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      The prevalence and correlates of suicidal behaviours (ideation, plan and attempt) among adolescents in senior high schools in Ghana

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          Abstract

          Suicide is recognised as the third leading cause of death among adolescents globally. There is however limited data on the prevalence and factors associated with suicide particularly in Ghana. To explore the prevalence and risk and protective factors associated with suicide in Ghana, a nationwide Global School-based Student Health Survey data collected among senior high school adolescents in Ghana was used. The prevalence of suicidal behaviours was 18.2%, 22.5% and 22.2% for suicidal ideation, suicidal plan and suicidal attempt respectively. In the final analysis, anxiety increases the odds of suicidal behaviour, even after controlling for other variables. Loneliness increases the odds of suicidal behaviour but after adjusting for other factors the odds remained for only suicidal plan. Being bullied, physically attacked, involved in a physical fight and food insecurity remained risk factors for suicidal behaviour (i.e. ideation, plan and attempt) after adjusting for other factors. Truancy was found as a risk factor for both suicidal ideation and plans but such effect diminished for suicidal plan after adjusting for other variables. Increasing number of close friends remained a risk factor for both suicidal plan and attempt but such effect diminished for suicidal ideation after adjusting for other variables. Parental understanding of adolescents’ problems and worries remained a significant protective factor for all the indices of suicidal behaviour after adjusting for other variables. Parental respect for privacy was protective of suicidal attempt but was not significant after adjusting for other variables. Early identification and intervention for at-risk adolescents in senior high schools, for example those experiencing different forms of physical abuse, drug and substance use and hunger can potentially reduce the prevalence of suicide among this population in Ghana.

          Highlights

          • •

            The study showed high prevalence of suicidal behaviour among school-going adolescents.

          • •

            Anxiety, loneliness, hunger, physical abuse, bullying and the lack of parental understanding were strongly related suicidal behaviour.

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            Interventions for suicide prevention should take into consideration the school and family settings.

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          Most cited references38

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          The relationship between nonsuicidal self-injury and attempted suicide: converging evidence from four samples.

          Travis Glenn, E Klonsky, Rhea M May (2013)
          Theoretical and empirical literature suggests that nonsuicidal self-injury (NSSI) may represent a particularly important risk factor for suicide. The present study examined the associations of NSSI and established suicide risk factors to attempted suicide in four samples: adolescent psychiatric patients (n = 139), adolescent high school students (n = 426), university undergraduates (n = 1,364), and a random-digit dialing sample of United States adults (n = 438). All samples were administered measures of NSSI, suicide ideation, and suicide attempts; the first three samples were also administered measures of depression, anxiety, impulsivity, and borderline personality disorder (BPD). In all four samples, NSSI exhibited a robust relationship to attempted suicide (median Phi = .36). Only suicide ideation exhibited a stronger relationship to attempted suicide (median Phi = .47), whereas associations were smaller for BPD (median rpb = .29), depression (median rpb = .24), anxiety (median rpb = .16), and impulsivity (median rpb = .11). When these known suicide risk factors and NSSI were simultaneously entered into logistic regression analyses, only NSSI and suicide ideation maintained significant associations with attempted suicide. Results suggest that NSSI is an especially important risk factor for suicide. Findings are interpreted in the context of Joiner's interpersonal-psychological theory of suicide; specifically, NSSI may be a uniquely important risk factor for suicide because its presence is associated with both increased desire and capability for suicide. 2013 APA, all rights reserved
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            Rebuilding the tower of Babel: a revised nomenclature for the study of suicide and suicidal behaviors. Part 1: Background, rationale, and methodology.

            Morton Silverman, Alan L Berman, Nels Sanddal … (2007)
            Article 0 comments Cited 129 times – based on 0 reviews     Review now
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              The Good School Toolkit for reducing physical violence from school staff to primary school students: a cluster-randomised controlled trial in Uganda

              Karen Devries, Louise Knight, Jennifer Child … (2015)
              Summary Background Violence against children from school staff is widespread in various settings, but few interventions address this. We tested whether the Good School Toolkit—a complex behavioural intervention designed by Ugandan not-for-profit organisation Raising Voices—could reduce physical violence from school staff to Ugandan primary school children. Methods We randomly selected 42 primary schools (clusters) from 151 schools in Luwero District, Uganda, with more than 40 primary 5 students and no existing governance interventions. All schools agreed to be enrolled. All students in primary 5, 6, and 7 (approximate ages 11–14 years) and all staff members who spoke either English or Luganda and could provide informed consent were eligible for participation in cross-sectional baseline and endline surveys in June–July 2012 and 2014, respectively. We randomly assigned 21 schools to receive the Good School Toolkit and 21 to a waitlisted control group in September, 2012. The intervention was implemented from September, 2012, to April, 2014. Owing to the nature of the intervention, it was not possible to mask assignment. The primary outcome, assessed in 2014, was past week physical violence from school staff, measured by students' self-reports using the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool—Child Institutional. Analyses were by intention to treat, and are adjusted for clustering within schools and for baseline school-level means of continuous outcomes. The trial is registered at clinicaltrials.gov, NCT01678846. Findings No schools left the study. At 18-month follow-up, 3820 (92·4%) of 4138 randomly sampled students participated in a cross-sectional survey. Prevalence of past week physical violence was lower in the intervention schools (595/1921, 31·0%) than in the control schools (924/1899, 48·7%; odds ratio 0·40, 95% CI 0·26–0·64, p<0·0001). No adverse events related to the intervention were detected, but 434 children were referred to child protective services because of what they disclosed in the follow-up survey. Interpretation The Good School Toolkit is an effective intervention to reduce violence against children from school staff in Ugandan primary schools. Funding MRC, DfID, Wellcome Trust, Hewlett Foundation.
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                Author and article information

                Contributors
                Kwaku Oppong Asante
                Journal
                Journal ID (nlm-ta): SSM Popul Health
                Journal ID (iso-abbrev): SSM Popul Health
                Title: SSM - Population Health
                Publisher: Elsevier
                ISSN (Electronic): 2352-8273
                Publication date PMC-release: 06 May 2017
                Publication date Collection: December 2017
                Publication date (Electronic): 06 May 2017
                Volume: 3
                Pages: 427-434
                Affiliations
                [a ]Department of Psychology, University of Ghana, Accra, Ghana
                [b ]Institute for Psychosocial Research in Child and Adolescent Wellbeing, Accra, Ghana
                [c ]Department of Family & Community Health, University of Health and Allied Sciences, Hohoe, Ghana
                [d ]School of Psychology, University of Leeds, Leeds, West Yorkshire, UK
                [e ]Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
                Author notes
                [* ]Corresponding author at: Department of Psychology, University of Ghana, P. O. Box LG 84, Legon, Accra, Ghana. kwappong@ 123456gmail.com koppongasante@ 123456ug.edu.gh
                Article
                Publisher ID: S2352-8273(17)30032-0
                DOI: 10.1016/j.ssmph.2017.05.005
                PMC ID: 5769048
                PubMed ID: 29349236
                SO-VID: 8426b040-cc77-4826-a65c-6e7adaee1fe5
                Copyright © © 2017 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 6 February 2017
                Date revision received : 4 May 2017
                Date accepted : 5 May 2017
                Categories
                Subject: Article

                Keywords: suicide,adolescents,risk and protective factors,ghana
                Data availability:
                Keywords: suicide, adolescents, risk and protective factors, ghana

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