Poverty and Suicidal Ideation Among Hispanic Mental Health Care Patients Leading Up to the COVID‐19 Pandemic
Open accessAbstract
Introduction: Suicide rates have risen in Hispanic communities since 2015, and poverty rates among Hispanics often exceed the national average. Suicidality is a complex phenomenon. Mental illness may not alone explain whether suicidal thoughts or behaviors will occur; it remains uncertain how poverty affects suicidality among Hispanic persons with known mental health conditions. Our objective was to examine whether poverty was associated with suicidal ideation among Hispanic mental healthcare patients from 2016 to 2019. Methods: We used de-identified electronic health record (EHR) data from Holmusk, captured using the MindLinc EHR system. Our analytic sample included 4,718 Hispanic patient-year observations from 13 states. Holmusk uses deep-learning natural language processing (NLP) algorithms to quantify free-text patient assessment data and poverty for mental health patients. We conducted a pooled cross-sectional analysis and estimated logistic regression models. Results: Hispanic mental health patients who experienced poverty had 1.55 greater odds of having suicidal thoughts in a given year than patients who did not experience poverty. Conclusion: Poverty may put Hispanic patients at greater risk for suicidal thoughts even when they are already receiving treatment for psychiatric conditions. NLP appears to be a promising approach for categorizing free-text information on social circumstances affecting suicidality in clinical settings.
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NLP was applied in five studies to extract SDOH information from unstructured clinical notes.
“NLP was applied in five studies to extract SDOH information from unstructured clinical notes [28, 29, 33, 35] and to compare NLP performance against structured EHR data [27].”
Poverty was significantly associated with higher odds of suicidal ideation pre-pandemic among Hispanic mental health care patients.
“NLP extracted poverty‐related SDOH and suicidal ideation from unstructured notes; poverty significantly associated with higher odds of suicidal ideation pre‐pandemic”
NLP extracted poverty-related SDOH and suicidal ideation from unstructured clinical notes.
“NLP extracted poverty‐related SDOH and suicidal ideation from unstructured notes; poverty significantly associated with higher odds of suicidal ideation pre‐pandemic”
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Cites
Suicide: A Study in Sociology.
Alpert, H., Durkheim, É., Spaulding, J. A., Simpson, G. L., Solovay, S. A., Mueller, J. H., & Catlin, G. (1951) · American Sociological Review · doi:10.2307/2088294 · Cited by 3,910 · see citing works
Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research
Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., Huang, X., Musacchio, K. M., Jaroszewski, A. C., Chang, B. P., & Nock, M. K. (2017) · Psychological Bulletin · doi:10.1037/bul0000084 · Cited by 3,784 · see citing works
Suicide Prevention Strategies: A Systematic Review
Mann, J. J., Apter, A., Bertolote, J., Beautrais, A., Currier, D., Haas, A., Hegerl, U., Lonnqvist, J., Malone, K., Marusic, A., et al. (2005) · JAMA · doi:10.1001/jama.294.16.2064 · Cited by 2,852 · see citing works
Czeisler, M. É., Lane, R. I., Petrosky, E., Wiley, J. F., Christensen, A., Njai, R., Weaver, M. D., Robbins, R., Facer-Childs, E. R., Barger, L. K., et al. (2020) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6932a1 · Cited by 2,686 · see citing works
(2005) · JAMA · doi:10.1001/jama.294.19.2423-c · Cited by 2,325 · see citing works
Web-based Injury Statistics Query and Reporting System (WISQARS)
:unav (2009) · Harvard Dataverse · doi:10.7910/dvn/n8emxe · Cited by 1,803 · see citing works
Adolescent Suicide Attempts: Risks and Protectors
Borowsky, I. W., Ireland, M., & Resnick, M. D. (2001) · PEDIATRICS · doi:10.1542/peds.107.3.485 · Cited by 788 · see citing works
Relationship Between Household Income and Mental Disorders
Sareen, J., Afifi, T. O., McMillan, K. A., & Asmundson, G. J. G. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.15 · Cited by 685 · see citing works
Walker, E. R., Cummings, J. R., Hockenberry, J. M., & Druss, B. G. (2015) · Psychiatric Services · doi:10.1176/appi.ps.201400248 · Cited by 392 · see citing works
Latino Homicide: Immigration, Violence, and Community
Ousey, G. C., & Martinez, R. (2003) · Contemporary Sociology A Journal of Reviews · doi:10.2307/1556595 · Cited by 313 · see citing works
Wadsworth, T., & Kubrin, C. E. (2007) · American Journal of Sociology · doi:10.1086/512711 · Cited by 115 · see citing works
Monitoring Suicidal Patients in Primary Care Using Electronic Health Records
Anderson, H. D., Pace, W. D., Brandt, E., Nielsen, R., Allen, R. R., Libby, A. M., West, D. R., & Valuck, R. J. (2015) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2015.01.140181 · Cited by 101 · see citing works
Suicide among Hispanics in the United States
Silva, C., & Orden, K. V. V. (2017) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2017.07.013 · Cited by 95 · see citing works
Suicidality, ethnicity and immigration in the USA
Borges, G. L. G., Orozco, R., Rafful, C. M., Miller, E. P., & Breslau, J. A. (2011) · Psychological Medicine · doi:10.1017/s0033291711002340 · Cited by 76 · see citing works
Developing an Intervention for Suicide Prevention: A Rapid Review of Lived Experience Involvement
Watling, D. P., Preece, M. H. W., Hawgood, J. L., Bloomfield, S., & Kõlves, K. (2020) · Archives of Suicide Research · doi:10.1080/13811118.2020.1833799 · Cited by 74 · see citing works
Medical Expenditures on and by Immigrant Populations in the United States: A Systematic Review
Flavin, L., Zallman, L., McCormick, D., & Boyd, J. W. (2018) · International Journal of Health Services · doi:10.1177/0020731418791963 · Cited by 55 · see citing works
Measuring mental illness stigma among Hispanics: A systematic review.
