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International Journal of Adolescent Medicine and Health

Editor-in-Chief: Merrick, Joav

Editorial Board: Birch, Diana ML / Blum, Robert W. / Greydanus, MD, Dr. HC (Athens), Donald E. / Hardoff, Daniel / Kerr, Mike / Levy, Howard B / Morad, Mohammed / Omar, Hatim A. / de Paul, Joaquin / Rydelius, Per-Anders / Shek, Daniel T.L. / Sher, Leo / Silber, Tomas J. / Towns, Susan / Urkin, Jacob / Verhofstadt-Deneve, Leni / Zeltzer, Lonnie / Tenenbaum, Ariel

CiteScore 2018: 0.79

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Suicidal ideation and suicide attempt among Indonesian adolescent students

I Gusti Ngurah Edi PutraORCID iD: https://orcid.org/0000-0002-1014-6949 / Putu Ayu Emmy Savitri Karin / Ni Luh Putu AriastutiORCID iD: https://orcid.org/0000-0002-5811-9042
Published Online: 2019-06-01 | DOI: https://doi.org/10.1515/ijamh-2019-0035


Suicide among young people is growing as a public health threat worldwide. With a paucity of studies on this issue in Indonesia, this study aimed to identify factors associated with suicidal behaviors (suicidal ideation and suicide attempt) among Indonesian adolescents. This was a cross-sectional study using secondary data analysis from the Global School-based Student Health Survey (GSHS) of Indonesia in 2015. The samples were 8634 school-going adolescents aged 13–18 years old. The data analysis consisted of univariate, bivariate and multivariate analysis. The chi-square (χ2) test was employed to identify proportion differences of suicidal behaviors by independent variables whereas multiple logistic regression was used to develop models for factors associated with suicidal ideation and suicide attempt. This study found that 4.75% and 2.46% reported for having suicidal ideation and suicide attempt in the last 12 months, respectively. The effects of intrapersonal factors (sex, age, loneliness, anxiety, current use of tobacco and alcohol) and interpersonal factors (physically attacked, bullying victimization, having no close friends, parental understanding and having sexual intercourse) varied by suicidal behavior and sex. Therefore, developing comprehensive approaches for prevention of mental health problems, including suicidal behaviors in the school setting is essential by asking for a collaboration of schools, parents, public health centers (PHCs), related stakeholders and non-governmental organizations (NGOs).

Keywords: adolescents; Indonesia; mental health; suicidal ideation; suicide attempt


  • [1]

    Wasserman D, Cheng Q, Jiang G-X. Global suicide rates among young people aged 15–19. World Psychiatry. 2005;4(2):114–20.PubMedGoogle Scholar

  • [2]

    World Health Organization (WHO). Preventing suicide: a global imperative. Geneva: WHO; 2014.Google Scholar

  • [3]

    World Health Organization (WHO). Mental health: suicide data [Internet]. WHO. World Health Organization; 2018 [cited 2019 Feb 2]. Available from: https://www.who.int/mental_health/prevention/suicide/suicideprevent/en/

  • [4]

    Patton GC, Coffey C, Sawyer SM, Viner RM, Haller DM, Bose K, et al. Global patterns of mortality in young people: a systematic analysis of population health data. Lancet. 2009;374(9693):881–92.CrossrefPubMedGoogle Scholar

  • [5]

    World Health Organization (WHO). Maternal, newborn, child and adolescent health: adolescent health [Internet]. WHO. World Health Organization; 2014 [cited 2019 Feb 3]. Available from: https://www.who.int/maternal_child_adolescent/epidemiology/adolescence/en/

  • [6]

    Hendin H, Phillips MR, Vijayakumar L, Pirkis J, Wang H, Yip P, et al. Suicide and suicide prevention in Asia. Geneva: WHO; 2008.Google Scholar

  • [7]

    UNICEF. Adolescent development in East Asia and the Pacific: Realizing their potential. A summary of trends, programming and policy experiences. New York: UNICEF; 2006.Google Scholar

  • [8]

