Mental health treatment use and perceived treatment need among suicide planners and attempters in the United States: between and within group differences

BACKGROUND: Despite many previous studies of suicidal ideation and/or attempts, little research has examined mental health treatment use and perceived treatment need among and within groups of ideators and/or attemptors. We examined mental health treatment use and perceived treatment need in four groups of US adults who had serious suicidal ideation: (1) no suicide plan/no attempt; (2) planned/no attempt; (3) no plan/attempted; and (4) planned/attempted. METHODS: We compared ideators and nonideators using the 154,923 U.S. residents aged 21 and older who participated in the 2008–2012 National Survey on Drug Use and Health (NSDUH). We then employed logistic regression analyses to discern factors associated with treatment use and perceived treatment need among and within the four groups of ideators (N = 7,348). RESULTS: More than 30% of ideators who made suicide plans and/or attempted suicide received no treatment before or after planning or attempting. Racial/ethnic minorities had lower odds of treatment use in all four groups, but major depression significantly increased the odds in all but the no plan/attempted group. Treatment use and substance use disorder increased the odds of perceived need in all four groups. CONCLUSIONS: The four groups have different rates of treatment access and perceived treatment need that do not appear to be commensurate with their risk level. The findings underscore the importance of treatment access for all those at-risk of suicide, especially racial/ethnic minorities and those of lower SES.