Abstract
Suicide deaths, attempts, and ideation among minoritized adolescents are a global public health concern that is often inadequately addressed. Research is limited on suicide-related behaviors among adolescents in many developing countries, specifically in the Anglophone Caribbean, like the small island state of Trinidad and Tobago. This study aims to identify the prevalence and correlates of suicidal ideation among adolescents in Trinidad and Tobago. This is a secondary data analysis of a nationally representative sample of high school students (n = 3840) from Trinidad and Tobago using the Global School-Based Student Health Survey in 2017. Multivariate logistic regression assessed the association between correlates (e.g., gender, anxiety) and suicidal ideation in the past 12 months. The study found that 22.2% (16% males and 28% females) reported experiencing suicidal ideation during the past 12 months. In multivariate analyses, variables associated with higher odds for suicidal ideation were anxiety (OR 2.69, p < .001, 95% CI 2.08, 3.48), loneliness (OR 2.47, p < .001, 95% CI 1.91, 3.19), being bullied (OR 2.02, p < .001 CI 1.56, 2.59), and marijuana use (OR 2.20, p < .001, 95% CI 1.58, 3.06). Youth reporting parental understanding were half as likely to report suicidal ideation as their counterparts (OR .53, p < .001, 95% CI .42, .67). The findings highlight the need to implement school-based suicide prevention and intervention, employ more school social workers, and provide psychoeducation to parents to help them better understand suicidal ideation.
Similar content being viewed by others
References
Ahmad, N., Cheong, S. M., Ibrahim, N., & Rosman, A. (2014). Suicidal ideation among Malaysian adolescents. Asia-Pacific Journal of Public Health, 26(5 Suppl), 63S-S69.
Aizer, A. (2004). Home alone: Supervison after school and child behavior. Journal of Public Economics, 88(9–10), 1835–1848.
Alkhraiji, M. H., Barker, A. R., & Williams, C. A. (2022). Reliability and validity of using the global school-based student health survey to assess 24 hour movement behaviours in adolescents from Saudi Arabia. Journal of Sports Sciences, 40(14), 1578–1586.
Assari, S., Moghani Lankarani, M., & Caldwell, C. H. (2017). Discrimination increases suicidal ideation in Black adolescents regardless of ethnicity and gender. Behavioral Sciences, 7(4), 75.
Bahadur, G. (2014). Coolie woman: The odyssey of indenture. University of Chicago Press.
Barzilay, S., Klomek, A. B., Apter, A., Carli, V., Wasserman, C., Hadlaczky, G., Hoven, C. W., Sarchiapone, M., Balazs, J., Kereszteny, A., Brunner, R., Kaess, M., Bobes, J., Saiz, P., Cosman, D., Haring, C., Banzer, R., Corcoran, P., Kahn, J. P., & Wasserman, D. (2017). Bullying victimization and suicide ideation and behavior among adolescents in Europe: a 10-country study. Journal of Adolescent Health, 61(2), 179–186.
Becker, A. E., Roberts, A. L., Perloe, A., Bainivualiku, A., Richards, L. K., Gilman, S. E., & Striegel-Moore, R. (2010). Youth health-risk behavior assessment in Fiji: The reliability of global school-based student health survey content adapted for ethnic Fijian girls. Ethnicity & Health, 15(2), 181–197.
Bennett, D. A. (2001). How can I deal with missing data in my study? Australian and New Zealand Journal of Public Health, 25(5), 464–469.
Biswas, T., Scott, J. G., Munir, K., Renzaho, A. M. N., Rawal, L. B., Baxter, J., & Mamun, A. A. (2020). Global variation in the prevalence of suicidal ideation, anxiety and their correlates among adolescents: A population based study of 82 countries. EClinicalMedicine, 24, 100395.
Blum, R. W., Halcón, L., Beuhring, T., Pate, E., Campell-Forrester, S., & Venema, A. (2003). Adolescent health in the Caribbean: Risk and protective factors. American Journal of Public Health, 93(3), 456–460.
Boeninger, D. K., Masyn, K. E., Feldman, B. J., & Conger, R. D. (2010). Sex differences in developmental trends of suicide ideation, plans, and attempts among European American adolescents. Suicide and Life Threatening Behavior, 40(5), 451–464.
Brener, N. D., Collins, J. L., Kann, L., Warren, C. W., & Williams, B. I. (1995). Reliability of the youth risk behavior survey questionnaire. American Journal of Epidemiology, 141(6), 575–580.
