Published: June 24, 2020


A global mental health study led by the Life Course Centre has found approximately one in five teenagers experience thoughts of suicide or anxiety.

The University of Queensland study investigated data collected from more than 275,000 adolescents aged between 12-17 years across 82 low, middle and high income countries. It found 14 per cent of adolescents had suicidal thoughts and 9 per cent had anxiety over a 12-month period. The overall pooled prevalence was approximately one in five.

UQ Institute for Social Science Research (ISSR) Life Course Centre PhD student Tuhin Biswas said those at highest risk of experiencing suicidal ideation and anxiety were older teenage girls from low income backgrounds with no close friends. “Our study shows many adolescents around the world, irrespective of their country’s income status, experience suicidal thoughts and anxiety, but there is high variation between different continental regions. Teenagers from Africa had the highest rates of suicidal thoughts at 21 per cent, while the lowest was in Asia at 8 per cent. The highest rate of teenage anxiety, at 17 per cent, was in the Eastern Mediterranean, while Europe had the lowest rate at 4 per cent.”

The research team found that in every country, teens with fewer peer and parental supports and higher levels of parental control were more likely to report thoughts of suicide and anxiety. The risks were also higher for teens who had experienced peer conflict, victimisation, isolation and loneliness.


“This study provides the evidence base to help identify protective factors against adolescent suicidal ideation and anxiety, and to inform targeted responses in policy and practice.”


 

The study is based on data collected in the World Health Organization Global School-based Health Surveys between 2003 and 2015. Participants were asked if they had seriously considered attempting suicide during the past 12 months, and if they had been so worried about something they could not sleep at night. Only those adolescents and their parents or guardians who provided consent participated.

Professor James Scott, who heads QIMR Berghofer Medical Research Institute’s Mental Health Program, said the study provided the most comprehensive summary to date of the worldwide prevalence of suicidal ideation and anxiety among adolescents. “Adolescent mental health problems such as suicidal ideation and anxiety are a major global public health concern. Positive relationships with family and friends are crucial to mental health and wellbeing during adolescence, and this study reinforces the importance of those supports.”

Professor Scott said the higher prevalence of suicidal ideation among female adolescents was consistent with other studies such as those focusing on internalising disorders like depression. He said suicidal ideation was only loosely connected with completed suicide, which was higher among males, and a likely proxy for psychological distress. Prevention strategies could include female-specific initiatives and fostering family and peer relationships that are socio-culturally sensitive.

Associate Professor Abdullah Mamun of UQ’s ISSR, and supervisor of Mr Biswas, said mental health remained under-reported in many low-to-middle countries due to social stigma, religious or cultural taboos, and inadequate mental health resources. Of the 82 countries in this study, 36 had no specific mental health policy. “Culturally appropriate interventions can modify the parent-adolescent relationship to promote greater mental wellbeing in adolescence. This can include recognizing the adolescent’s individual separation, while still maintaining parental monitoring and understanding. School-based programmes or community activities that increase peer connectedness may also help reduce anxiety and suicidal ideation.”

Professor Janeen Baxter, Director of the Life Course Centre, said adolescence was a pivotal developmental stage that exerted life-long influence on health and wellbeing. She said mental health issues came with enormous personal, social and economic costs in lost opportunities and required strategic early intervention. “This study provides the evidence base to help identify protective factors against adolescent suicidal ideation and anxiety, and to inform targeted responses in policy and practice. These could include peer-based programs to enhance social connectedness and parent skills training to improve parent-child relationships. Family environments and peer relationships have a critical role to play in adolescent mental health. It is also important to tailor protective strategies in line with regional, socioeconomic and cultural circumstances.”

The study, Global variation in the prevalence of suicidal ideation, anxiety and their correlates among adolescents: a population based study of 82 countries’, appeared in EClinicalMedicine, published by The Lancet.

Led by Mr Biswas, it featured collaborations with Professor Scott of QIMR Berghofer Medical Research Institute, Professor Baxter and Associate Professor Mamun of ISSR, Kerim Munir of Harvard Medical School, Professor Andre Renzaho of the School of Social Sciences and Psychology at Western Sydney University, and Dr Lal Rawal of the School of Health, Medical and Applied Sciences at Central Queensland University.

The Life Course Centre-supported study follows on from an earlier study, also led by Mr Biswas and published in EClinicalMedicine by The Lancet in February 2020, on the global prevalence of bullying victimisation that found 30 per cent of adolescents worldwide had experienced bullying.