Pathways to suicidal ideation for young people engaged in mental health care
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Background
Suicidal thoughts and behaviours (STBs) have a profound impact on individuals, communities, and healthcare systems. A wide range of factors have been shown to be associated with STBs. Within prior research it is also common to distinguish between proximal and distal factors, usually by distinction of short compared to long-term prediction. We frame the distinction between proximal and distal factors on suicidal ideation as direct or indirect dependencies using the inferred structure of probabilistic graphical models (PGMs).
Methods
We used cross-sectional data from a sample of 1020 help-seeking individuals aged 12-25 years from Australia that while engaged in a mental health care, contributed data to a digital platform. We inferred the posterior distribution of the dependency structure assuming both undirected PGMs and Bayesian networks (BNs). We then used the BN analysis to infer the causal effect that changing one variable has on another using a counterfactual query.
Results
We show that factors encompassing depressed mood, functional impairment, poor social connection, and psychosis-like experiences are proximal. Whereas experiencing a traumatic event, anxiety, insomnia, and unrefreshed sleep are distal factors. Proximal factors tended to have the greatest effect on suicidal ideation, while anxiety symptoms and experiencing a traumatic event were the most influential distal factors.
Conclusions
These relative timings of events and their effects on suicidal ideation could be used to understand the future likelihood of suicidal ideation, and aid planning of targeted interventions.
