Suicidal Ideation and Its Clinical and Psychosocial Correlates among Adolescents: A Mixed-method Study

Abstract Introduction: Suicide is the most prevalent and second-leading cause of death among adolescents. With every fifth Indian being an adolescent, the cost of an adolescent dying by suicide is enormous. Early recognition and treatment of suicidal ideation may prevent suicide among adolescents. This necessitates understanding the potential risk factors of suicidal ideation among adolescents. Aim: The study aims to explore suicidal ideation and its clinical and psychosocial correlates among adolescents, which may influence suicidal ideation in adolescents. Setting and Design: The study was carried out in a tertiary care hospital, both in the outpatient and inpatient departments in the Child and Adolescent Psychiatry Department, NIMHANS, Bengaluru. The convergence–concurrent (parallel) design was employed for the study using a mixed-method approach. Subjects and Methods: A total of n = 81 adolescents were selected using convenience sampling for the quantitative approach, and among them, those who have suicidal ideation were selected for qualitative data collection using purposive sampling during quantitative data collection. Data collection was done for the qualitative approach from 30 adolescents. The Columbia-Suicide Severity Rating Scale (C-SSRS) is used for the data collection on suicidal ideation for both approaches. Statistical Analysis: The association between clinical and psychosocial variables with suicidal ideation were analyzed using Pearson’s Chi-square test, Fisher’s exact test, and linear-by-linear association test. Qualitative data were collected, organized, and analyzed with thematic analysis using ATLAS Ti software. Results: Quantitative data ( n = 81) revealed a significant association at p < 0.05 between suicidal ideation and clinical variables, type of illness, the severity of disease, and past suicidal attempts and also between psychosocial variables including abuse experienced; hence, the null hypotheses were rejected. The qualitative analysis identified three major themes and 5 subthemes of suicidal ideation – Intent, method and plan, and five themes of clinical and psychosocial factors that may influence suicidal ideation. The salient findings of quantitative and qualitative data were integrated. Conclusion: The significant factors found in the present study, severity of illness, past suicidal attempts, and experience of abuse, are essential in identifying suicidal ideation among adolescents. To prevent suicidal attempts among adolescents or any age group, it is vital to understand the associated factors of suicide.