Comparisons of mental health symptoms, treatment access, and self-harm behaviors in rural adolescents before and during the COVID-19 pandemic.

The COVID-19 pandemic disrupted the lives of adolescents worldwide, and research on the mental health effects are ongoing. Adolescents living in rural areas of the United States were already known to be at a disadvantage in terms of access to mental health services, as well as elevated rates of mental health concerns and self-harm risk. Research on how these factors may have changed since the pandemic began is needed to better understand which areas saw the biggest impact and where we can best direct resources to assist youth. Data from the current study were taken from a project examining adolescent mental health and self-harm risk. The pandemic disrupted the timeline for the study resulting in data being collected in two separate waves: before (n = 695) and after (n = 206) the pandemic began. Comparisons were made between these two samples on multiple factors including depression, anxiety, emotion dysregulation, alcohol and substance use, experiencing of bullying, overall impairment, mental health services access, and self-harm. Results indicated that adolescents in the pandemic sample were more likely to have seen a counselor and been hospitalized for a mental health reason, and were more likely to have experienced past-year suicide thoughts and plans than adolescents in the pre-pandemic sample. The pandemic sample also showed more depression and anxiety symptoms, greater emotion dysregulation, and greater intensity of recent suicide ideation. Implications for assisting youth through post-pandemic times are discussed.

Examining Nonsuicidal Self-Injury Features as Motivational Moderators in the Relationship Between Hopelessness and Suicide Ideation.

OBJECTIVE: Nonsuicidal self-injury (NSSI) is a robust predictor of suicide ideation and attempts, but it is not clear how and why this connection is so strong. Using the Integrated Motivational-Volitional Model of suicide as a framework, select features of NSSI were examined as motivational moderators between hopelessness and suicide ideation. METHOD: Data were collected from 420 emerging adults (mean age = 18.9; 84% female, 92% white), all of whom had past-year NSSI. Participants completed self-report measures that assessed NSSI and suicide history, effectiveness of NSSI in achieving functions, and hopelessness; they also completed the self-injury Implicit Association Test (IAT). RESULTS: Moderation analyses revealed that none of the interactions were significant. Additional analyses tested unconditional effects of all predictor variables and found hopelessness, self-rated future likelihood of engaging in NSSI, effectiveness of NSSI in achieving intrapersonal functions, and self-injury IAT scores were each significantly associated with suicide ideation. CONCLUSIONS: These results reinforce the important role of hopelessness, perceived effectiveness of NSSI in achieving intrapersonal functions, acknowledgement of future NSSI, and self-identification with NSSI as potential indicators of increased suicide risk, while also emphasizing further study of other possible moderating factors.HIGHLIGHTSFeatures of NSSI did not moderate the hopelessness-suicide ideation relationship.Features of NSSI did associate with increased suicide ideation frequency.Future likelihood of, implicit association with, and intrapersonal effectiveness of NSSI were important.