• Elyse J Thulin, Sarah K Lipson, Justin E Heinze, and Sasha Zhou.
• Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan; The Michigan Institute for Data Science, University of Michigan, Ann Arbor, Michigan; Injury Prevention Center, University of Michigan, Ann Arbor, Michigan. Electronic address: ethulin@umich.edu.
• Am J Prev Med. 2023 Aug 1; 65 (2): 307312307-312.

IntroductionDespite 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-emerging adults.MethodsData 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 (conducted in 2022) were used to evaluate the risk and protective factors associated with suicidality (ideation, planning, attempt) by gender (male, female, trans/gender nonbinary).ResultsSuicidal 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 identities, 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.ConclusionsSuicidality 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 students facing individual, relational, or challenges within their communities.Copyright © 2023 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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