    Bertolote J, Wasserman D, Wasserman C. Development of definitions of suicidal behaviours. In: Wasserman D, Wasserman C, editors. Suicidology and suicide prevention: a global perspective. Oxford, UK: Oxford University Press; 2009. p. 87–90.Google Scholar

  • [9]

    National Institute of Mental Health. Mental health information: suicide [Internet]. 2018 [cited 2019 Feb 3]. Available from: https://www.nimh.nih.gov/health/statistics/suicide.shtml

  • [10]

    Herba CM, Ferdinand RF, van der Ende J, Verhulst FC. Replicated prediction of men’s suicide attempt history from parent reports in late childhood. J Am Acad Child Adolesc Psychiatry. 2008;47(7):835–6.CrossrefGoogle Scholar

  • [11]

    Reinherz HZ, Tanner JL, Berger SR, Beardslee WR, Fitzmaurice GM. Adolescent suicidal ideation as predictive of psychopathology, suicidal behavior, and compromised functioning at age 30. Am J Psychiatry. 2006;163(7):1226–32.PubMedCrossrefGoogle Scholar

  • [12]

    Ahmad N, Cheong SM, Ibrahim N, Rosman A. Suicidal ideation among Malaysian adolescents. Asia Pacific J Public Heal. 2014;26(5 Suppl):63S–9S.Google Scholar

  • [13]

    Peltzer K, Pengpid S. Suicidal ideation and associated factors among school-going adolescents in Thailand. Int J Environ Res Public Health. 2012;9(2):462–73.PubMedCrossrefGoogle Scholar

  • [14]

    Lee H, Yoo R, Ahn H, Yoon S, Lee J, Kim J, et al. Personal and interpersonal factors related to suicidal ideation among rural Vietnamese adolescents. Southeast Asian J Trop Med Public Health. 2016;47(6):1366–78.PubMedGoogle Scholar

  • [15]

    Page RM, Yanagishita J, Suwanteerangkul J, Zarco EP, Mei-Lee C, Miao N-F. Hopelessness and loneliness among suicide attempters in school-based samples of Taiwanese, Philippine and Thai adolescents. Sch Psychol Int. 2006;27(5):583–98.CrossrefGoogle Scholar

  • [16]

    Page RM, West JH. Suicide ideation and psychosocial distress in sub-Saharan African youth. Am J Health Behav. 2011;35(2):129–41.PubMedGoogle Scholar

  • [17]

    Badr HE-S. Suicidal behaviors among adolescents – the role of school and home environment. Crisis. 2017;38(3):168–76.PubMedCrossrefGoogle Scholar

  • [18]

    Shaikh MA, Lloyd J, Acquah E, Celedonia KL, L. Wilson M. Suicide attempts and behavioral correlates among a nationally representative sample of school-attending adolescents in the Republic of Malawi. BMC Public Health. 2016;16(1):843.CrossrefGoogle Scholar

  • [19]

    Oppong Asante K, Kugbey N, Osafo J, Quarshie EN-B, Sarfo JO. The prevalence and correlates of suicidal behaviours (ideation, plan and attempt) among adolescents in senior high schools in Ghana. SSM Popul Health. 2017;3:427–34.PubMedCrossrefGoogle Scholar

  • [20]

    Jong HN. Suicide still silent killer in Indonesia [Internet]. 2014 [cited 2019 Feb 7]. Available from: https://www.thejakartapost.com/news/2014/09/12/suicide-still-silent-killer-indonesia.html

  • [21]

    Wirasto RT. Suicide prevention in Indonesia: providing public advocacy. Jpn Med Assoc J. 2012;55:98–104.Google Scholar

  • [22]

    World Health Organization (WHO). World health statistics 2017: monitoring health for the SDGs, Sustainable Development Goals. Geneva, Switzerland: WHO; 2017.Google Scholar

  • [23]

    Ministry of Health (MoH) Indonesia. Hasil utama riset kesehatan dasar 2018 [Main findings of 2018 basic health research]. Jakarta: MoH, 2018.Google Scholar

  • [24]

    Rozaki A. Suicide among Indonesian children/teenagers. Kyoto Rev Southeast Asia [Internet]. 2012;12. Available from: https://kyotoreview.org/wp-content/uploads/Bunuh-Diri-Remaja-Indonesia_Englishtranslation.pdf

