Trends in Suicide Attempt By Race/Ethnicity Among College Students: Findings from Healthy Mind Study, 2014-2023

Background: Young adults are vulnerable to suicidal thoughts and behaviors due to the challenges related to the formation of new social relationships, exploration of self-identity, and financial independence. College and universities are vital settings for suicide prevention, considering a large proportion of young adults are enrolled in college. Unfortunately, a national study showed that suicidal ideation increased among college students for each racial/ethnic group from 2013 to 2021 (Lipson et al., 2022). However, it is unknown about the trend in suicide attempts, which is the most prominent risk factor of suicide death. This study aims to examine the trend in suicide attempts among college students by different racial and ethnic groups from 2014-2023. The results will help us identify potential disparities in suicide attempts and areas to focus prevention and intervention efforts.

Methods: Data were from 617231 college students (age>18) surveyed in the Healthy Mind Study from 2014-2023. This is a nationally representative cross-sectional survey conducted annually among colleges and universities across the US. Participants were primarily female (55%) and white (59%), with a mean age of 23. Other racial and ethnic groups include Hispanic (14%), Black (10%), Asian (10%), multiracial (5%), and American Indian and Alaska Native (AIAN) students (0.3%). Past-year suicide attempt was measured using a binary question. The trend in prevalence of suicide attempt among the full sample and each racial/ethnic group will be visualized using graph. Logistic regression was used to analyze the trend by race/ethnicity. Survey year was included in the model as a continuous variable to estimate the linear trend. Then, both linear year variable and quadratic terms of year were included to assess an overall trend overtime and nonlinear variation. All models were controlled for gender and age. Statistical significance was set to p<0.05. Analysis was conducted using Stata 15.1. Survey weights were used.

Results: Results indicate the weighted rate of overall suicide attempts is 1.4%. Logistic regression suggests that overall, there is a significant annual linear increase trend of suicide attempts (OR=1.43, P<0.001). Results stratified by race/ethnicity showed significant annual increase trends among White (OR=1.02, p=0.029), Hispanic (OR=1.07, p=0.009), Black (OR=1.12, p=0.002), AIAN (OR=1.27, p=0.049) college students. The quadratic term was only significant for White college students (OR=0.97, p<0.001). In addition, compared to white college students, Hispanic (OR=1.47, p<0.001), Black (OR=1.83, p<0.001), Asian (OR=1.23, p=0.001), Multiracial (OR=2.01, p<0.001) students have higher suicide attempts compared to White college students controlling for gender and age.

Conclusion: This study found an overall increase trend in suicide attempts among White, Hispanic, Black, and AIAN college students. However, the increase is decelerating over time only for White college students, not for other racial/ethnic group students. Racial/ethnic difference disparities in suicide attempts is found. These findings indicate that college suicide prevention program should focus more on understanding and addressing this racial/ethnic disparities in suicide attempts. Potentially direction for practice or policies can be adapting suicide prevention, mental health services and institutional policies to be more culturally sensitive and inclusive for racial/ethnic minority students.