Brown, C. R., Hambleton, I. R., Sobers-Grannum, N., Hercules, S. M., Unwin, N., Harris, E. N., Wilks, R., MacLeish, M., Sullivan, L., Murphy, M., The U.S. Caribbean Alliance for Health Disparities Research Group. (2017). Social determinants of depression and suicidal behaviour in the Caribbean: A systematic review. BMC Public Health, 17(1), 577.
Campisi, S. C., Carducci, B., Akseer, N., Zasowski, C., Szatmari, P., & Bhutta, Z. A. (2020). Suicidal behaviours among adolescents from 90 countries: A pooled analysis of the global school-based student health survey. BMC Public Health, 20(1), 1102. https://doi.org/10.1186/s12889-020-09209-z
Centers for Disease Control. (2018). Global school-based student health survey (GSHS).
Colmenero-Navarrete, L., García-Sancho, E., & Salguero, J. M. (2022). Relationship between emotion regulation and suicide ideation and attempt in adults and adolescents: A systematic review. Archives of Suicide Research, 26(4), 1702–1735.
Cromer, K. D., Villodas, M. T., & Chou, T. (2019). Gender differences in psychological distress as a mediational pathway to suicidal ideation among adolescents at high risk for victimization by violence. Psychology of Violence, 9(6), 587–595. https://doi.org/10.1037/vio0000200
Darves-Bornoz, J. M., Choquet, M., & Ledoux, S. (2021). Differentiated health problems according to gender among adolescents reporting sexual or physical assault. The European Journal of Psychiatry, 35(1), 19–23. https://doi.org/10.1016/j.ejpsy.2020.07.001
Dhoray, D. (2019). Cyberbullying policy. https://cybersafett.com/cyberbullying-policy/
Dorol, O., & Mishara, B. L. (2021). Systematic review of risk and protective factors for suicidal and self-harm behaviors among children and adolescents involved with cyberbullying. Preventive Medicine, 152, 106684.
Dupuy, A. (1983). Slavery and underdevelopment in the Caribbean: A critique of the “planation economy” perspective. Dialectical Anthropology, 7(3), 237–251.
Fleming, L. C., & Jacobsen, K. H. (2009). Bullying among middle-school students in low- and middle-income countries. Health Promotion International, 25(1), 73–84.
Florentine, J. B., & Crane, C. (2010). Suicide prevention by limiting access to methods: A review of theory and practice. Social Science & Medicine, 70(10), 1626–1632. https://doi.org/10.1016/j.socscimed.2010.01.029
Haji, E., Sabt, A., Hasani, F., Abdalrasool, F., Jamsheer, F., Nuhaily, I., & Jassim, G. (2022). Validation of global school-based student health survey in Bahrain. Cogent Public Health, 9(1), 2120576. https://doi.org/10.1080/27707571.2022.2120576
Hill, K., Wainwright, V., Stevenson, C., Senior, J., Robsinson, C., & Shaw, J. (2022). Prevalence of mental health and suicide risk in prisons in low-and middle-income countries: A rapid review. The Journal of Forensic Psychiatry & Psychology, 33(1), 37–52.
Hutchinson, G., Daisley, H., Simeon, D., Simmond, V., Shetty, M., & Lynn, D. (1999). High rates of paraquat-induced suicide in southern Trinidad. Suicide & Life -Threatening Behavior, 29(2), 189–191.
Isaac, M., Elias, B., Katz, L. Y., Belik, S. L., Deane, F. P., Enns, M. W., Sareen, J., Swampy Cree Suicide Prevention Team. (2009). Gatekeeper training as a preventative intervention for suicide: A systematic review. The Canadian Journal of Psychiatry, 54(4), 260–268.
Kim, K. M. (2021). What makes adolescents psychologically distressed? Life events as risk factors for depression and suicide. European Child and Adolescent Psychiatry, 30, 359–367.
Koyanagi, A., Oh, H., Carvalho, A. F., Smith, L., Haro, J., Vancampfort, D., Stubbs, B., & Devylder, J. (2019). Bullying victimization and suicide attempt among adolescents aged 12–15 years from 48 countries. Journal of the American Academy of Child & Adolescent Psychiatry, 58(9), 907–918.
Kukoyi, O., Shuaib, F. M., Campbell-Forrester, S., Crossman, L., & Jolly, P. E. (2010). Suicidal ideation and suicide attempt among adolescents in Western Jamaica: A preliminary study. Crisis, 31(6), 317–327. https://doi.org/10.1027/0227-5910/a000038
Lagman, J., Gara, M., Baweja, R., & Kim, W. (2021). Correlates of suicide attempts in Filipino youths: An analysis based on the 2015 global school-based student health survey. Cureus, 13(9), e18100. https://doi.org/10.7759/cureus.18100
Langhinrichsen-Rohling, J., Friend, J., & Powell, A. (2009). Adolescent suicide, gender, and culture: A rate and risk factor analysis. Aggression and Violent Behavior, 14(5), 402–414.
