Stressors and suicidal ideation in low-income adults in Malaysia

A serial mediation analysis of social support and mental health symptoms

Bibliographic Data

ID7176403
AuthorsMadihah Shukri (0000-0001-7817-5677, Universiti Malaysia Terengganu, corresponding author), Christopher J Armitage (0000-0003-2365-1765, University of Manchester), Chong Siew Koon (0000-0001-8491-5619, Department of Psychiatry and Mental Health, Kuala Lumpur Hospital, Wilayah Persekutuan, Malaysia), Nurul Nabila Tarmizi (Universiti Malaysia Terengganu)
Year2024
Volume71
Issue2
Pages295-306
Publication date2024-10-16
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueInternational Journal of Social Psychiatry (JOURNAL)
Journal identifiersISSN: 0020-7640 • E-ISSN: 1741-2854
PublisherSAGE Publishing (PUBLISHER • US)
DOI10.1177/00207640241288686
PMID39412828
OpenAlexW4403478929
LanguageEN
Citations received1
References cited84

Background: Studies have documented a heightened risk of suicidal ideation in response to stressors, especially among people from socioeconomically disadvantaged backgrounds. However, the mechanisms of this association remain elusive. Aims: Drawing on the social deterioration and counteractive models, this study aims to elucidate the pathways linking stressors to suicidal ideation through serial mediation of social support and mental health symptoms in Malaysia. Method: Data were collected from 404 low-income adults (33.2% male and 66.8% female) receiving monthly financial assistance from Malaysia’s social welfare department. We employed stressor measures (i.e. financial, family and work), the Oslo Social Support Scale, the Patient Health Questionnaire and the Suicidal Behaviour Questionnaire-Revised. Results: A total of 46.8% of participants reported mild-to-severe anxiety and depressive symptoms, with 11.1% classified as high risk for suicide. Direct and indirect effects were found. After controlling for age and gender, social support and mental health symptoms mediated the link between stressors and suicidal ideation. The serial mediation analysis indicates that stressors are connected to heightened suicidal ideation through a sequence involving insufficient social support, followed by elevated levels of mental health symptoms. Conclusion: Understanding the multifaceted relationships among stressors, social support, mental health symptoms and suicide ideation expands the potential for developing targeted interventions and preventive strategies tailored for vulnerable populations. Clinical work with low-income individuals may include implementing early systematic efforts to develop accessible mental health and integrated care services

Association (psychology · Disadvantaged · Environmental health · Mediation · Mental health · Poison control · Psychiatry · Psychotherapist · Social support · Stressor · Suicidal ideation · Suicide prevention · Child and Adolescent Psychosocial and Emotional Development · Clinical Psychology · Medicine · Mental Health Treatment and Access · Psychology · Social Psychology · Suicide and Self-Harm Studies