Eghaneyan, B. H., & Murphy, E. R. (2019) · Stigma and Health · doi:10.1037/sah0000207 · Cited by 45 · see citing works
Becerra, B. J., Sis-Medina, R. C., Reyes, A., & Becerra, M. B. (2015) · Preventing Chronic Disease · doi:10.5888/pcd12.150334 · Cited by 43 · see citing works
Natural Language Processing-Based Quantication of the Mental State of Psychiatric Patients
Mukherjee, S. S., Yu, J., Won, Y., McClay, M. J., Wang, L., Rush, A. J., & Sarkar, J. (2020) · Computational Psychiatry · doi:10.1162/cpsy_a_00030 · Cited by 21 · see citing works
Chronic Physical Illness Burden and Suicidal Ideation Among Dominicans in New York City
Goldmann, E., Roberts, E. T., Parikh, N. S., & Boden-Albala, B. M. (2016) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-016-0477-0 · Cited by 15 · see citing works
Messias, E., Salas, J., & Scherrer, J. F. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.04.068 · Cited by 5 · see citing works
Hispanic Immigrants and Suicide: Overcoming Data Challenges in an Anti-immigrant Climate
Goldstein, E. V., & Wilson, F. A. (2022) · AJPM Focus · doi:10.1016/j.focus.2022.100038 · Cited by 5 · see citing works
Self-citationGoldstein, E. V., Bailey, E. V., & Wilson, F. A. (2022) · Psychiatric Services · doi:10.1176/appi.ps.20220240 · Cited by 5 · see citing works
Self-citationHispanic Suicides in Miami-Dade County, Florida, 2008–2018
Brenes, F., Beason, F. A., Koncsol, S. W., Umadhay, T., Chin, C. R., Cachon, P., & Scaccianoce, M. (2022) · Hispanic Health Care International · doi:10.1177/15404153221137339 · Cited by 4 · see citing works
Mental Health Disparities and Suicide Risk in U.S. Hispanic Immigrants
Brenes, F. (2023) · Journal of Transcultural Nursing · doi:10.1177/10436596231158137 · Cited by 3 · see citing works
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Wood, B. M., Hall, A., & Baiden, P. (2025) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2025.04.043 · Cited by 8 · see citing works
Akhtar, M., Mughees, M., Faisal, N., Aamir, J., Rehman, K. A., Raza, M. S., Afridi, M. K., Waqas, S. A., & Maleki, N. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116885 · Cited by 5 · see citing works
Automatically extracting social determinants of health for suicide: a narrative literature review
Schoene, A. M., Garverich, S., Ibrahim, I., Shah, S., Irving, B., & Dacso, C. C. (2024) · npj Mental Health Research · doi:10.1038/s44184-024-00087-6 · Cited by 5 · see citing works
Investigating Generative Artificial Intelligence Readiness in the Internet of Medical Things
Shafik, W. (2025) · Advances in computational intelligence and robotics book series · doi:10.4018/979-8-3693-6180-1.ch002 · Cited by 5 · see citing works
Acosta-Batista, C., Rios-Alonso, D., Maden, K. V., Gomez, R. M., & Rodriguez, M. V. (2026) · Cureus · doi:10.7759/cureus.103269 · Cited by 4 · see citing works
Rajwal, S., Pandey, A. K., Zhang, Z., Chen, Y., Liu, M. X., Das, S., Rogers, H., Sarker, A., & Xiao, Y. (2026) · Journal of Medical Internet Research · doi:10.2196/83793 · Cited by 1 · see citing works
Razzano, A. V. (2026) · Health Science Reports · doi:10.1002/hsr2.73083
Tharp, D., Goldstein, E. V., Medina, R., Brewer, S., Bakian, A. V., & Coon, H. H. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1358043 · Cited by 1 · see citing works
Self-citationModerators of Depression and Suicidal Ideation Among Latinos in the United StatesPreprint
Watkins, L. G., Cobb, C. L., Chung, S. Y., & Montemayor, B. N. (2025) · Research Square · doi:10.21203/rs.3.rs-6806639/v1
Rajwal, S., Pandey, A. K., Zhang, Z., Chen, Y., Liu, M. X., Das, S., Rogers, H., Sarker, A., & Xiao, Y. (2025) · doi:10.2196/preprints.83793
Watkins, L. G., Cobb, C. L., Chung, S. Y., & Montemayor, B. N. (2026) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2026.10.022
- Authors
- Goldstein, E. V., Bailey, E. V., & Wilson, F. A.
- Affiliations
- University of Utah (US)
- Corresponding author
- Goldstein, Evan V.
- Venue
- Hispanic Health Care International
- Publisher
- SAGE Publications
- Published
- 2023-06-13
- Volume
- 22
- Issue
- 1
- Pages
- 6-10
- ISSN
- 1540-4153 (ISSN-L)
- 1938-8993
- PMC
- PMC10271853
- OpenAlex
- W4380577628
- Cited by
- 11
- References
- 25
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 2
- FWCI
- 3.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hispanic Health Care International (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (UM1TR004409)
- National Center for Advancing Translational Sciences
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- poverty, suicidal ideation, Hispanic patients, mental health services, suicide risk, natural language processing, clinical text, social determinants of health, psychiatric treatment, COVID-19 pandemic
- MeSH terms
- COVID-19, Cross-Sectional Studies, Hispanic or Latino, Humans, Mental Health, Poverty, Risk Factors, Suicide, Attempted, Pandemics, Suicidal Ideation
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