National Trends and Disparities in Suicidal Ideation, Attempts, and Health Care Utilization Among U.S. Adults

Recent trends in U.S. suicide rates underscore a need for research on the risk for suicidality. The authors aimed to estimate national trends in suicidal ideation, suicide attempts, and health care utilization by using data from the 2015–2019 National Survey on Drug Use and Health.

Logistic regression was used to estimate the adjusted odds of past-year suicidal ideation and, among individuals with ideation, past-year suicide attempts, with separate interaction models estimating time trends by sex, age, and race-ethnicity. Time trends were further examined with logistic regression to estimate annual prevalence, overall and by sociodemographic, behavioral, and clinical characteristics. Logistic regression was used to estimate past-year general and mental health care utilization among adults with suicidal ideation. Analyses were survey weighted.

Overall, 4.3% (N=13,195) of adults (N=214,505) reported suicidal ideation, and 13.0% (N=2,009) of those with ideation reported suicide attempts. Increases in prevalence of suicidal ideation, from 4.0% in 2015 to 4.9% in 2019, were significantly higher for young adults ages 18–25 years (p=0.001) than for older adults. Decreases in prevalence of suicide attempts among White adults (by 32.9%) were offset by increases among adults reporting Black (by 48.0%) and multiracial or other (by 82.3%) race-ethnicity. Less than half of adults with suicidal ideation (47.8%) received past-year mental health care, with significantly lower receipt for nearly all minoritized racial-ethnic groups, compared with White adults.

Widening racial-ethnic disparities in suicide attempts and lower mental health care utilization for minoritized groups underscore the importance of developing and implementing equity-focused, evidence-based suicide prevention strategies across health care settings.