Abstract
There is an increasing recognition that suicidal ideation is a major public health concern in sub-Saharan Africa. We employed a case study design, taking a case study of adolescents currently under the care of Uganda Youth Development Link (UYDEL). The data analyzed were collected from 219 female and male adolescents (13–19 years) recruited through UYDEL in Kampala, Uganda. A Poisson regression model with robust variance was used to assess the risk factors associated with suicidality. The prevalence of suicidal ideation in the past 4 weeks and attempt within the past 6 months among adolescents was 30.6% (95% CI: 24.8, 38.0%) and 24.2% (95% CI: 18.7, 30.4%), respectively. The most stressful precursors of suicidal ideation or attempt included financial difficulties (59.5%), family breakdown or conflicts (37.4%), and trauma (23.1%). Suicidal ideation in the past 1 week preceding the survey was as high as 13.3% (95% CI: 9.0, 18.6%), of which 75.0% (95% CI: 55.1%, 89.3%) had a suicide plan. Prevalence of suicidal ideation in the past 4 weeks was significantly higher among respondents with moderate psychological distress [Prevalence Ratio (PRR) = 2.74; 95% CI: 0.96, 7.84] and severe psychological distress (PRR = 4.75; 95% CI: 1.72, 13.08) but lower among adolescents who knew where to obtain professional psychological care (PRR = 0.51; 95% CI: 0.30, 0.87). Similarly, suicidal attempt was significantly higher among respondents with moderate psychological distress (PRR = 4.72; 95% CI: 1.01, 12.03) and severe psychological distress (PRR = 11.8; 95% CI: 4.66, 32.37), and who abuse drugs or substances (PRR = 2.13; 95% CI: 1.13, 4.01). Therefore, suicidal ideation is a major public health issue among adolescents living in poor urban settlements in Kampala, Uganda. Psychological distress due to financial difficulties, unemployment, and family breakdown are major facilitators of suicidality among adolescents in urban poor settlements in Kampala. Interventions aimed at preventing suicide among vulnerable adolescents in urban settlements in Kampala, Uganda should incorporate this unique risk factor profile.
Highlights
Suicide is a major public health concern (Luxton et al, 2012) and one of the leading causes of death among adolescents ages 15–19 years (Hottes et al, 2015; Gjertsen et al, 2019; World Health Organization (WHO), 2020a)
Suicidal ideation was lower among adolescents who knew where to obtain professional psychological care (PRR = 0.51; 95% CI: 0.30, 0.87)
Adolescents who abuse drugs or substances had a higher prevalence of suicide attempts than those who do not (PR = 2.13; 95% CI: 1.13, 4.01)
Summary
Suicide is a major public health concern (Luxton et al, 2012) and one of the leading causes of death among adolescents ages 15–19 years (Hottes et al, 2015; Gjertsen et al, 2019; WHO, 2020a). There is an increasing recognition that suicidal ideation is a major public health concern in sub-Saharan Africa (SSA) (Page and West, 2011; Quarshie et al, 2020). A few studies in Uganda have indicated that suicidal ideation among youth in Uganda is high in rural areas (21.6%) (Rudatsikira et al, 2007). Other studies (Culbreth et al, 2018, 2021) have reported suicide ideation to be 24% among young people living in urban areas of Uganda. Suicidal ideation and attempts are likely higher among youth living in the slums or on the streets due to the severe psychosocial challenges they face (Swahn et al, 2012). This study hypothesized that suicidal ideations and attempts among vulnerable urban youth receiving support from the Uganda Youth Development Link (UYDEL) could be experiencing higher rates of suicidal ideation and attempts than their youth counterparts
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