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Suicide is one of the 10 leading causes of death in the general population, and it is the second leading cause of death among 17 to 24-year olds. With higher education leaders entrusted with caring for this young adult demographic, it makes understanding risk factors and personality traits for suicidal behavior and suicidal ideation all the more important. And while there’s no single cause, taking a closer look at traits of certain students who may have a propensity for suicide can help campuses make sure these student populations have the mental health resources they need for their health and well-being.
What does research show about the student groups who may be living with suicidal thoughts or behavior?
Men are more likely to die of suicide
A study conducted by the Suicide Prevention Resource Center and the Harvard Injury Control Research Center found that 88% of young adults who died of suicide were male. While the American Foundation for Suicide Prevention reported that women are 1.66 times more likely to make a suicide attempt, men have suicide rates 3.63 times higher than women.
The risk of suicide increases for students who have previously attempted suicide
A 32-year longitudinal study found that individuals who attempt suicide have a risk of suicide over several decades, with a particularly high risk within the first year after a suicide attempt. An earlier suicide attempt should be considered a risk factor for a suicide death regardless of when the attempt occurred. This systematic review confirmed that severity of intent and the use of a violent method are both important to consider for at least the first five years an attempt. It’s important to take a long-term — perhaps a lifetime — perspective when it comes to secondary suicide and self-harm preventive interventions for those who attempt suicide, especially repeat attempters and those with a major depressive disorder or a psychiatric disorder.
College students in a new environment can experience increased suicidal ideation
While transitioning from high school to college presents new environments filled with risks and responsibilities young people must navigate for the first time, it further burdens students of particular identities who might need additional time, space, and resources to adjust.
There are many unique stressors for an international student. Of course, exams, homework, internships, work-study jobs, social life, life events, family issues, and finances are part of college students’ experience. But, add to that the adjustment to a new academic environment, culture shock during the first year of college, language barriers, prejudice, and living far from the support of family and friends. Then it becomes clear why living and studying abroad is taxing on international students’ mental health.
Additionally, international college and university students often feel pressure from family to succeed academically based on their cultural background and their families’ financial sacrifices to allow them to study abroad. For instance, Chinese students studying in America as well as those in Asian American communities are burdened with the “model minority” stereotype. This is an assumption that depicts international students as uniformly well-adjusted, attaining more socioeconomic success than other minority groups, and excelling academically — particularly in math. However, both Asian American students and Chinese students studying in America are highly diverse across subgroups in rates of socioeconomic, physical health, and mental health challenges.
Though mental health problems affect all students, research has shown that international students have been less likely than domestic students to seek and receive mental health support. A study published in the Journal of American College Health that surveyed more than 550 international graduate students found that only 61% of international students surveyed were aware of the available mental health support services on their campus, compared with 78.6% of domestic graduate students. Only one-third of international graduate students had considered using counseling services, compared with more than half of all domestic students. And while more than a third of domestic students had used these services, only 17% of international students had.
Read more about how to support the health and well-being of international students.
The World Mental Health International College Student Project (WMH-ICS) sent a questionnaire about suicidal thought and behavior (STB) prevalence to nearly 14,000 first-year students from colleges in eight countries worldwide. The final report found that, “Lifetime prevalence of ideation, plans, and attempts were 32.7%, 17.5%, and 4.3%, respectively. Comparable 12-month estimates were 17.2%, 8.8%, and 1.0%, respectively. More than one-half (53.4%) of lifetime ideators made the transition to a suicide plan, with slightly more than one-fourth (26.8%) of lifetime ideators having a plan in the past 12 months. In addition, 22.1% of lifetime planners made the transition to an attempt, with 5.4% doing so in the past 12 months. Attempts among lifetime ideators without a plan were less frequent (3.1%; 0.3% of lifetime ideators in the past 12 months).” These results confirm the distribution of STB in first-year students is widespread.
College presents new stressors that challenge psychosocial adjustments for first-year college students and generally worsen across the first two years. Students are more likely to experience increased emotional distress (i.e. decreased self-esteem, increased depressive symptoms, anxiety, and stress), cognitive-affective strategies (i.e. decreased active emotional coping, increased avoidant emotional coping), and social adjustment (i.e. decreased social support from friends).
The following two years generally see improvement for students, though only recovering to pre-college levels in self-esteem and active emotional coping for women and only the latter for men. Women experience worse initial psychological functioning (i.e., more distress and lower self-esteem), though their self-esteem recovers by the end of college. Men exhibit worse friend support and active emotional coping, and a pattern of worsening avoidant emotional coping throughout college.
