increased among white individuals, supporting a link between the prescription opioid epidemic and heroin use in this population. Findings highlight the need for educational campaigns regarding harms related to heroin use and the need to expand access to treatment in populations at increased risk for heroin use and heroin use disorder.

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Section: Methodsmentioning

confidence: 99%

Changes in US Lifetime Heroin Use and Heroin Use Disorder

et al. 2017

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“…85 Finally, patients at the community health center were relatively young, white, and privately insured (indicating they were employed or students), and therefore these findings may not generalize to other settings that serve more diverse communities. 86 – 88 Community-embedded research can help to enrich our understanding of TGD experiences, and identify research and treatment priorities.…”

Section: Discussionmentioning

confidence: 99%

Suicidal Ideation Disparities Among Transgender and Gender Diverse Compared to Cisgender Community Health Patients

et al. 2023

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Background Transgender and gender diverse (TGD) individuals experience more severe psychological distress and may be at higher risk for suicide compared to cisgender individuals. The existing literature largely consists of small-sample studies that do not assess subgroup differences. Objective To examine rates of self-reported suicidal ideation among four TGD groups compared to cisgender individuals. Design Data were extracted from the electronic health records of patients receiving primary care at a community health center specializing in sexual and gender minority health. A logistic regression was used to examine the relationship between sociodemographic variables and the presence of current suicidal ideation. Participants 29,988 patients receiving care at a community health center in Northeastern US between 2015 and 2018. Main Measures Demographic questionnaire, 9-item Patient Health Questionnaire Key Results Younger age, sexual and gender minority identity, and public/grants-based insurance were associated with significantly higher odds of suicidal ideation. Relative to cisgender men, transgender men (OR=2.08; 95% CI=1.29–3.36; p =.003), transgender women (OR=3.08; 95% CI=2.05–4.63; p <.001), nonbinary (NB) individuals assigned male at birth (AMAB; OR=3.55; 95% CI=1.86–6.77; p <001), and NB individuals assigned female at birth (AFAB; OR=2.49; 95% CI=1.52–4.07; p <001) all endorsed significantly higher odds of current suicidal ideation, controlling for age, race, ethnicity, sexual orientation, and insurance status. Larger proportions of transgender women (23.6%) and NB AMAB individuals (26.7%) reported suicidal ideation not only compared to cisgender men (6.1%) and women (6.6%), but also compared to transgender men (17.4%; χ 2 [5, n =25,959]=906.454, p <0.001). Conclusions TGD patients were at significantly increased risk of suicidal ideation, even after accounting for age, race, ethnicity, sexual orientation, and insurance status. Findings suggest distinct risk profiles by assigned sex at birth. Consistent assessment of and intervention for suicidal ideation should be prioritized in settings that serve TGD patients.

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“…With a current unemployment rate of 27.1% and more than half the population living below the national poverty line [ 62 , 63 ] it is clear that population-wide poverty and inequality that resulted from apartheid policies have still not been addressed. Poverty and inequality are established risk factors for SIB [ 64 ] and SUDs [ 65 ], and the combination of poverty and substance use is a strong predictor of first-time suicide attempts [ 66 ]. With one SA study showing that 56.9% of individuals who died by suicide over a 5 year period were unemployed [ 67 ], it is evident that poverty and inequality are relevant risk factors for suicide in SA.…”

Section: Discussionmentioning

confidence: 99%

Mental health care providers’ perceptions of the barriers to suicide prevention amongst people with substance use disorders in South Africa: a qualitative study

Goldstone

Bantjes

2017

Int J Ment Health Syst

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BackgroundSubstance use is a well-established, and potentially modifiable, risk factor for suicide. Suicide prevention interventions are typically framed within the biomedical paradigm and focus on addressing individual risk factors, improving access to psychiatric care, and improving the skills of medical personnel to recognise at-risk individuals. Few studies have focused on contextual factors that hinder suicide prevention in people with substance use disorders, particularly in low-resource settings. The aim of this qualitative study was to explore mental health care providers’ perceptions of barriers to suicide prevention in people with substance use disorders in South Africa.MethodsSemi-structured interviews were conducted with 18 mental health care providers who worked with suicidal people with substance use disorders in Cape Town, South Africa. Data were analysed using thematic analysis and Atlas.ti software was used to code the data inductively.ResultsTwo superordinate themes were identified: structural issues in service provision and broad contextual issues that pose barriers to suicide prevention. Participants thought that inadequate resources and insufficient training hindered them from preventing suicide. Fragmented service provision was perceived to lead to patients not receiving the psychiatric, psychological, and social care that they needed. Contextual problems such as poverty and inequality, the breakdown of family, and stigma made participants think that preventing suicide in people with substance use disorders was almost impossible.ConclusionsThese findings suggest that structural, social, and economic issues serve as barriers to suicide prevention. This challenges individual risk-factor models of suicide prevention and highlights the need to consider a broad range of contextual and socio-cultural factors when planning suicide prevention interventions. Findings suggest that the responsibility for suicide prevention may need to be distributed between multiple stakeholders, necessitating intersectoral collaboration, more integrated health services, cautious use of task shifting, and addressing contextual factors in order to effectively prevent suicide in people with substance use disorders.

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Substance Use Disorders and Poverty as Prospective Predictors of Adult First-Time Suicide Ideation or Attempt in the United States

Cited by 21 publications

References 71 publications

Changes in US Lifetime Heroin Use and Heroin Use Disorder

Changes in US Lifetime Heroin Use and Heroin Use Disorder

Suicidal Ideation Disparities Among Transgender and Gender Diverse Compared to Cisgender Community Health Patients

Mental health care providers’ perceptions of the barriers to suicide prevention amongst people with substance use disorders in South Africa: a qualitative study

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