2 - (SYM 77) Mental Health Treatment Engagement Among Adults with a History of Nonsuicidal Self-injury: An Exploration of Racial and Ethnic Differences

Nonsuicidal self-injury (NSSI) robustly predicts suicide (Whitlock et al., 2013). Yet, little is known about mental health (MH) treatment utilization among those with a NSSI history. Prior work suggests 56.2% of adults with NSSI history have never received treatment for their behavior (Liu, 2023). Despite knowing that racially minoritized adults underutilize MH treatment for suicidality (Sheehan et al., 2018), this pattern remains unexplored among NSSI. Thus, this study examined racial and ethnic differences in MH treatment engagement among adults with NSSI history.

539 adults with a NSSI history, recruited via social media, completed an online survey in service of a larger study on NSSI disorder. Participants completed self-report measures on demographic characteristics, NSSI history, and MH care utilization. Participants were aged 18 to 55 years (M=26.5, SD=6.1), identified as majority White (64.4%), and non-Hispanic (66.3%).

Most (90.7%) participants had prior engagement in MH treatment, 73.8% were currently in care, and 85.1% reported NSSI as a focus of treatment. Participants reported multiple methods of treatment – 65.3% have used psychotropic medication, 68.3% therapy, 50% inpatient care, 47.7% received care in emergency department, and 42.9% sought care at a residential treatment facility. There was also variability in time engaged in care, number of separate periods of care, and number of prior providers.

Compared to adults of color, White adults were more likely to be in care currently (χ²(1)=4.11, p< .05), been in longer periods of care (χ²(7)=15.31, p< .05), seen more providers (χ²(3)=9.02, p< .05), and have been engaged in care at a residential treatment facility (χ²(1)=8.06, p< .01).

Compared to Hispanic adults, non-Hispanic adults were more likely to be in care currently (χ²(1)=9.48, p< .01), been in longer periods of care (χ²(7)=20.53, p< .01), seen more providers (χ²(3)=28.27, p< .001), have less separate periods of care (χ²(3)=17.44, p< .001), referred to care by a health care provider, or sought care independently (χ²(4)=13.90, p< .01), used psychotropic medication (χ²(1)=6.57, p< .05), and previously engaged in outpatient therapy (χ²(1)=7.16, p< .01). Yet, Hispanic adults were more likely to have engaged in a partial hospitalization program (χ²(1)=5.98, p< .05) and inpatient care (χ²(1)=9.18, p< .01).  

Results demonstrate that White (vs. adults of color), and non-Hispanic (vs. Hispanic) adults with NSSI history have more engagement with MH treatment, yet Hispanic adults engage in more critical care.