Lewinsohn, P. M., Rohde, P., Seeley, J. R., & Baldwin, C. L. (2001). Gender differences in suicide attempts from adolescence to young adulthood. Journal of the American Academy of Child & Adolescent Psychiatry, 40(4), 427–434.
Liverpool, S., Prescod, J., Pereira, B., & Trotman, C. (2023). Prevalence of mental health and behaviour problems among adolescents in the English-speaking Caribbean: Systematic review and meta-analysis. Discover Mental Health, 3(1), 1–17.
Maharaj, R. G., Alli, F., Cumberbatch, K., Laloo, P., Mohammed, S., Ramesar, A., Rampersad, N., Roopnarinesingh, N., & Ramtahal, I. (2008). Depression among adolescents, aged 13–19 years, attending secondary schools in Trinidad: Prevalence and associated factors. The West Indian Medical Journal, 57(4), 352–359.
Maharajh, H. D., & Abdool, P. S. (2005). Cultural aspects of suicide. The Scientific World Journal, 5, 736–746. https://doi.org/10.1100/tsw.2005.88
Mascayano, F., Tapia, T., Schilling, S., Alvarado, R., Tapia, E., Lips, W., & Yang, L. H. (2016). Stigma toward mental illness in Latin America and the Caribbean: A systematic review. Brazilian Journal of Psychiatry, 38(1), 73–85.
McKinnon, B., Gariépy, G., & Sentenac, M. (2016). Adolescent suicidal behaviours in 32 low- and middle-income countries. Bulletin of the World Helath Organization, 94(5), 340–350.
Ministry of the Attorney General and Legal Affairs. (1996). Education Act.
Mulenga, D., Siziya, S., Mazyanga, M., Kwangu, M., & Njunju, E. (2017). Correlates of suicidal ideation among in-school adolescents in Trinidad and Tobago. International Public Health Journal, 9(4), 437–442.
National Association of Social Workers. (2018). NASW highlights the growing need for school social workers to prevent school violence. https://www.socialworkers.org/News/News-Releases/ID/1633/NASW-Highlights-the-Growing-Need-for-School-Social-Workers-to-Prevent-School-Violence
Nobie, M. J., & Hutchinson, G. (2018). Demographic factors associated with suicide in Trinidad and Tobago: An analysis of completed suicide, 2000–2016. Caribbean Journal of Psychology, 10(1).
Nock, M., Green, J. G., Hwang, I., McLaughlin, K., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2013). Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: Results from the national comorbidity survey replication adolescent supplement. JAMA Psychiatry, 70(3), 300–310.
Norström, T., & Rossow, I. (2016). Alcohol consumption as a risk factor for suicidal behavior: A systematic review of associations at the individual and at the population level. Archives of Suicide Research, 20, 489–506.
Pandey, A., Bista, B., Dhungana, R., Aryal, K., Chalise, B., & Dhimal, M. (2019). Factors associated with suicidal ideation and suicidal attempts among adolescent students in Nepal: Findings from global school-based students health survey. PLoS ONE, 14(4), e0210383.
Paul, A.-L. (2021). Shortage of school social workers. https://www.cnc3.co.tt/shortage-of-school-social-workers/
Pengpid, S., & Peltzer, K. (2021). The prevalence and correlates of suicidal behaviour among adolescents in Trinidad and Tobago. Journal of Psychology in Africa, 31(4), 424–429.
Roopnarine, L. (2006). Indo-Caribbean indenture: Resistance and accommodation. University Press of the West Indies.
Ruiz-Casares, M., & Rousseau, C. (2010). Between freedom and fear: Children’s view on home alone. The British Journal of Social Work, 40(8), 2560–2577.
Schafer, J. L. (1999). Multiple imputation: A primer. Statistical Methods in Medical Research, 8(1), 3–15.
Seidu, A.-A., Amu, H., Dadzie, L. K., Amoah, A., Ahinkorah, B. O., Ameyaw, E. K., Acheampong, H. Y., & Kissah-Korsah, K. (2020). Suicidal behaviours among in-school adolescents in Mozambique: Cross-sectional evidence of the prevalence and predictors using the global school-based health survey data. PLoS ONE, 15(7), e0236448. https://doi.org/10.1371/journal.pone.0236448
Siziya, S., Mazaba, M., Njunju, E., Kwangu, M., & Mulenga, D. (2017). Suicidal ideation in Guyana: Prevalence and its associated factors among adolescents in a global school health-based survey. Internation Public Health Journal, 9(4), 415–422.
