(PS11-2) A National Study of Greek-life Affiliation and Suicidality Among College Students

Suicidality among young adults is a rising public health concern across college campuses. Greek-life involvement is often perceived negatively because it is associated with risky behaviors among college students, such sexual risk-related behaviors and nonmedical prescription drug use, as well as generally lower mental health. However, involvement in Greek organizations could also plausibly provide a sense of social connectedness, which may be protective against suicidality. Understanding the current national prevalence of suicidality among students involved in Greek-life can help inform interventions tailored to this population. Using data from the American College Health Association-National College Health Assessment III, a cross-sectional survey of mental and physical health, we examined the extent to which Greek-life affiliation is associated with risk for suicidality. Our analyses included 90,027 undergraduate students (ages 18-24) from 203 universities between Fall 2021 and Fall 2022. The sample was majority cis-female (62.9%) and White (62.4%). Students self-reported suicidal ideation, suicide attempt, and self-harm in the past year, and we additionally assessed suicide risk with scores from the Suicide Behaviors Questionnaire-Revised. Among included undergraduates, 8.2% reported non-residential Greek-life affiliation (i.e., without living in a fraternity or sorority), and 1.8% reported residential Greek-life affiliation. Of those groups, 23.7% and 24.1%, respectively, had an elevated suicide risk score, compared with 30.2% of non-Greek-life students. After accounting for potential individual- and university-level sociodemographic confounders, we found negative associations between Greek-life affiliation and suicidal ideation, self-harm, and suicide risk score (analytic Ns ≥ 88,341). For example, in modified Poisson regression accounting for the clustering of students within universities, students with residential Greek-life affiliation had lower risk of suicidal ideation than non-Greek-life students (relative risk [RR], 0.89 [95% CI, 0.81-0.97]), and this risk was similarly lower for non-residential Greek-life students (RR, 0.85 [95% CI, 0.81-0.89]). In contrast, risk of suicide attempt was greater (RR, 1.47 [95% CI, 1.19-1.82]) or comparable (RR, 1.00 [95% CI, 0.86-1.17]) among students with residential and non-residential Greek-life affiliation, respectively, compared with non-Greek-life students. Overall, our findings support the possibility that Greek-life affiliation may be a protective factor for some facets of suicidality, particularly suicidal ideation, self-harm, and a validated suicide risk score. However, any putative protection may not extend to suicide attempt, particularly among students in Greek-life residences, who had greater risk of suicide attempt relative to non-Greek-life students. Further research is needed to disentangle possible processes underlying suicidality and suicide attempt among Greek-life students.