Stigma of Suicide's Effects on Gatekeeping Behaviors Among Latinos

Background and Purpose:

Gatekeepers, such as parents, serve a crucial role in assisting individuals contemplating suicide by identifying risk factors, symptoms, and facilitating access to mental health services. In 2020, suicide was the second leading cause of death for Latinos in the U.S. ages 10-14 and 25-34, and the third leading cause among Latinos ages 15-24. In Mexico, age-standardized death by suicide rates have increased by about 26% from 1999 to 2019, with a 43% increase among females during that time. Due to the rise of suicide ideation and attempts in the last two decades among Latinos, the purpose of this study was to assess the relationship between suicide stigma and gatekeeping among a nationwide sample of parent and youth dyads in Mexico.

Methods:

Data for this study was collected from parent-youth dyads living in Mexico via online surveys. Sampling initially targeted families living in primarily rural Mexican states and was later expanded to all Mexican states. Inclusion criteria for this study included a household in Mexico consisting of at least one parent/guardian, and one youth between the ages of 14-17. The final sample consisted of 373 parent-youth dyads, or 746 individuals.

Results:

T-tests indicated gender difference in gatekeeper behavior (t = 2.34, p <.05) between males (M = 5.86, SD = 1.38) and females (M = 6.20, SD = 1.22) with males reporting less gatekeeping behaviors than females. Linear regressions revealed that stigma of suicide scores were predictive of gatekeeper behavior scores within each gatekeeping domain: preparedness (b = - 0.45, p < 0.05), likelihood (b = -0.17, p < 0.05), and self-efficacy (b = -0.32, p < 0.05). Help-seeking behaviors were also predictive of gatekeeping behaviors by each subscale: preparedness (b = 0.10, p < 0.01), likelihood (b = 0.04, p < 0.01), and self-efficacy (b = 0.06, p < 0.01)

Conclusions and Implications:

Among our sample, higher levels of suicide stigma predicted lower gatekeeping behaviors. Higher help-seeking behaviors, within our sample, predicted higher gatekeeping behaviors. Our findings in Mexico are aligned with other studies around the world that suggest cultural stigma of mental illness is a barrier to help-seeking behaviors. Stigma based on cultural beliefs and attitudes regarding mental illness may likewise negatively affect gatekeeping behaviors. Other studies have suggested that Latino parents are less likely to recognize suicide-risk symptoms and have knowledge of available treatments, which can also contribute to lower utilization of mental health services and help-seeking behaviors related to gatekeeping. Future studies could examine more around stigma of mental health issues in Mexico to better understand how cultural factors in Mexico influence gatekeeper behaviors, which can better culturally inform gatekeeper trainings and interventions for parents, caregivers, teachers, and other gatekeepers in Mexico.