  • [25]

    Mubasyiroh R, Putri IYS, Dwi HT. Determinan gejala mental emosional pelajar SMP-SMA di Indonesia tahun 2015 [Mental emotional symptoms’ determinants of junior-senior high school student in Indonesia 2015]. Buletin Penelitian Kesehatan. 2017;45(2):103–12.Google Scholar

  • [26]

    Asmika A, Harijanto H, Handayani N. Prevalensi depresi dan gambaran stressor psikolososial pada remaja sekolah menengah umum di wilayah Kotamadya Malang [The prevalence of depression and description of phsycosocial stressor in adolescent of senior high schools in Malang District]. Jurnal Kedokteran Brawijaya. 2008;24(1):15–21.CrossrefGoogle Scholar

  • [27]

    Damaiyanti M, Fitriani DR. The relation of educational level, academic achievement (GPA) and depression among public school adolescent. Indonesian J Nurs Pract. 2018;1(3):83–90.Google Scholar

  • [28]

    Ministry of Health (MoH) Indonesia. Global school-based student health survey (GSHS). 2007. Jakarta: MoH, 2007.Google Scholar

  • [29]

    Ministry of Health (MoH) Indonesia. Perilaku berisiko kesehatan pada pelajar SMP dan SMA di Indonesia (Healthy risk behavior among junior and senior high school students in Indonesia). Jakarta: MoH, 2015.Google Scholar

  • [30]

    Pandey AR, Bista B, Dhungana RR, Aryal KK, Chalise B, Dhimal M. Factors associated with suicidal ideation and suicidal attempts among adolescent students in Nepal: findings from global school based students health survey. Plos One. 2019. DOI: .CrossrefPubMedGoogle Scholar

  • [31]

    Ayub N. Predicting suicide ideation through intrapersonal and interpersonal factors: the interplay of Big-Five personality traits and social support. Personal Ment Health. 2015;9(4):308–18.CrossrefPubMedGoogle Scholar

  • [32]

    Lockman JD, Servaty-Seib HL. College student suicidal ideation: perceived burdensomeness, thwarted belongingness, and meaning made of stress. Death Stud. 2016;40(3):154–64.PubMedCrossrefGoogle Scholar

  • [33]

    National Cancer Institute. Theory at a glance: a guide for health promotion practice. 2nd ed. U.S. Department of Health and Human Services; 2005.Google Scholar

  • [34]

    Kouwenberg M, Rieffe C, Theunissen SCPM. Intrapersonal and interpersonal factors related to self- repor ted symptoms of depression in DHH youth. Int J Ment Heal Deaf. 2011;1(1):46–57.Google Scholar

  • [35]

    Mahfoud ZR, Afifi RA, Haddad PH, DeJong J. Prevalence and determinants of suicide ideation among Lebanese adolescents: results of the GSHS Lebanon 2005. J Adolesc. 2011;34(2):379–84.PubMedCrossrefGoogle Scholar

  • [36]

    Chen PCY, Lee LK, Wong KC, Kaur J. Factors relating to adolescent suicidal behavior: a cross-sectional Malaysian school survey. J Adolesc Heal. 2005;37(4):337.e11–16.Google Scholar

  • [37]

    World Health Organization (WHO). NCDs: Global school-based student health survey (GSHS) [Internet]. WHO. World Health Organization; 2017 [cited 2018 Dec 14]. Available from: https://www.who.int/ncds/surveillance/gshs/indonesia/en/

  • [38]

    Rudatsikira E, Muula AS, Siziya S. Prevalence and associated factors of suicidal ideation among school-going adolescents in Guyana: results from a cross sectional study. Clin Pract Epidemiol Ment Health. 2007;3:13.PubMedCrossrefGoogle Scholar

  • [39]

    Wilson M, Dunlavy A, Viswanathan B, Bovet P. Suicidal expression among school-attending adolescents in a middle-income Sub-Saharan country. Int J Environ Res Public Health. 2012;9(11):4122–34.CrossrefGoogle Scholar

