You’ve got to have friends: the predictive value of social integration and support in suicidal ideation among rural communities

• Published in: Social Psychiatry and Psychiatric Epidemiology 2012-08, Vol.47 (8), p.1281-1290
• Main Authors: Handley, Tonelle E., Inder, Kerry J., Kelly, Brian J., Attia, John R., Lewin, Terry J., Fitzgerald, Michael N., Kay-Lambkin, Frances J.
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Age; Aged; Analysis; Biological and medical sciences; Cross-Sectional Studies; Epidemiology; Female; Follow-Up Studies; Friends - psychology; Humans; Interpersonal Relations; local communities; Longitudinal studies; Male; Medical research; Medical sciences; Medicine; Medicine & Public Health; Medicine, Experimental; Mental disorders; Mental Health; Middle Aged; New South Wales; Original Paper; Perception; Predictive Value of Tests; Psychiatry; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Regression Analysis; Risk Factors; ROC Curve; Rural areas; Rural Health; Rural Population - statistics & numerical data; Social aspects; Social networks; Social psychiatry. Ethnopsychiatry; Social Support; Stress (Psychology); Suicidal behavior; Suicidal Ideation; Suicide; Suicides & suicide attempts; Surveys and Questionnaires
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-011-0436-y

Purpose To explore the role of social integration and support in the longitudinal course of suicidal ideation (SI) in a rural population. Methods Baseline and 12-month data were obtained from participants within the Australian Rural Mental Health Study, a longitudinal study of community residents within rural and remote New South Wales, Australia. SI was assessed using the Patient Health Questionnaire. Individual psychological factors, family and community characteristics were examined alongside personal social networks (Berkman Syme Social Network Index), availability of social support (Interview Schedule for Social Interaction) and perception of local community (Sense of Community Index). Results Thirteen hundred and fifty-six participants were included in the analysis (39% male, mean age 56.5 years). Sixty-one participants reported recent SI at baseline, while 57 reported SI at follow-up. Baseline SI was a strong predictor of SI at 12 months [odds ratio (OR) 19.0, 95% confidence interval (CI) 8.6–42.3); significant effects were also observed for baseline values of psychological distress (OR 1.4, 95% CI 1.0–1.9) and availability of social support (OR 0.76, 95% 0.58–1.0) on 12-month SI. The emergence of SI at 12-month follow-up was predicted by higher psychological distress (OR 1.8, 95% CI 1.3–2.4); there was a marginal effect of lower availability of support (OR 0.74, 95% CI 0.55–1.0); neither of these variables predicted SI resolution. Conclusions This study investigated factors associated with SI over a 12-month period in a rural cohort. After controlling for known risk factors for SI, low availability of social support at baseline was associated with greater likelihood of SI at 12-month follow-up.