Prevalence and associated determinants of suicidal ideation and attempt among adolescents; a descriptive cross-sectional study at public and private schools of Jhang, Pakistan

Abstract Background Suicidal ideation and attempts among adolescents constitute a significant public health challenge globally, with varying prevalence rates influenced by socio-cultural, economic, and psychological factors. In Pakistan, where mental health awareness is limited, understanding the determinants of these phenomena is crucial. This study aims to assess the prevalence of suicidal thoughts and behaviors among adolescents in both public and private schools in Jhang, exploring associated factors such as socioeconomic status, academic pressure, and familial relationships. Methods This descriptive cross-sectional study was conducted in Jhang, Pakistan, targeting adolescents aged 12 to 18 years enrolled in both public and private schools. A multi-stage sampling technique was used to ensure a representative sample, with schools selected randomly from each sector. The final sample size was determined to be 384 students, calculated using the following statistical parameters: a 5% margin of error (e), a 95% level of confidence (z), a prevalence (p) of suicidal ideation estimated at 50%, and a 10% non-response rate. Data was collected using an adapted version of Columbia severity rating scale that assessed suicidal ideation and attempts, alongside potential associated determinants such as socio-economic status, and familial factors. Statistical analysis was performed using SPSS software, employing descriptive statistics to determine prevalence rates and chi square test to identify significant associations between variables. p values less than 0.05 was considered statistically significant. Ethical approval was obtained from relevant authorities, and informed consent was secured from participants and their guardian. Results Most of the respondents were males 236 (61.30%), having urban residence 300 (77.92%). The findings from the current study revealed a 25% lifetime prevalence of suicidal ideation while 22% of adolescents were involved in suicidal behavior during their lifetime. 17 (4.42%) of the participants were involved in actual attempts in a lifetime while 7 (1.82%) in past three months. Family history of suicide attempts with and without death, substance abuse, and use of social media were significantly associated with suicidal ideation and behavior. Conclusion A 25% lifetime prevalence of suicidal ideation and 22% of suicidal behavior is alarming and critical. Government, semi-government non- government concerned departments should design strategies to minimize risk.