A Qualitative Examination of the Impact of Suicidal Thoughts and Behavior on Help-Seeking Among University Students in Colombia and Mexico.

This study examined descriptions of suicidal thoughts and behavior (STB) to identify risk and protective factors that may present in clinical settings among university students from Latin America. Our focus was on answering the following key questions: How are suicidal thoughts and behavior described? What are reasons for wanting to die and for living? What impact do STBs have on motivations to seek or avoid psychological treatment? To this end, 55 qualitative interviews were completed with university students from Colombia and Mexico who recently endorsed emotional difficulties in the World Mental Health International College Student (WMH-ICS) surveys. Interviews were coded to identify themes specific to STBs. Findings revealed insight on symptom presentations and consequences of STBs. Participants described uncontrollable somatic symptoms during periods of high suicide risk, which serves as a relevant clinical marker for health providers. An important reason for living was to avoid suffering for family, which was protective against suicide and motivates familial involvement in treatment planning. Participants sought solutions to emotional problems after experiencing STBs, including psychological treatment. Cultural stigma of mental illness induced feelings of shame and burden, which led to avolition, avoidance, and nondisclosure of symptom severity. This study provides insight into the utility of evaluating cultural context in (a) detecting antecedents to STBs frequently reported as somatic symptoms, (b) identifying protective factors against suicide, and (c) recognizing how stigma of mental illness and suicide, shame avoidance, and familism might influence personal motivations to seek or avoid help for emotional distress.

Barriers to methamphetamine treatment seeking in residential centers in Aguascalientes, Mexico.

Introduction: In the Aguascalientes, most people who seek treatment go to non-governmental residential centers, and about half request treatment for meth use. Although some barriers to treatment seeking among these users are known, few studies have been conducted with the Mexican population, specifically with users of residential centers. The aim of this study was to explore the main barriers reported by these patients, the relationship between reported barriers and meth use, as well as identify possible user profiles based on the barriers and the pattern of consumption. Methods: We designed a brief survey that evaluated sociodemographic data, consumption pattern, help-seeking for consumption and use of services, barriers in the search for services, depression, and suicide attempts. Here, we report the results of barriers and consumption patterns. The study sample consisted of 865 individuals receiving treatment for meth use in 23 certified residential centers. Results: Patients reported an average of 2.12 barriers, the main ones being not considering the services useful for them (41.6%), not considering it important to attend (35%), and not finding time to attend the consultation (29.8%). We found a statistically significant relationship, although weak, between the number of barriers reported by participants and the age of onset of meth use, dangerous perception of meth use, attempts to quit, and the number of problems associated with use. We used a cluster analysis that was performed using the k-means machine learning algorithm, which revealed two clusters. The first was formed by patients who started using meth at a young age which has more problems associated with meth use and more barriers in seeking services, while the other was formed by patients who started at an older age which have fewer problems and fewer barriers. We found statistical differences between groups, where it was found that young group reported consuming more substances, more problems associated, and more barriers in seeking services. Discussions: This study revealed the main barriers to seeking treatment among patients in residential centers and found that the age of onset of meth use is a risk factor for presenting more barriers and more problems associated with consumption.

Prevalence of 12-month mental and substance use disorders in sexual minority college students in Mexico.

PURPOSE: Mental health disparities have been documented among sexual minority college students, but there is a dearth of evidence from developing countries. The aim is to estimate the prevalence of 12-month mental and substance use disorders across a range of sexual identities among first-year college students in Mexican universities, and test whether there is an association between sexual identity and disorders and whether the association is moderated by gender. METHOD: The University Project for Healthy Students, a web-based survey conducted as part of the World Health Organization's World Mental Health International College Student initiative, recruited 7874 students from nine Mexican universities in 2016 and 2017. Logistic regressions estimated the association of sexual identity with 12-month major depressive episode, generalized anxiety disorder, panic disorder, alcohol abuse/dependence, and drug abuse/dependence, with interaction terms for gender. RESULTS: Compared to heterosexual students reporting no same-sex attraction (SSA), heterosexual students with SSA (AORs range 1.77-3.67) and lesbian/gay and bisexual students (AORs range 2.22-5.32) were at a higher risk for several disorders. Asexual students were at higher risk for drug abuse/dependence (AOR = 3.64). Students unsure of their sexual identity were at a higher risk for major depressive episode, panic disorder, and drug abuse/dependence (AORs range 2.25-3.82). Gender differences varied across sexual identity and disorder. CONCLUSION: These findings are the first empirical report of sexual minority psychiatric disparities among a college student population from a developing nation and underscore the importance of clinical interventions that address mental health needs among sexual minority college students.

Suicide thought and behaviors, non-suicidal self-injury, and perceived life stress among sexual minority Mexican college students.

BACKGROUND: Sexual minority college students are at a higher risk for suicidal thoughts and self-injurious behaviors compared to heterosexual students. Minority stress theory proposes sexual minority individuals experience higher stress due to stigma. Using a sample of Mexican college students, this study tested perceived life stress as a mediator of suicide and self-injury outcomes across various sexual orientation groups. METHODS: The sample of college students (N=7882) was recruited from nine Mexican universities as part of the WHO World Mental Health International College Student (WMH-ICS) initiative. Participants completed an online survey including demographic questions, measure of perceived life stress, suicide outcomes, and non-suicidal self-injury (NSSI) in the past 12 months. RESULTS: Logistic regression analyses revealed identifying as a sexual minority significantly predicted a higher likelihood of suicide ideation (ORs 2.05-3.00), suicide attempts (ORs 2.48-8.73), and NSSI (ORs 2.92-4.18) compared to heterosexual students reporting no same-gender attraction. Significant indirect effects from mediation path analyses showed perceived life stress mediated the relationship between a sexual minority identity and suicide ideation (range of proportion mediated 10.48-31.48%), attempts (10.48-31.48%), and NSSI (7.69-20.09%) across each group except among asexual students. LIMITATIONS: The cross-sectional nature of the survey design precludes drawing causal inferences. CONCLUSION: Findings from this study contribute to minority stress theory by elucidating the role of perceived life stress as a mediator of suicide ideation and attempts and NSSI among sexual minority college students. Clinical interventions may benefit in focusing on experiences of stress across various life areas when supporting sexual minority college students.