IMPORTANCE Although suicide attempts remain the strongest risk factor for future suicide, little is known about recent trends in the prevalence of and risk factors for suicide attempts and past-year use of services among adults who attempted suicide. OBJECTIVE To estimate annual rates of suicide attempts and use of mental health services among US adults from 2008 to 2019. DESIGN, SETTING, AND PARTICIPANTS This US nationally representative cross-sectional study used the National Survey of Drug Use and Health (NSDUH) from 2008 through 2019. Participants included noninstitutionalized US civilians 18 years or older (n = 484 732). The overall annual rates of suicide attempts per 100 000 adults in the general population and national trends from 2008 to 2019 were estimated, with suicide attempts defined as self-reported efforts to kill one's self in the past 12 months. Subgroup analyses were also performed by demographic characteristics and clinical conditions. The trends in past-year use of mental health services among those who reported past-year suicide attempts were then examined. Data were analyzed from October to December 2021. MAIN OUTCOMES AND MEASURES Rate of suicide attempts from 2008 to 2019. Multivariate-adjusted logistic regression analyses were used to determine whether adjusting for sociodemographic and clinical factors associated with past-year suicide attempts could account for the change within the study period. RESULTS Of 484 732 survey participants, most were 35 years or younger (69.8%), women (51.8%), and non-Hispanic White individuals (65.7%). From 2008 to 2019, the weighted unadjusted suicide attempt rate per 100 000 population increased from 481.2 to 563.9 (odds ratio [OR], 1.17 [95% CI, 1.01-1.36]; P = .04) and remained significant after controlling for sociodemographic characteristics (adjusted OR [aOR], 1.23 [95% CI, 1.05-1.44]; P = .01). Rates of suicide attempt increased particularly among young adults aged 18 to 25 years (aOR, 1.81 [95% CI, 1.52-2.16]; P < .001), women (aOR, 1.33 [95% CI, 1.09-1.62]; P = .005), those who were unemployed (aOR, 2.22 [95% CI, 1.58-3.12]; P < .001) or never married (aOR, 1.60 [95% CI, 1.31-1.96]; P < .001), and individuals who used substances (aOR, 1.44 [95% CI, 1.19-1.75]; P < .001). In multivariate analyses, the temporal trend of increasing suicide attempts remained significant even after controlling for other significant sociodemographic and clinical factors (aOR, 1.36 [95% CI, 1.16-1.60]; P < .001). Several sociodemographic and clinical subgroups remained independently associated with suicide attempts, especially those with serious psychological distress (aOR, 7.51 [95% CI, 6.49-8.68]; P < .001), major depressive episodes (aOR, 2.90 [95% CI, 2.57-3.27]; P < .001), and alcohol use disorder (aOR, 1.81 [95%CI, 1.61-2.04]; P< .001) as well as individuals who reported being divorced or separated (aOR, 1.65 [95% CI, 1.35-2.02]; P < .001) or being unemployed (aOR, 1.47 [95% CI, 1.27-1.70]; P< .001) and those who identified as Black (aOR, 1.41 [95% CI, 1.24-1.60]; P < .001) or American Indian or Alaska Native, Asian, or Native Hawaiian or Other Pacific Islander (aOR, 1.56 [95% CI, 1.26-1.93]; P < .001). Among adults with a suicide attempt, there was no significant change in the likelihood of receiving past-year mental health or substance-related services. During the study period, 34.8% to 45.5% reported needing services but did not receive them, with no significant change from 2008 to 2019. CONCLUSIONS AND RELEVANCE Although suicide attempts appear to be increasing, use of services among those who attempted suicide has not increased, suggesting a need to expand service accessibility and/or acceptability, as well as population-wide prevention efforts.

中文翻译：

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过去 12 个月内企图自杀的美国成年人心理保健全国趋势。

重要性 尽管自杀未遂仍然是未来自杀的最强风险因素，但人们对自杀未遂的流行趋势和危险因素以及自杀未遂成年人过去一年使用服务的近期趋势知之甚少。目的 估计 2008 年至 2019 年美国成年人自杀未遂和使用心理健康服务的年发生率。设计、地点和参与者 这项美国具有全国代表性的横断面研究使用了 2008 年的全国药物使用和健康调查 (NSDUH)到 2019 年。参与者包括 18 岁或以上的非机构化美国平民 (n = 484 732)。估计了 2008 年至 2019 年普通人群中每 100 000 名成年人的总体年自杀未遂率和全国趋势，其中自杀未遂定义为自我报告的企图杀死一个人的行为。过去 12 个月内的自我。还根据人口统计学特征和临床状况进行了亚组分析。然后检查报告过去一年自杀未遂的人过去一年使用心理健康服务的趋势。分析了 2021 年 10 月至 2021 年 12 月的数据。主要结果和测量指标 2008 年至 2019 年自杀未遂率。使用多变量调整逻辑回归分析来确定调整与过去一年自杀未遂相关的社会人口学和临床因素是否可以解释自杀未遂率。研究期内的变化。结果 在 484 732 名调查参与者中，大多数为 35 岁或以下 (69.8%)、女性 (51.8%) 和非西班牙裔白人 (65.7%)。从 2008 年到 2019 年，每 10 万人的加权未经调整的自杀未遂率从 481.2 上升到 563。9（比值比 [OR]，1.17 [95% CI，1.01-1.36]；P = .04）并且在控制社会人口特征后仍然显着（调整后的 OR [aOR]，1.23 [95% CI，1.05-1.44]； P = .01）。自杀未遂率增加，尤其是在 18 至 25 岁的年轻人中 (aOR，1.81 [95% CI，1.52-2.16]；P < .001)，女性 (aOR，1.33 [95% CI，1.09-1.62]；P = .005)、失业者 (aOR, 2.22 [95% CI, 1.58-3.12]; P < .001) 或从未结婚 (aOR, 1.60 [95% CI, 1.31-1.96]; P < .001) , 以及使用物质的个体 (aOR, 1.44 [95% CI, 1.19-1.75]; P < .001)。在多变量分析中，即使在控制了其他重要的社会人口学和临床因素后，自杀未遂增加的时间趋势仍然显着 (aOR，1.36 [95% CI，1.16-1.60]；P < .001)。几个社会人口学和临床亚组仍然与自杀未遂独立相关，尤其是那些有严重心理困扰（aOR，7.51 [95% CI，6.49-8.68]；P < .001）、重度抑郁发作（aOR，2.90 [95% CI， 2.57-3.27]；P < .001）和酒精使用障碍（aOR，1.81 [95%CI，1.61-2.04]；P<.001）以及报告离婚或分居的个人（aOR，1.65 [95 % CI, 1.35-2.02]; P < .001) 或失业 (aOR, 1.47 [95% CI, 1.27-1.70]; P< .001) 以及被认定为黑人的人 (aOR, 1.41 [95% CI, 1.24-1.60]；P < .001）或美洲印第安人或阿拉斯加原住民、亚洲人或夏威夷原住民或其他太平洋岛民（aOR，1.56 [95% CI，1.26-1.93]；P < .001）。在有自杀未遂的成年人中，接受去年心理健康或物质相关服务的可能性没有显着变化。在研究期间，34.8% 到 45.5% 的人报告需要服务但没有得到服务，从 2008 年到 2019 年没有显着变化。结论和相关性 尽管自杀未遂似乎在增加，但自杀未遂者对服务的使用并没有增加，表明需要扩大服务的可及性和/或可接受性，以及全民预防工作。