Suicidal ideation and suicide attempts among adolescents and youth in the aftermath of the Tigray war, 2024: prevalence and associated factors

Background Suicide is a leading cause of death among adolescents and youth globally and represents an important public health concern in low- and middle-income and conflict-affected settings. Prior evidence from Ethiopia showed substantial levels of suicidal behavior among young populations even before the recent conflict. Exposure to war-related trauma, violence, displacement, and disruption of health and social systems may further increase the risk of suicidality among adolescents and youth. However, there is limited evidence regarding suicidal ideation and suicide attempts among adolescents and youth in post-war Tigray, Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of suicidal ideation and suicide attempts among adolescents and youth in the aftermath of the Tigray War.Methods A school-based cross-sectional study was conducted among 599 adolescents and youth aged 15-24 years in post-war Tigray, Ethiopia, of whom 57.4% were female. Data were collected using validated tools assessing suicidal ideation, suicide attempts, depression, anxiety, post-traumatic stress disorder, and exposure to violence. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with suicidal ideation and suicide attempts.Results The prevalence of suicidal ideation was 19.9% (95% CI: 16.7%, 23.3%), while the prevalence of suicide attempts was 9.7% (95% CI: 7.4%, 12.3%).Depression, anxiety, and post-traumatic stress disorder were significantly associated with both suicidal ideation and attempts. Sexual abuse and witnessing physical violence increased the odds of suicidal Attempts. However, physical activity was protective against suicidal ideation.Conclusion The findings suggest that suicidal ideation and suicidal attempts represent important mental health concerns among adolescents and youth in post-war Tigray. Depression, anxiety, PTSD symptoms, and trauma-related experiences were significantly associated with suicidality in this study. Given the cross-sectional nature of the study, causal relationships cannot be inferred. Nevertheless, the findings underscore the need for strengthened adolescent mental health services and trauma-informed support programs in conflict-affected settings.Clinical trial number Not applicable.