Interpersonal violence and substance use: mental health and self-harm/suicide among Mexicans in VDS-UMS in the United States

BackgroundInterpersonal violence victimization (IVV) is associated with adverse mental health outcomes, including substance use, self-harm, and suicidal thoughts and behaviors. This study examined the relationships among these conditions in Mexican immigrants living in the United States, stratified by sex and mental health treatment-seeking status.MethodsWe conducted a cross-sectional study of 896 Mexican immigrants residing in the United States. Participants were predominantly women (72%), and 71% were seeking mental health treatment. Structural equation models were estimated for the overall sample and separately by sex and treatment-seeking status.ResultsIVV was associated with posttraumatic stress symptoms and substance use. Substance use and depressive symptoms were, in turn, associated with self-harm and suicidal thoughts and behaviors. These associations were consistent across sex and treatment-seeking groups. Substance use contributed more strongly to the model among men, whereas posttraumatic stress symptoms contributed more strongly among participants seeking mental health treatment.ConclusionMexican immigrants visiting the Ventanillas de Salud and Mobile Health Units (VDS-UMS) reported psychoactive substance use associated with interpersonal violence victimization and self-harm and suicidal thoughts and behaviors, whereas depressive symptoms were independently related to suicide risk. These findings support integrated screening and treatment strategies addressing violence exposure, substance use, and mental health symptoms among Mexican immigrants served through these programs in the United States, all within the context of stressors that interact with vulnerability associated with migration.Clinical implicationsIntegrating screening and early intervention for interpersonal violence victimization and substance use within existing binational community mental health programs may reduce self-harm and suicidal behaviors among Mexican immigrants.