Citation

Yilmaz SK, Bohara AK. Soc. Psychiatry Psychiatr. Epidemiol. 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00127-020-01987-6

PMID

33221929

Abstract

PURPOSE: There is economic importance to stimulating awareness about preventing adolescent suicide and other associated deleterious mental and behavioral health outcomes, especially the long-term costs from lost productivity. However, the presence of stigma and poor healthcare reporting systems which often prevent data access have frequently limited research into these topics in low-and-middle income (LMICs) countries. The majority of existing research on these topics using LMICs data primarily focuses on prevalence rates and basic correlational associations, and is often a-theoretic. Empirically rigorous work, mostly found using data from the developed world, has primarily relegated suicide into a box of utility-maximization-based decisions. Social integration theory may be a more relevant approach for researching the mitigating factors to deleterious heath behaviors among adolescents in LMICs.

METHODS: Using data from the Global School-based Student Health Survey (GSHS) of six different countries, we estimate a reduced-form, simultaneous model incorporating specialized clustering to determine the influence of social integration on five different deleterious health outcomes, including three levels of suicidal behavior.

RESULTS: Robust results indicate that positive parenting and social exclusion reduce and increase the likelihood of all outcomes, respectively, among both pooled and individual country samples.

CONCLUSION: Such results provide an impetus for pursuing interventions in LMICs, which focus on social-based, multi-level approaches. Such interventions could include such elements as peer-to-peer training support and awareness/promotion of mental health among parents of adolescents.

Language: en

Keywords

Suicide; Cross-country; Design-weighting; Low-and-middle-income countries (LMIC); Multivariate probit; Social integration