Suicide Attempts Among Immigrants with Intimate Partner Problems: Associations with Mental Health and Substance Use and Variations By Race and Ethnicity

Background: Suicide research has demonstrated a higher prevalence of suicide among immigrants who experience intimate partner problems (IPP) such as infidelity, financial struggles, conflicts, and violence. However, this population has received less attention in understanding specific conditions and risk factors contributing to their suicidality, as well as their variations by race and ethnicity. Notably, examining suicidal thoughts and attempts in immigrants experiencing IPP could provide significant insights for identifying suicide risk and preventing fatalities. Accordingly, this study aims to examine how race and risk factors, such as mental health and substance use, are associated with suicidal thoughts and attempted suicide among immigrants with IPP who died by suicide.

Methods: Data comprised 17 waves of the National Violent Death Reporting System from 2003–2019, which includes 3,177 immigrants who died by suicide facing IPP. We first conducted a latent class analysis (LCA) to classify immigrant suicide victims based on seven dichotomous: having mental health diagnosis, depressive mood, alcohol problem, substance abuse problems, other addictions; having current treatment; and having treatment history. Logistic regression analyses were conducted to examine the associations between suicide risk types and suicide attempt history, controlling for survivors’ gender, age, education, and marital status. Interaction terms between race/ethnicity and risk types were tested for moderating effects of race/ethnicity to examine diverse patterns among race groups.

Results: The sample consisted of 40.1% Caucasian, 5.2% Black, 33.8% Hispanic, 17.6% Asian/Pacific Islander, and 3.3% Other Races. Three groups are Minor Risk group with a low likelihood of having depressed mood (66.9%, n=2,126); Mental Health group with high probabilities of having mental health problems and current and previous treatment experiences (MH, 26.6%, n=844); Alcohol group (6.5%, n=207) with a high probability of having alcohol problems. Females were more likely to have suicidal thoughts and attempt suicide than males. Older age was positively associated with having suicidal thoughts but negatively associated with attempting it. Compared to the Minor Risk group, the MH and Alcohol groups were more likely to have both suicidal thoughts and a history of attempts. In comparison to Whites, Blacks were less likely to have made previous attempts. Interaction terms between race and types of risks showed that survivors’ race and ethnicity moderated the relationship between types of risks and suicide attempts. In contrast to White victims in the MH group, Hispanics in the MH group were more likely to have made previous attempts.

Conclusion: Findings show that immigrants' race/ethnicity and suicide risk factors, including mental health and alcohol problems, are associated with their previous history of suicide intention and attempts among immigrants with IPP. When considering that the MH group had mental health issues and treatment history, a higher likelihood of suicide attempts among Hispanics in the MH group may suggest their needs are not well treated or met compared to those of other race groups. Further research is warranted to comprehensively understand the unique needs and vulnerabilities faced by diverse immigrant groups experiencing IPP, particularly within the context of their racial background and mental health-related risk factors.