Suicidal ideation and attempt among school going adolescents in Bhutan – a secondary analysis of a global school-based student health survey in Bhutan 2016

Abstract

BackgroundSuicide is one of the leading causes of death and Disability Adjusted Life Years (DALYs) worldwide. The economic, emotional and human cost of suicidal behaviour to individuals, families, communities and society makes it a serious public health issue. We aim to determine the prevalence and factors associated with self-reported suicidal behaviour (suicidal ideation and attempt) among school going adolescents (13–17 years).MethodsThis is a secondary analysis of a nationally representative data for Bhutan namely Global School Based Student Health Survey in 2016 which reports on various dimensions of adolescent health including suicidal behaviour. The survey employed a multistage sampling method to recruit participants aged 13–17 years (n = 5809) from 50 schools (25 each in rural and urban area). The survey used an anonymous self-administered pre-tested 84-item questionnaire. Weighted analysis was done. Adjusted prevalence ratios (aPRs) and adjusted Odds Ratios (aORs) have been presented with 95% confidence intervals (95% CI).ResultsA total of 667 (11.6%) adolescents reported considering a suicide attempt whereas 656 (11.3%) reported attempting suicide in the past 12 months. Among those reporting suicidal ideation, 388 (58.6%) reported attempting a suicide and 274 (41.4%) had ideation alone, whereas, 247 (38.9%) reported attempting a suicide without previous ideation. Female sex, food insecurity, physical attack, sexual violence, bullying, feeling of loneliness, low parental engagement, reported worry about lack of sleep, urge to use drugs/alcohol, smokeless tobacco use, drug abuse and parental smoking were the factors associated with suicidal attempt. All these factors except smokeless tobacco use and parental smoking were associated with suicidal ideation. Having helpful/close friends was found to be protective against suicide ideation.ConclusionSuicidal behaviour among school going adolescents in Bhutan is high and alarming, especially among girls. Bullying, sexual violence, feeling of loneliness and drug abuse were some of the key risk factors identified. It is important to identify these risk factors early and effectively tackle them in order to prevent suicides. It requires a multi-faceted intervention with the support of the children, community, teachers and parents.

Impact of Parents’ Knowledge about the Development of Self-Esteem in Adolescents and Their Parenting Practice on the Self-Esteem and Suicidal Behavior of Urban High School Students in Nepal

“…Nepalese adolescents have high rates of health and social vulnerabilities and psychosocial problems, and they are especially higher among girls. Furthermore, the psychosocial well-being of adolescents is also affected by their SES in Nepal [84]. Despite efforts to reduce gender inequality, women/girls in Nepal are still marginalized in society (e.g., discrepancy in the available roles, priorities, opportunities, and resources) which affects their health, development and well-being [85].…”

Prevalence and associated factors of suicidality in Japanese adolescents: results from a population-based questionnaire survey

“…In some Western countries, the reported prevalence of suicidal ideation was 12.1-22.0% and that of suicidal attempts was 1.0-7.6% [3][4][5][6][7]. However, low-and middle-income countries showed higher prevalence rates [8][9][10], and some Asian countries had equal or lower prevalence rates than those reported for Western countries [11][12][13].…”

Relationships Between Parental Involvement and Suicidal Ideation among In-school Adolescents in Vietnam: A Multilevel Analysis of the Global School-Based Student Health Survey 2019

“…Previous studies found that adolescents connected to their parents were less likely to commit suicide (Kidd et al 2006), and parental support and supervision were linked to low suicidal ideation and attempt (Dema et al 2019;Peltzer and Pengpid 2017;Putra et al 2019). However, the recent study using data from 48 LMICs indicated that parental over-protection (i.e., too much parental care and monitoring) was associated with higher odds of suicidal ideation and suicide plan among adolescents (Kim 2019).…”

“…The reasons behind suicidal behaviors are complex and affected by a variety of risk factors at multiple levels. At the individual level, these factors include demographic characteristics: higher age, a few close friends (Peltzer and Pengpid 2017; Putra et al 2019; Uddin et al 2019); mental health disorders: depression, anxiety, poor self-esteem, loneliness (Itani et al 2017; Putra et al 2019; Shayo and Lawala 2019; Wilson et al 2012); lifestyle risk behaviors: drugs use, drinking, smoking (Almansour and Siziya 2017; Itani et al 2017; Peltzer and Pengpid 2015; Putra et al 2019); peer victimization: being violence, bullying victim, involved in the physical fight (Almansour and Siziya 2017; Dema et al 2019; Page and West 2011); and poor academic performance (Almansour and Siziya 2017). At the household level, parental separation, parental divorce, or poor family relationships are the key factors associated with suicidal behaviors (Hawton et al 2012; McMahon et al 2010).…”