The impact of violence at home to psychoemotional distress, well-being and suicidal risk: a massive mental health screening using smartphones

Abstract

Violence at home and mental health disorders are psychosocial factors related to suicidality. In Mexico, these factors are claimed to be associated with suicides from adolescents to elders. This study aimed to replicate a study undertaken in 2019 to explore the relationship between well-being and suicidality, adding violence at home together with emotional distress in the Mexican State of Yucatan after the COVID-19 outbreak. A cross-sectional study was carried out with 32,530 citizens who were surveyed using a smartphone app, and partial least squares structural equation models were applied. We examined whether domestic violence operates primarily indirectly—via depression or anxiety—on suicidality and whether associations differ by gender. A total of 17,846 complete cases (from 15 to 80 years old) responded. Depression showed the strongest direct association with suicidality, with concomitant links to higher anxiety and lower well‑being. Domestic violence had no direct path to suicidality but showed a significant total (indirect) effect via depression and anxiety. Gender‑stratified models indicated differences across sex; namely, a non‑significant anxiety to suicidality path among women, and a non‑significant well‑being to suicidality path among men. Domestic violence was reported as frequent/very frequent a 12.0% of the sample, high suicidality in 10.3%, clinically relevant anxiety in 12.2%, and low well‑being in 27.3%. Well-being was protective against suicidal risk except in men, while anxiety was unrelated to suicidality in women. Findings support a stress–appraisal pathway where domestic violence acts as a chronic stressor primarily increasing suicidality indirectly via emotional distress, with gender-specific patterns. At system level, population-scale digital screening can complement community detection and referral in Yucatán.