  • [40]

    Kukoyi OY, Shuaib FM, Campbell-Forrester S, Crossman L, Jolly PE. Suicidal ideation and suicide attempt among adolescents in Western Jamaica. Crisis. 2010;31(6):317–27.CrossrefPubMedGoogle Scholar

  • [41]

    Ziaei R, Viitasara E, Soares J, Sadeghi-Bazarghani H, Dastgiri S, Zeinalzadeh AH, et al. Suicidal ideation and its correlates among high school students in Iran: a cross-sectional study. BMC Psychiatry. 2017;17(1):147.CrossrefPubMedGoogle Scholar

  • [42]

    Nock MK, Borges G, Bromet EJ, Alonso J, Angermeyer M, Beautrais A, et al. Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry. 2008;192(02):98–105.CrossrefPubMedGoogle Scholar

  • [43]

    Maniam T, Marhani M, Firdaus M, Kadir AB, Mazni MJ, Azizul A, et al. Risk factors for suicidal ideation, plans and attempts in Malaysia – Results of an epidemiological survey. Compr Psychiatry. 2014;55:S121–5.PubMedCrossrefGoogle Scholar

  • [44]

    Eskin M, Ertekin K, Dereboy C, Demirkiran F. Risk factors for and protective factors against adolescent suicidal behavior in Turkey. Crisis. 2007;28(3):131–9.PubMedCrossrefGoogle Scholar

  • [45]

    McKinnon B, Gariépy G, Sentenac M, Elgar FJ. Adolescent suicidal behaviours in 32 low- and middle-income countries. Bull World Health Organ. 2016;94(5):340–50F.CrossrefPubMedGoogle Scholar

  • [46]

    Pampel FC. National context, social change, and sex differences in suicide rates. Am Sociol Rev. 1998;63(5):744.CrossrefGoogle Scholar

  • [47]

    Vijayakumar L. Suicide in women. Indian J Psychiatry. 2015;57(Suppl 2):S233–8.CrossrefPubMedGoogle Scholar

  • [48]

    Ibrahim N, Amit N, Din NC, Ong HC. Gender differences and psychological factors associated with suicidal ideation among youth in Malaysia. Psychol Res Behav Manag. 2017;10:129–35.CrossrefPubMedGoogle Scholar

  • [49]

    Hantsoo L, Epperson CN. Anxiety disorders among women: a female lifespan approach. Focus (Am Psychiatr Publ). 2017;15(2):162–72.PubMedGoogle Scholar

  • [50]

    Nolen-Hoeksema S. Emotion regulation and psychopathology: the role of gender. Annu Rev Clin Psychol. 2012;8(1):161–87.CrossrefPubMedGoogle Scholar

  • [51]

    Nguyen DT, Dedding C, Pham TT, Wright P, Bunders J. Depression, anxiety, and suicidal ideation among Vietnamese secondary school students and proposed solutions: a cross-sectional study. BMC Public Health. 2013;13(1):1195.PubMedCrossrefGoogle Scholar

  • [52]

    Koenig LJ, Isaacs AM, Schwartz JAJ. Sex differences in adolescent depression and loneliness: why are boys lonelier if girls are more depressed? J Res Pers. 1994;28(1):27–43.CrossrefGoogle Scholar

  • [53]

    Liu J, Li D, Purwono U, Chen X, French DC. Loneliness of Indonesian and Chinese adolescents as predicted by relationships with friends and parents. Merrill Palmer Q. 2015;61(3):362.CrossrefGoogle Scholar

  • [54]

    Jobe-Shields L, Cohen R, Parra GR. Patterns of change in children’s loneliness: trajectories from third through fifth grades. Merrill-Palmer Quarterly. 2011;57:25–47.Google Scholar

  • [55]

    Zhang B, Gao Q, Fokkema M, Alterman V, Liu Q. Adolescent interpersonal relationships, social support and loneliness in high schools: mediation effect and gender differences. Soc Sci Res. 2015;53:104–17.CrossrefPubMedGoogle Scholar

  • [56]

