Risk and Protective Factors Associated with Moderate and Acute Suicidal Ideation among a National Sample of Tribal College and University Students 2015-2016

Objectives We examined the relationship between suicide risk and disability status, as well as risk and protective factors, adjusting for demographic characteristics, among students attending 22 Tribal Colleges and Universities (TCU; 20 rural and 2 urban) across the United States in fall 2015 and 2016. Methods Tribal college students (N = 3,239) participated in a cross-sectional online or paper survey assessing alcohol use patterns and mental health outcomes, yielding a response rate of 31.3%. Results Of the students surveyed, 8.8% indicated moderate or high suicide risk. Hearing impairment was significantly associated with moderate/high suicide risk (OR = 2.11; 1.24-3.61,P = .006), as was vision impairment (OR = 3.03; 1.92-4.77,P < .001), having a physical/mental/or emotional condition (OR = 2.12; 1.75-2.57,P < .001), experiencing critical appraisal (OR = 1.30; 1.24-1.36,P < .001), and experiencing critical isolation (OR = 1.83; 1.66-2.01,P < .001). Scoring high on resilience (OR = 0.93; 0.92-0.95,P < .001), reporting higher emotional social support (OR = 0.75; 0.70-0.79,P < .001), and reporting higher levels of instrumental social support (OR = 0.69, 0.62-0.76,P < .001) were significantly associated with lower suicide risk. Conclusions Students attending tribal colleges who experience hearing impairment, sight impairment, or a physical/emotional/mental condition have a greater risk of suicidality. Students experiencing critical appraisal and critical isolation may benefit from behavioral health interventions to reframe these experiences and develop resiliency skills. Developing avenues of emotional and instrumental social support within TCU settings offers key protective factors to buffer the risk of suicidality. Examining additional ways to build resiliency may also offer protection from suicide risk in this population.