To compound these issues, sleep disruption fueled by excess caffeine and all-nighters is associated with heightened anxiety. Also, excessive social media use causes an increased sense of isolation. The COVID-19 pandemic adds to the stress students typically experience when transitioning to college life. College Parents of America says that in addition to academic performance, variables like culture shock, homesickness, family history, and adjustments in social life can overwhelm first-time college students. A bad grade, a fight with a roommate, or a relationship ending can lead to feelings of sadness, loneliness, or low self-worth.
Read more about how to support the health and well-being of Gen Z college students.
According to the Postsecondary National Policy Institute (PNPI), students who identify as LGBTQ+ comprise an estimated 10% of the college population — approximately 2.5 million LGBTQ+ young adults ages 18 to 24. The growing acceptance of those who identify as LGBTQ+ in America is encouraging more students to come out. In a 2019 Pew Research poll, 61% of Americans supported same-sex marriage while only 31% opposed it — a change that’s developed in recent decades. Additionally, 74% of millennials and 58% of Gen Xers who participated in the poll approved of same-sex marriage.
LGBTQ+ students, like all college student populations, are at risk for suicide. However, studies confirm that LGBTQ college students are one of the groups that show the highest risk:
- LGBTQIA students have two to three times greater risk of completing suicide than their heterosexual peers
- Twenty-five percent of the gay/bisexual-identified male college-aged population made suicidal actions.
- Lesbian/bisexual-identified college students are three to four times more likely to consider suicide than their heterosexual peers.
- LGBTQIA+ individuals across all social demographics who “come out” are at increased risk for depression, substance abuse, and suicidal behavior.
- African American, Latino, Native American, and Asian American people who are lesbian, gay, or bisexual attempt suicide at especially high rates.
Research finds that most LGBTQ+ students consider suicide in response to bullying, discrimination, homophobia, depression, anxiety, substance abuse, violence, gender nonconformity, low self-esteem, and societal and family rejection.
Read more about how to support the health and well-being of LGBTQ college students.
Improve the health and wellness of at-risk students
Some personality factors may increase the risk of suicide for college students
Previous studies confirm that select personality traits are a factor in STB. Among various theories of personality, the big five-factor model of personality has been widely accepted for young people and older adults. This model conceptualizes personality as a hierarchical organization that consists of extraversion, agreeableness, conscientiousness, neuroticism, and openness.
- Extraversion includes seeking interaction with other people, being energetic and active, and joyfulness.
- Agreeableness consists of comfortable and harmonious interpersonal relationships.
- Conscientiousness consists of self-discipline and following social rules.
- Neuroticism consists of emotional distress, dysphoria, and uncontrolled feelings.
- Openness consists of seeking novel stimuli, intellectual exploration, and being imaginative.
A present study of 6,000 participants sought to address which of these five personality traits are significantly related to suicidal ideation in college students. The report states, “agreeableness … was negatively associated with suicidal ideation, whereas high neuroticism … was positively associated with suicidal ideation among young adults. Openness … had a positive association, and conscientiousness … had a negative association with suicidal ideation among the middle-aged group. Neuroticism is the only influencing factor for suicidal attempts among the young adult … and older … groups.” In summary, extraversion and agreeableness were negatively associated with suicidal ideation, but neuroticism and openness were positively associated with suicidal ideation among young adults.
The meta-analysis also found alcohol use disorders, mood disorders, mental disorders, personality disorders, and anxiety disorders were predictors of suicide ideation and attempts in nearly all age groups. In fact, more than one in three people who die of suicide are found to be under the influence of alcohol or other substance use. Additionally, nicotine use correlates with suicidality among the young adults’ group.
Supporting the mental health and well-being of at-risk student groups
In response to this research, it is critical for higher education institutions to put a comprehensive suicide prevention plan in place. This plan should prioritize student mental health and ensure that appropriate and relevant resources are available as part of a comprehensive, public-health approach to promoting student well-being on campus. And having resources like telehealth provides easy, 24/7 access to emotional support when and where students need it.
Focused on improving the health, wellness, and cultural adjustment of at-risk student populations, TimelyMD offers colleges and universities virtual mental health resources and services, including on-demand emotional support, psychiatry, and health coaching, centered around telehealth. TimelyMD’s total health and well-being solution is an extension of on-campus health services and student support to improve the mental and physical health of your students. With 24/7/365 access to providers in all 50 states, TimelyMD helps you meet the needs of at-risk student populations and your broader student population.
To explore telehealth programs that deliver quality care and protective factors for student support, contact TimelyMD.