Association Between Consultation Themes and Suicidal Ideation Among Callers to the Hangzhou Mental Health Hotline: A Gender-Stratified Cross-Sectional Study

Abstract

Objective: This cross-sectional study aims to investigate the association between consultation themes and suicidal ideation among callers to the Hangzhou Mental Health Hotline using data from 128,245 hotline calls made between January 1, 2014, and December 31, 2023. The study specifically focuses on gender disparities in this association. Methods: The study analyzed hotline calls, distinguishing between those with and without suicidal ideation. Propensity score matching was employed for group comparability, and logistic regression explored the link between consultation themes and suicidal ideation, adjusting for confounders. A gender-stratified analysis aimed to identify gender-specific patterns. Results: The prevalence of suicidal ideation among callers was 9.6%, with a higher incidence observed among females (54.1%) and individuals aged 10-19 years (25.5%). Logistic regression analysis revealed significant associations between consultation themes and suicidal ideation. Mental health issues (OR = 3.00, 95% CI: 2.90-3.11), romantic relationship dilemmas (OR = 1.89, 95% CI: 1.78-2.01), and marital/family problems (OR = 1.81, 95% CI: 1.70-1.93) were strongly linked to suicidal ideation. Additionally, physical illness discussions had a significantly higher association with suicidal ideation in females (OR = 5.87, 95% CI: 3.46-9.94) than in males (OR = 2.89, 95% CI: 1.95-4.31). Notably, consultations on sexual issues were inversely associated with suicidal ideation in males (OR = 0.12, 95% CI: 0.06-0.20), providing a protective effect. However , work-related issues were significantly associated with suicidal ideation in females (OR = 2.19, 95% CI: 1.52-3.13), indicating increased vulnerability in this demographic. Conclusion: The study’s results indicate a notable link between specific consultation themes and suicidal ideation, with the highest risks associated with mental health issues, relationship dilemmas, and family problems. Gender differences were pronounced, highlighting the need for gender-sensitive approaches in addressing suicidal ideation, especially regarding physical illness and work-related stress. The findings suggest that targeted interventions in hotline services could significantly impact suicide prevention, particularly for high-risk groups.