Abstract
Objective
Despite being preventable, suicide remains a leading cause of death globally, with depression being one of the more prominent risk factors. This study examines the roles of social support and positive mental health in the depression-suicidality pathway.
Methods
We utilized data from the Singapore Mental Health Study 2016. Social support and positive mental health were examined as mediators in the relationship between 12-month depression and 12-month suicidality using survey-weighted generalized structural equation modeling.
Results
Overall positive mental health was found to partially mediate the relationship between depression and suicide. Of the discrete positive mental health domains, the depression-suicidality relationship was partially mediated by general coping and fully mediated by personal growth and autonomy.
Conclusion
While findings regarding social support were inconclusive, positive mental health may play a significant role in alleviating the effects of depression on suicidality. This highlights the multifaceted nature of suicidality and reveals positive mental health as a new area in assessing and treating at-risk people, to improve clinical outcomes.
The effect of depression on suicidality was partially mediated by overall positive mental health.
General coping partially mediated the relationship between depression and suicidality.
Personal growth and autonomy fully mediated the relationship between depression and suicidality.
HIGHLIGHTS
ETHICAL APPROVAL
The study was reviewed and approved by the National Healthcare Groups’ Domain Specific Review Board. Written informed consent was obtained from all participants and parents or legally acceptable representatives of those aged below 21 years.
AUTHOR CONTRIBUTIONS
YSK analyzed the data collected from the SMHS 2016. VS wrote the first draft of the manuscript, while YSK, JAV, SS, SC, SV, WLC, SAC, and MS critically reviewed the manuscript and gave their intellectual input before approving the final version for publication.
DISCLOSURE STATEMENT
No potential conflict of interest was reported by the author(s).
DATA AVAILABILITY STATEMENT
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Additional information
Funding
Notes on contributors
Vanessa Seet
Vanessa Seet, Yen Sin Koh, Janhavi A. Vaingankar, Shazana Shahwan, Sherilyn Chang, Siow Ann Chong, and Mythily Subramaniam, Research Division, Institute of Mental Health, Singapore, Singapore.
Yen Sin Koh
Vanessa Seet, Yen Sin Koh, Janhavi A. Vaingankar, Shazana Shahwan, Sherilyn Chang, Siow Ann Chong, and Mythily Subramaniam, Research Division, Institute of Mental Health, Singapore, Singapore.
Janhavi A. Vaingankar
Vanessa Seet, Yen Sin Koh, Janhavi A. Vaingankar, Shazana Shahwan, Sherilyn Chang, Siow Ann Chong, and Mythily Subramaniam, Research Division, Institute of Mental Health, Singapore, Singapore.
Shazana Shahwan
Vanessa Seet, Yen Sin Koh, Janhavi A. Vaingankar, Shazana Shahwan, Sherilyn Chang, Siow Ann Chong, and Mythily Subramaniam, Research Division, Institute of Mental Health, Singapore, Singapore.
Sherilyn Chang
Vanessa Seet, Yen Sin Koh, Janhavi A. Vaingankar, Shazana Shahwan, Sherilyn Chang, Siow Ann Chong, and Mythily Subramaniam, Research Division, Institute of Mental Health, Singapore, Singapore.
Swapna Verma
Swapna Verma, Department of Psychosis and East Region, Institute of Mental Health, Singapore, Singapore and Office of Education, Duke-NUS Medical School, Singapore, Singapore.
Wai Leng Chow
Wai Leng Chow, Epidemiology and Communicable Diseases Division, Ministry of Health, Singapore, Singapore.
Siow Ann Chong
Vanessa Seet, Yen Sin Koh, Janhavi A. Vaingankar, Shazana Shahwan, Sherilyn Chang, Siow Ann Chong, and Mythily Subramaniam, Research Division, Institute of Mental Health, Singapore, Singapore.
Mythily Subramaniam
Vanessa Seet, Yen Sin Koh, Janhavi A. Vaingankar, Shazana Shahwan, Sherilyn Chang, Siow Ann Chong, and Mythily Subramaniam, Research Division, Institute of Mental Health, Singapore, Singapore.