Suicidal Ideation in American Indian and Alaskan Native College-Attending Students

Introduction: Despite being at the highest risk of suicide, American Indian/Alaskan Native (AIAN)-emerging adults are underrepresented in mental health research. There is great diversity in individual and community experiences and access within AIAN-identifying individuals, prompting the need for research on risk and protective factors of suicidality within AIAN-emerg-ing adults. Methods: Data from AIAN-identifying emerging adults (mean age = 24.4 years) collected between 2017 and 2020 (n=2,551) were drawn from the Healthy Minds Study, a national annual panel study on mental/behavioral health within higher education settings. Multivariate logistic regressions (con-ducted in 2022) were used to evaluate the risk and protective factors associated with suicidality (idea-tion, planning, attempt) by gender (male, female, trans/gender nonbinary). Results: Suicidal ideation rates were high; over 1 in 5 AIAN-emerging adults reported ideation, 1 in 10 reported planning, and 3% reported attempt in the previous year. AIANs identifying as a gender minority (trans/nonbinary) were 3 times more likely to report suicidality across event type. Across all gender identi-ties, suicidality was significantly associated with nonsuicidal self-injury and self-perceived need for help; flourishing was predictive of lower odds of suicidality event for male-and female-identifying AIAN students. Conclusions: Suicidality is high for AIAN college-attending students, particularly for gender minority -identifying students. Embracing a strength-based approach to highlight student awareness of mental health services is critical. Future research should examine the protective factors as well as community and structural factors that might provide meaningful support within and outside of university contexts for stu-dents facing individual, relational, or challenges within their communities.

Automated summary

Despite the high risk of suicide, mental health research on American Indian/Alaskan Native (AIAN) emerging adults is lacking. This study aims to explore the risk and protective factors of suicidality among AIAN-identifying individuals. The results show high rates of suicidal ideation, particularly among gender minority-identifying students. Non-suicidal self-injury, self-perceived need for help, and flourishing are associated with suicidality across all gender identities. It is crucial to emphasize student awareness of mental health services and further investigate protective factors and community support for AIAN college students.