Snyder, T. L. (2010). Suicide, slavery, and memory in North America. The Journal of American History, 97(1), 39–62.
Soares, F. C., Hardman, C. M., Rangel Junior, J. F., Bezerra, J., Petribú, K., Mota, J., de Barros, M. V. G., & Lima, R. A. (2020). Secular trends in suicidal ideation and associated factors among adolescents. Brazilian Journal of Psychiatry, 42(5), 475–480.
Toussaint, L., Wilson, C. M., Wilson, L., & Williams, D. R. (2015). Religiousness and suicide in a nationally representative sample of Trinidad and Tobago adolescents and young adults. Social Psychiatry and Psychiatric Epidemiology, 50(9), 1441–1450. https://doi.org/10.1007/s00127-015-1045-y
Trinidad and Tobago Ministry of Education. (2022). 2019/2020 Education statistics digest. Educational Planning Division. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/. https://storage.moe.gov.tt/corporate/2022/12/2019-2020-EDUCATION-STATISTICS-DIGEST-ccd-1.pdf
Trinidad and Tobago Ministry of Planning and Sustainable Development. (2012). Trinidad and Tobago 2011 population and housing census demographic report. Ministry of Planning and Sustainable Development Central Statistical Office. https://cso.gov.tt/stat_publications/2011-population-and-housing-census-demographic-report/
Twenge, J. M., Haidt, J., Lozano, J., & Cummins, K. M. (2022). Specification curve analysis shows that social media use is linked to poor mental health, especially among girls. Acta Psychologica, 224, 103512. https://doi.org/10.1016/j.actpsy.2022.103512
United Nations Children’s Fund. (2021). The State if the World’s children 2021: On my mind promoting, protecting and caring for children’s mental health. UNICEF.
Van Meter, A. R., Knowles, E. A., & Mintz, E. H. (2023). Systematic review and meta-analysis: International prevalence of suicidal ideation and attempt in youth. Journal of the American Academy of Child and Adolescent Psychiatry. https://doi.org/10.1016/j.jaac.2022.07.867
Wasserman, D., Cheng, Q., & Jiang, G. (2005). Global suicide rates among young people aged 15–19. World Psychiatry, 4, 114–120.
World Health Organization. (2013). Global school based student health survey.
World Health Organization. (2019). Global school based student health survey. https://www.who.int/ncds/surveillance/gshs/en/
World Health Organization. (2020). Global school-based student health survey. https://cdn.who.int/media/docs/default-source/ncds/ncd-surveillance/data-reporting/trinidad-and-tobago/gshs/trinidad_and_tobago__trinidad_2017_gshs_fs.pdf?sfvrsn=5e5f4895_5&download=true
World Health Organization. (2021). Suicide. https://www.who.int/news-room/fact-sheets/detail/suicide
World Population Review. (2023b). Trinidad And Tobago population 2023 (Live). https://worldpopulationreview.com/countries/trinidad-and-tobago-population
World Population Review. (2023a). Caribbean countries 2023. https://worldpopulationreview.com/country-rankings/caribbean-countries
Xiao, Y., Cerel, J., & Mann, J. J. (2021). Temporal trends in suicidal ideation and attempts among US adolescents by sex and race/ethnicity, 1991–2019. JAMA Network Open, 4(6), e2113513. https://doi.org/10.1001/jamanetworkopen.2021.13513
Ziaei, R., Viitasara, E., Soares, J., Sadeghi-Bazarghani, S., Dastgiri, S., Zeinalzadeh, A., Bahadori, F., & Mohammdi, R. (2017). Suicidal ideation and its correlates among high school students in Iran: A cross sectional study. BMC Psychiatry, 17(1), 147. https://doi.org/10.1186/s12888-017-1298-y
Acknowledgements
The authors would like to thank the Ministry of Health in Trinidad and Tobago, in collaboration with the World Health Organization, which conducted the Global School-Based Student Health Survey (GSHS) and made the dataset and report available online.
Funding
This study did not receive any funding.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest to report.
Research Involving Human Participants and/or Animals
Not applicable.
Informed Consent
Not required.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Modeste-James, A., Huggins, C., Freedenthal, S. et al. Suicidal Ideation and Its Correlates Among Adolescents in Trinidad and Tobago. Child Adolesc Soc Work J (2023). https://doi.org/10.1007/s10560-023-00953-w
Accepted:
Published:
DOI: https://doi.org/10.1007/s10560-023-00953-w