Psychiatric, Sociodemographic, and Community Belonging Correlates of Suicidal Ideation in Canada: Findings from the 2022 Mental Health and Access to Care Survey
Jae-Hon Lee, Lena Palaniyappan, Sung-Wan Kim, Kelly K. Anderson, Verinder Sharma, Patricia Hall, Arlene G. MacDougall, Mohamad Elfakhani, Kounseok LeeObjective
To estimate the prevalence of suicidal ideation among Canadians, identify psychiatric and sociodemographic correlates of past-12-month ideation and its association with community belonging, and compare the out-of-fold predictive performance of logistic regression and random forest models.
Method
We analyzed the nationally representative 2022 Mental Health and Access to Care Survey (analytic
Results
Past-12-month suicidal ideation was reported by 3.4% (95% CI, 2.9% to 3.9%) and lifetime-only ideation by 7.4% (95% confidence interval (CI), 6.7% to 8.2%). Independent correlates of past-12-month ideation were major depressive episode (MDE) (adjusted odds ratio (aOR) = 5.80; 95% CI, 3.61 to 9.33), very weak community belonging (aOR = 3.64; 95% CI, 1.88 to 7.04), generalized anxiety disorder (aOR = 2.65; 95% CI, 1.56 to 4.50), bipolar disorder (aOR = 2.43; 95% CI, 1.27 to 4.66), and separation/divorce (aOR = 2.25; 95% CI, 1.22 to 4.17). Adjusted probability rose from 2.0% at very strong to 6.0% at very weak belonging. No interaction was supported. Adding belonging did not improve discrimination (area under the curve (AUC), 0.823 vs. 0.823; difference = 0.000; 95% CI, −0.011 to 0.011); the random forest AUC was 0.843 (difference = 0.020; 95% CI, 0.004 to 0.038).
Conclusions
Psychiatric morbidity, separation/divorce, younger age, and very weak community belonging were associated with past-12-month suicidal ideation. Community belonging was independently associated but did not improve cross-validated discrimination, whereas MDE was the most robust correlate.