Addressing Suicide Risk in Counseling: The Role of Social Determinants of Health in a National Sample of Young Adults

ABSTRACT Suicide remains a leading cause of death among young adults, including those in mental health treatment. This study examined how social determinants of health (SDOH) influence suicidal ideation, planning, and attempts among 3,690 young adults (ages 18 to 25 years) who received mental health services in the past year. Using data from the 2022 National Survey on Drug Use and Health, analyses were based on a weighted sample representing approximately 9.1 million young adults in the United States. Multivariable logistic regression analyses controlled for sex, race and ethnicity, sexual orientation, psychological distress, and functional impairment. Results indicated that several SDOH indicators were associated with suicide risk. Lower educational attainment was linked to higher odds of suicidal ideation, while lack of health insurance and frequent moves were associated with suicide attempts. These findings underscore the importance of integrating SDOH into assessment, safety planning, and intervention in counseling with young adult clients.