Latent profiles of mental health in older adults living in nursing homes: the challenge of suicide prevention

Objectives: Suicide prevention in nursing homes requires a deeper understanding of the psychological mechanisms underlying suicidal ideation. This study aimed to identify mental health profiles in institutionalized older adults based on risk and protective variables, and to explore their association with suicidal ideation. Methods: A total of 231 older adults (60-97 years) from nine Spanish nursing homes were assessed on depression, hopelessness, perceived burden, purpose in life, resilience, and self-efficacy. Latent Profile Analysis (LPA) was used to identify distinct profiles, and ANCOVA tested differences in suicidal ideation across groups. Results: Four psychological profiles were identified: (1) High Risk (high symptomatology, low protection), (2) Burdensomeness (low depression and hopelessness, high burden), (3) Weakened Strengths (low symptomatology, low resources), and (4) Optimal Mental Health (low risk, high protection). Suicidal ideation levels differed significantly across profiles, and these differences remained after controlling for age, sex, and perceived health. The High Risk group showed the highest levels of suicidal ideation, whereas the Optimal Mental Health group showed the lowest. Conclusion: These profiles offer a basis for more personalized and effective prevention interventions tailored to each group's risk-protection balance. Screening for suicidal ideation in nursing homes should incorporate both risk factors (depression, hopelessness, perceived burden) and protective factors (resilience, purpose in life, self-efficacy). A person-centered approach allows gerontologists to tailor prevention strategies to specific psychological profiles.