Ideation-to-Action Continuum Among Latinx Youth: An Ecological Systems Perspective

Background and purpose:  Suicidality (i.e., suicide ideation, plan, and attempt) remains an ever-growing problem for Latinx youth as many of them face systematic inequalities associated with adverse mental health outcomes.  For example, Latinx youth struggling with suicidality, especially those in exclusionary state-level immigration policy climates (SLIPC), confront multi-level barriers to care.  Yet, little is known regarding how such systematic-level factors influence the suicide ideation-to-action continuum among this vulnerable population.  Through an ecological systems framework, this study examined the association between micro, mezzo, and macro-level factors and their influence on the suicide ideation-to-action continuum among Latinx youth.

 Method:  This study used a sub-sample of self-identified Latinx youth (N = 3,653) from the 2017-National Youth Risk Behavioral Survey (YRBS).  Three questions on the YRBS that respectively captured the suicide ideation-to-action continuum were used as outcome variables.  Independent variables included: micro (i.e., depression, cannabis use, intimate partner violence [IPV], and sexual assault); mezzo (i.e., experiences at school with bullying, physical fighting, and safety); and macro (SLIPC) level variables.  Chi-squares were conducted to determine the associations between each of the independent variables and suicidality.  Binomial logistic regression models were used to examine multivariate models that regressed suicidality on micro, mezzo, and macro level variables.  Additional logistic regressions were used to examine gender differences. 

 Results:  The sample consisted of 51.09% Latinx females and 48.91% males between the age of 16 (24.40%) to 17 (25.05%).  Results indicated that 36.89% (n = 229) of the Latinx youth that reported suicide ideation (n = 621) did not engage in making a suicide plan; and, of those who made a suicide plan (n = 226), 23.89% did not attempt suicide.  Binomial logistic regression results revealed that IPV and sexual assault increased the odds of each stage of suicidality (p < 0.05).  Depression and using cannabis increased the odds of experiencing suicide ideation and plan (p < 0.05) but not attempt.  Bullying at school and an unsafe school environment impacted the odds of ideation (p < 0.05) but not planning nor attempting.  Results differed when broken down by gender.  For example, physical violence at school impacted suicide attempt in Latinx females (p < 0.05), but not males.  SLIPC was not statistically significant.

Conclusions and Implications:  Latinx youth continue to exhibit high incident rates of suicidality; yet, little is known regarding the correlates that influence the suicide ideation-to-action continuum in this vulnerable population.  Our findings delineate the complex relationships between suicide ideation-plan-and-attempt and their variation by gender among Latinx youth.  Accounting for these variations has the potential to aid the practitioners.  The micro and mezzo factors associated with suicidality in our study are ones that could be addressed by a variety of practitioners—such as social workers, nurses, school counselors, teachers, and various advocates.   Indicating the need for interdisciplinary work around this growing public health concern.  Lastly, the findings also have implications for the development of more data-driven state-level policies and support services that respond to population-specific needs of vulnerable groups at the local levels