Suicidality and Mental Health Treatment Among Young Adults

Suicide among young adults is a major public health concern, as data from 2014 show that it is the second leading cause of death among persons aged 15–24 years in the United States. The pathway to suicide often includes prior attempts and suicidal ideation, which are themselves linked. A previous suicide attempt is a strong predictor of death by suicide, and suicidal ideation is strongly associated with attempts. In 2012, for instance, about 20% of young adults with suicidal ideation attempted suicide. Furthermore, many young suicide attempters have long-term mental, physical, and social health problems that last into later adulthood. This background suggests the importance of studying suicidality in young persons, but a key question is which population to study.

While college students have been the focus of many studies on suicidality or mental health treatment, little attention has been given to their non–college-attending peers. Yet, only 41% of US adults aged 18–24 years were enrolled in college in 2012. Although it appears that college students and their non–college-attending peers have similar overall rates of psychiatric disorders, no existing studies systematically examined the 4 distinct suicidality categories (suicidal ideation only, suicidal ideation and suicide plan only, suicide attempt without a plan, and suicide attempt with a plan) and mental health treatment among both the college students and their non–college-attending peers.

To address these issues, we studied the following 4 young-adult groups in the overall US population: full-time college students, part-time college students, those without school/college enrollment, and those still enrolled in high school. We examined the 12-month prevalence and mental health treatment of suicidality among 135,300 persons aged 18–25 who participated in the 2008–2013 National Surveys on Drug Use and Health, which were conducted by the Substance Abuse and Mental Health Services Administration.

Compared with full-time college students, the other 3 groups (high school students, those not enrolled in school, and part-time college students) were more likely to attempt suicide with a plan (model-adjusted prevalence = 0.67% vs 1.09%, 1.06%, and 1.07%, respectively). However, the overall mental health treatment rates for young adults with suicidality were similar among all 4 groups.

We concluded that, compared with full-time college students, other young adults were at higher risk for attempting suicide with a plan. Suicide prevention and intervention strategies should emphasize increasing access to mental health treatment among both college students with suicidality and their non–college-attending peers (particularly among minorities and among those who seem to be at low risk for suicide because they are without serious mental illness and report no need for mental health treatment). Although young adults on college campuses can and should benefit from robust mental health prevention and treatment services, those outside of the college environment also need these services. It is critical to effectively reach and serve these vulnerable young adults.

Disclaimer: The findings and conclusions of this study are those of the authors and do not necessarily reflect the views of the Substance Abuse and Mental Health Services Administration and the National Institute on Drug Abuse of the National Institutes of Health, US Department of Health and Human Services.

Financial disclosure:Dr Compton is a stock shareholder of Pfizer, General Electric, and 3-M, unrelated to the submitted work. Dr Han has no relevant personal financial relationships to report.​