(PS9-C69) Prospective Examination of Suicidal Ideation Across Race/ethnicity and Gender Among Individuals Receiving Substance Use Treatment

Introduction. In the United States, suicide has consistently been the second leading cause of death for young adults (CDC, 2021). Substance use disorders have been shown to be a common risk factor for suicidal ideation for both women and men (Poorolaial et al., 2016; Lynch et al., 2020). Additionally, depression has been hypothesized to be a specific risk factor for women (Mandelli et al., 2015). However, little is known if depression is more strongly associated with suicidal ideation among women undergoing substance use treatment. This is important to investigate, as substance use treatment for women may also need to focus on depression. Furthermore, there is a dearth of research unpacking this association by race/ethnicity, which is needed as there is research that suggests that suicidal ideation is higher in Latina women compared to other races/ethnicities (Duarté-Vélez & Bernal, 2007). Culturally specific risk factors for suicidal ideation in Latinas include higher rates of mental health problems, specifically internalizing disorders (Fortuna et al., 2007; McLaughlin et al., 2007). To note, the majority of these studies have been cross-sectional, hence prospective associations have not been well explored. Thus, this study aimed to test if depression was prospectively associated with suicidal ideation at 12-month follow-up among those undergoing substance use treatment. Methods. Participants were from the National Treatment Improvement Evaluation Study (NTIES). NTIES was a congressionally mandated longitudinal study of the impact of drug and alcohol treatment on clients in clinical sites that received public support. To assess the intersectionality of the sample, we grouped participants by race/ethnicity and gender. Our final n was 5,274 (36% Black men, 11% Hispanic men, 25% White men, 17% Black women, 4% Hispanic women, and 7% White women). Depression and suicidal ideation were assessed at baseline with two items: “Have you ever had a time when you felt depressed for at least two weeks?” and “Have you ever experienced thoughts of suicide?”. At the 12-month follow-up (12 months after treatment initiation), the suicidal ideation item was reassessed. Results. Regression models revealed that depression at baseline was associated with suicidal ideation at 12-month follow-up for all racial/ethnic groups after controlling for baseline suicidal ideation. Specifically, Hispanic men showed the strongest association (β=.25, p< .05), followed by Black men (β = .23, p< .05), White men (β=.22, p< .05), White women (β=.18, p< .05), Black women (β=.17, p< .05), and Hispanic women (β=.08, p< .05). Discussion. Contrary to the hypothesis that depression is a women-specific risk factor, these results suggest that it is also a risk factor for men in substance use treatment. As such, future substance use interventions with men may benefit from targeting co-occurring depression. These results may also indicate a more appropriate and thorough assessment of depression and suicidal ideation is needed for this population (e.g., a multi-item survey of depression or a clinical interview). Further research may provide insight into proposed targets of substance use intervention for Hispanic women at risk for experiencing suicidal ideation.