Symposia
Mental Health Disparities
Ki Eun Shin, Ph.D. (she/her/hers)
Assistant Professor
Long Island University, Post
Brookville, New York
Seung Yeon Baik, MA
Doctoral Student
The Pennsylvania State University
University Park, Pennsylvania
Melissa Vázquez, B.A.
Medical Student
Washington University School of Medicine in St. Louis
St. Louis, Missouri
Jillian Shah, B.S.
NIMH Diversity Supplement Scholar
Washington University in St. Louis
St. Louis, Missouri
Ellen Fitzsimmons-Craft, Ph.D.
Associate Professor of Psychiatry
Washington University School Of Medicine in St. Louis
St. Louis, Missouri
C. Barr Taylor, M.D.
Professor of Psychiatry (Emeritus)
Stanford University School of Medicine
Stanford, California
Denise Wilfley, Ph.D.
Professor
Washington University School Of Medicine in St. Louis
St. Louis, Missouri
Daniel Eisenberg, Ph.D.
Professor
University of California, Los Angeles
Los Angeles, California
Michelle G. Newman, Ph.D. (she/her/hers)
Professor
Pennsylvania State University
University Park, Pennsylvania
Suicide is a serious public health concern on campuses, ranked as the second leading cause of death among college students. Nearly 20% of students report suicidal ideation in the past year (Nock et al., 2003). However, less than 30% of them seek treatment (Hom et al., 2015). Efforts to identify individuals at risk have involved examining the rates of suicidality and treatment utilization across various identity markers, including race, sexual orientation, gender, and socioeconomic status (e.g., Rogers & Taliafero, 2020). However, these identity markers have been mostly examined individually despite their inherent interconnectedness. Different theories exist as to how identity markers may constitutively determine risk. One view is an additive model, where identifying with multiple marginalized identities increases risk. Another, non-mutually exclusive theory is intersectionality, where identity markers interact, qualifying the effects of each other.
The current study examined how the rates of suicidal ideation and treatment utilization among college students varied based on race, ethnicity, sexual orientation, gender, socioeconomic status, and their intersections. 27,924 adults (Mage=20.20, SD=3.91) from 25 US colleges completed an online survey assessing demographics, suicidal ideation in the past two weeks, and mental health treatment utilization in the past month. The sample included 35% ethno-racial and 25% sexual and gender minorities. 28% were first-generation college students, and 25% reported financial difficulty in the past month. 23% endorsed suicidal ideation, and of those, 25% sought treatment in the past month. We used a novel multilevel modeling approach (Evans et al., 2018) where individuals are nested within strata defined by distinct combinations of identity markers. Results indicated support for the additive theory, where each minoritized identity except the first-generation college student status predicted greater risk (4-20% increase in the rate of suicidal ideation), ps< .01. Among those with suicidal ideation, racial/ethnic minorities and first-generation college students showed 5-7% lower rates of treatment utilization, ps< .01, whereas sexual/gender minorities showed 13% higher rates, p< .001. There was weak evidence for intersectionality, with less than 2% of variance in the outcomes attributable to interactions between the identity markers. Results suggest that additive models may hold promise for identifying students at elevated risk for suicidality and underutilization of treatment.