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. 2023 Jun;33(2):67-80.
doi: 10.1016/j.jbct.2023.04.001. Epub 2023 May 19.

A Qualitative Examination of the Impact of Suicidal Thoughts and Behavior on Help-Seeking Among University Students in Colombia and Mexico

Franchesca Castro-Ramirez  1 , María Abigail Paz-Pérez  2 , Taylor C McGuire  1 , Osiris Rankin  1 , María Carolina García Alfaro  3 , Andres Melchor Audirac  3 , Martha Luz Gómez Campuzano  4 , Parker Coady  1 , Mauricio Núñez-Delgado  4 , Jhovelis Manana  1 , Cristiny Hernández-de la Rosa  3 , Tida Tambedou  1 , Genesis A Vergara  1 , Libia Alvis Barranco  4 , Lorena Cudris-Torres  5 , Matthew K Nock  1 , John A Naslund  6 , Corina Benjet  3
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A Qualitative Examination of the Impact of Suicidal Thoughts and Behavior on Help-Seeking Among University Students in Colombia and Mexico

Franchesca Castro-Ramirez et al. J Behav Cogn Ther. 2023 Jun.

Abstract

This study examined descriptions of suicidal thoughts and behavior (STB) to identify risk and protective factors that may present in clinical settings among university students from Latin America. Our focus was on answering the following key questions: How are suicidal thoughts and behavior described? What are reasons for wanting to die and for living? What impact do STBs have on motivations to seek or avoid psychological treatment? To this end, 55 qualitative interviews were completed with university students from Colombia and Mexico who recently endorsed emotional difficulties in the World Mental Health International College Student (WMH-ICS) surveys. Interviews were coded to identify themes specific to STBs. Findings revealed insight on symptom presentations and consequences of STBs. Participants described uncontrollable somatic symptoms during periods of high suicide risk, which serves as a relevant clinical marker for health providers. An important reason for living was to avoid suffering for family, which was protective against suicide and motivates familial involvement in treatment planning. Participants sought solutions to emotional problems after experiencing STBs, including psychological treatment. Cultural stigma of mental illness induced feelings of shame and burden, which led to avolition, avoidance, and nondisclosure of symptom severity. This study provides insight into the utility of evaluating cultural context in (a) detecting antecedents to STBs frequently reported as somatic symptoms, (b) identifying protective factors against suicide, and (c) recognizing how stigma of mental illness and suicide, shame avoidance, and familism might influence personal motivations to seek or avoid help for emotional distress.

Keywords: Colombia; Mexico; college students; help-seeking; qualitative method; suicide.

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Conflict of interest statement

Declaration of competing interest: Dr Nock receives publication royalties from Macmillan, Pearson, and UpToDate. He has been a paid consultant in the past three years for Apple, Microsoft Corporation, and COMPASS Pathways, and for legal cases regarding death by suicide. He has stock options in Cerebral Inc. He is an unpaid scientific advisor for Empatica, Koko, and TalkLife. None of the other authors have competing interests to declare. Conflict of interest statement Dr Nock receives publication royalties from Macmillan, Pearson, and UpToDate. He has been a paid consultant in the past three years for Microsoft Corporation, the Veterans Health Administration, and COMPASS Pathways, and for legal cases regarding death by suicide. He has stock options in Cerebral Inc. He is an unpaid scientific advisor for Empatica, Koko, and TalkLife. None of the other authors have conflicts of interest to declare.

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