Prevalence and Predictors of Suicidal Ideations Among Students in Public National Schools in Nairobi

Abstract

Introduction: Suicidal ideation is a precursor to suicide which is a significant public health issue affecting adolescents globally. Suicide ideation is complex with multiple predicting factors which lead an individual on the suicidal path. There is need for systematic collection of suicide data which is lacking in Kenya. Identifying the specific predicting factors and understanding their roles in suicidal behaviour are central to preventing suicides. Aim: Determined the Prevalence and Predictors of suicidal ideation among students in Public National schools in Nairobi. Methods: The study was a descriptive cross sectional study where the dependent variable, suicidal ideation, and independent variables, family conflict, depression, bullying, alcohol and substance abuse were compared and analysed for significant association. A total of 330 students from 2 schools participated. Self-administered study tool was used. It included sociodemographic questionnaire, AUDIT, DAST-20 Adolescent version, PHQ-9, Illinois bullying scale and modified family conflict questionnaire. For triangulation key informants interviews were conducted to 10 teachers selected by purposive sampling. Data analysis: Qualitative data was analysed by Qualitative Solution for Research (QSR) Nvivo 10, whereby all transcripts was uploaded in Nvivo software and nodes were created thematically using a grounded theory approach and presented as a narrative. Study utilized exploratory data analysis techniques and multivariate logistic regression. The Quantitative data was managed by IBM SPSS version 22.0 and results presented using tables of frequency and percentages, graphs, pie chart, chi-squared tests for categorical variables and t-tests for continuous variables were used. All tests were two sided with level of significance set at P<0.05. Results: The overall prevalence of suicidal ideation was 26.7% (95% C.I 21.5% to 31.2%). Females were 1.17 times more likely to have suicidal ideation as compared to males. Form 3 students reported the highest prevalence of 35.9%.Psychosocial factors association with suicidal ideation were; participants with moderate family conflict were 2 times more (A.O.R=2.18 95%C.I. 1.19-4.02; P=0.012), with depression 4 times more (A.O.R=3.61 95%C.I. 1.94-6.70; P<0.001). For every unit increase in bullying the level of suicidality increases by 1.06 times more (A.O.R=1.06 95%C.I. 1.01-1.50; P=0.008).Most teachers cited family conflict (n=9) as significant predictor, followed by academic pressure (n=4) and depressive illness (n=4). Conclusion: Suicidal ideation is common among high school students. Family conflict, depression and bullying were statistically significant. Finding will provide data to guide policy and initiate preventive measures to prevent premature deaths by suicide.