A machine learning analysis of suicidal ideation and suicide attempt among U.S. youth and young adults from...

To investigate individual, interpersonal, health system, and community factors associated with suicidal ideation (SI) and attempts (SA).

Utilizing nationally representative data from the National Longitudinal Study of Adolescent to Adult Health (7^th-12^th graders in 1994-95 followed >20 years until 2016-18, N=18,375), least absolute shrinkage selector operator (LASSO) regression determined multilevel predictors of SA and SI. Models comprised full and diagnosis subgroups (ADD/ADHD, depression, PTSD, anxiety, learning disabilities [LD]).

Approximately 2.48% and 8.97% reported SA and SI, respectively. Over 25% had depression, and 20.98% anxiety, 6.42% PTSD, 4.55% ADD/ADHD, and 2.50% LD. LASSO regression identified 20 and 21 factors associated with SA and SI. Individual-level factors associated with SI and SA included educational attainment, substance use, ADD/ADHD, depression, anxiety, and PTSD. Interpersonal-level factors included social support, household size, and parental education, while health system-level factors comprised health care receipt, health insurance, and counseling. The strongest associations were among individual-level factors followed by interpersonal and health system factors.

The distinct factors associated with SI and SA across diagnostic subgroups highlight the importance of targeted, subgroup-specific suicide prevention interventions. These findings emphasize the value of precise, data-driven approaches for suicide prevention among diverse populations and individuals with disabilities across the life-course.