    Lodder GMA, Goossens L, Scholte RHJ, Engels RCME, Verhagen M. Adolescent loneliness and social skills: agreement and discrepancies between self-, meta-, and peer-evaluations. J Youth Adolesc. 2016;45:2406–16.CrossrefPubMedGoogle Scholar

  • [57]

    Heinrich LM, Gullone E. The clinical significance of loneliness: a literature review. Clin Psychol Rev. 2006;26(6):695–718.PubMedCrossrefGoogle Scholar

  • [58]

    Chan YY, Lim KH, Teh CH, Kee CC, Ghazali SM, Lim KK, et al. Prevalence and risk factors associated with suicidal ideation among adolescents in Malaysia. Int J Adolesc Med Health. 2018;30(3):1–9.Google Scholar

  • [59]

    National Family Planning Board (BKKBN), Statistics of Indonesia (BPS), Ministry of Health (Kemenkes), USAID. Survei demografi dan kesehatan Indonesia 2017: Kesehatan reproduksi remaja [Indonesia demographic and health survey 2017: Adolescent reproductive health]. 2018.Google Scholar

  • [60]

    Torres OV, O’Dell LE. Stress is a principal factor that promotes tobacco use in females. Prog Neuropsychopharmacol Biol Psychiatry. 2016;65:260–8.PubMedCrossrefGoogle Scholar

  • [61]

    Foster DW, Young CM, Steers M-L, Quist MC, Bryan JL, Neighbors C. Tears in your beer: gender differences in coping drinking motives, depressive symptoms and drinking. Int J Ment Health Addict. 2014;12(6):730–46.CrossrefPubMedGoogle Scholar

  • [62]

    Arseneault L, Bowes L, Shakoor S. Bullying victimization in youths and mental health problems: ‘Much ado about nothing’? Psychol Med. 2010;40(05):717.PubMedCrossrefGoogle Scholar

  • [63]

    Hall-Lande JA, Eisenberg ME, Christenson SL, Neumark-Sztainer D. Social isolation, psychological health, and protective factors in adolescence. Adolescence. 2007;42(166):265–86.PubMedGoogle Scholar

  • [64]

    Putra IGNE, Astuti D, Widyastari DA, Phuengsamran D. Prevalence and determinants of condom use among male adolescents in Indonesia. Int J Adolesc Med Health 2018. DOI: .CrossrefPubMedGoogle Scholar

  • [65]

    Pradnyani PE, Putra IGNE, Astiti NLEP. Knowledge, attitude, and behavior about sexual and reproductive health among adolescents students in Denpasar, Bali, Indonesia. Glob Heal Manag J. 2019;3(1):31–9.Google Scholar

  • [66]

    Nock MK, Borges G, Bromet EJ, Cha CB, Kessler RC, Lee S. Suicide and suicidal behavior. Epidemiol Rev. 2008;30(1):133–54.CrossrefPubMedGoogle Scholar

  • [67]

    Coleman N, Sykes W, Groom C. Peer support and children and young people’s mental health [Internet]. 2017 [cited 2019 Feb 12]. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/603107/Children_and_young_people_s_mental_health_peer_support.pdf.

  • [68]

    Stein BD, Sontag-Padilla LM, Osilla KC, Woodbridge MW, Kase CA, Jaycox LH, et al. Interventions to improve student mental health: A literature review to guide evaluation of California’s mental health prevention and early intervention initiative [Internet]. 2012 [cited 2019 Feb 12]. Available from: https://www.rand.org/content/dam/rand/pubs/technical_reports/2012/RAND_TR1319.pdf

  • [69]

    Ministry of Health (MoH) Indonesia. Pedoman standar nasional pelayanan kesehatan peduli remaja [National standard guideline for adolescent health services]. Jakarta: MoH Indonesia; 2014.Google Scholar

About the article

Received: 2019-02-15

Accepted: 2019-04-04

Published Online: 2019-06-01

Conflict of Interest: The authors declared no potential conflict of interest.

Funding sources: This study did not receive any funding.

Citation Information: International Journal of Adolescent Medicine and Health, 20190035, ISSN (Online) 2191-0278, DOI: https://doi.org/10.1515/ijamh-2019-0035.

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