Abstract: Suicide Risk Profiles and Barriers to Help-Seeking Among College Students at Elevated Risk for Suicide and Not Engaged in Mental Health Services (Society for Social Work and Research 29th Annual Conference)

Schedule:

Saturday, January 18, 2025

Kirkland, Level 3 (Sheraton Grand Seattle)

* noted as presenting author

Lindsay Bornheimer, PhD, LCSW, Associate Professor, University of Michigan-Ann Arbor, Ann Arbor, MI

Nicholas Brdar, BS, Project Coordinator, University of Michigan-Ann Arbor, Ann Arbor, MI

Hyun Jung Koo, MS, PhD Student, University of Minnesota-Twin Cities, MN

Juliann Li Verdugo, MSW, PhD Student, University of Washington, WA

Ewa Czyz, PhD, Assistant Professor, University of Michigan-Ann Arbor, MI

Daniel Eisenberg, PhD, Professor, University of California, Los Angeles, CA

Kai Zheng, PhD, Professor, University of California, Irvine, CA

Jacqueline Pistorello, PhD, Professor, University of Nevada, Reno, NV

Ronald Albucher, MD, Psychiatrist, Stanford University, CA

William Coryell, MD, Professor, University of Iowa, IA

Todd Favorite, PhD, Associate Professor, University of Michigan-Ann Arbor, MI

Cheryl King, PhD, Professor, University of Michigan

Background and Purpose: Suicide is the second leading cause of death among college students, yet many students with elevated suicide risk do not seek professional help. Suicide risk factors are multifaceted, with clinical characteristics shown to vary across individuals, including alcohol use and misuse, impulsivity, depression, social disconnection and isolation, suicide ideation, and history of attempt. These clinical characteristics have been examined at length in research among college students, yet less is known about clinical profiles of risk and how these relate to professional help-seeking behavior. Importantly, there remains a gap in our understanding of how unique combinations of suicide risk factors (i.e., profiles of risk) relate with different types of help seeking barriers. This study's collaborative investigative team sought to identify suicide risk profiles among college students and examined these in relation to students’ perceived barriers to professional help-seeking.

Methods: Data were obtained from college students (n=1,689) identified to be at elevated risk for suicide based at four US universities and participants originally participated in an online treatment linkage intervention study, Electronic Bridge to Mental Health (eBridge) for university students at heightened risk for suicide. Latent class analysis was performed to determine risk profiles, followed by examinations of differences in help-seeking barriers by profile groupings.

Results: Findings revealed three student groupings: (1) moderate internalizing and externalizing symptoms (with low alcohol misuse), (2) highest internalizing and externalizing symptoms (with highest social disconnection), and (3) lowest internalizing symptoms and low externalizing (with highest social connection and alcohol misuse). Group 1 included the youngest and most racially and sexually diverse students, Group 2 endorsed the most help-seeking barriers, and Group 3 endorsed the fewest barriers. Group 2 is especially concerning, considering the severe clinical characteristics, high number of barriers, and low connectedness to others for potential support.

Conclusions and Implications: Study findings highlight differences in suicide risk profiles and barriers to help-seeking among college students. Among this already high-risk sample of college students, there was a subgroup of students with particularly high internalizing and externalizing symptoms as well as high endorsement of social disconnection in comparison to the other groups who, in addition to appearing most reluctant to seek services, may also be the least likely to receive non-professional and peer support. Understanding differences in help-seeking barriers is important to inform tailored approaches to engaging college populations in mental health care. Future research is needed to examine differing approaches to outreach and intervention with tailoring for various risk profiles to address help-seeking barriers and unmet mental health treatment needs of students. Greater research is also needed by other collaborative investigative teams with multidisciplinary health and mental health expertise to inform suicide prevention in a more comprehensive and multi-level way.