Epidemiology of non-fatal suicidal behavior among first-year university students in South Africa

Bantjes, Jason; Breet, Elsie; Saal, Wylene; Löchner, Christine; Roos, Janine; Taljaard, Lian; Auerbach, Randy P.; Bruffærts, Ronny; Kessler, Ronald C.; Stein, Dan J.

doi:10.1080/07481187.2019.1701143

Cited by 21 publications

(28 citation statements)

References 27 publications

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“…Our findings highlight the marked prevalence of NFSB among university students in SA and the need for campus-based suicide prevention, echoing previous calls to prioritise suicide prevention programmes at SA universities (Bantjes, Breet, et al, 2019). We found 12-month prevalence estimates for suicide ideation, plan, and attempt of 40.9%, 22.3%, and 3.9%, which are significantly higher than the pooled 12-month estimates of 10.6%, 3.0%, and 1.2% reported in a systematic review of 36 studies of college students from across the globe ( N = 634,662) (Mortier, Cuijpers, et al, 2018).…”

Section: Discussionsupporting

confidence: 82%

“…The aim of this study was to establish the potential reduction in prevalence of NFSB that could be achieved by identifying and treating first-year university students with a history of CMDs, assuming a causal relationship between psychopathology and suicidal behaviour. We focused on first-year university students, given that rates of NFSB are high among this subgroup of students in South Africa (SA) (Bantjes, Breet, et al, 2019) and the transition into university is associated with an increase in stress and challenges adjusting to the higher education environment (Alonso et al, 2019; Mittelmeier et al, 2019). This study is part of the ongoing work of the World Health Organization (WHO) World Mental Health Surveys International College Student Initiative (Cuijpers et al, 2019).…”

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confidence: 99%

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Reducing nonfatal suicidal behaviour among university students: actuarial analysis of potential effects of treating common mental disorders

Bantjes

Breet

Löchner

et al. 2020

South African Journal of Psychology

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Campus-based suicide prevention is an important priority for universities. One approach could be to identify and treat common mental disorders, but it is unclear what potential reduction in suicide might be achieved by such an approach. Our aim was to quantify this potential effect on prevalence of nonfatal suicidal behaviour among first-year students. Data were collected from students at two South African universities ( N = 633) via an online survey. We assessed prevalence of nonfatal suicidal behaviour and six common mental disorders and used logistic regression models to identify all main and interaction associations of sociodemographic variables and common mental disorders as predictors of nonfatal suicidal behaviour. Population attributable risk analysis was used to quantify the potential reduction in nonfatal suicidal behaviour achieved by effectively treating common mental disorders, based on the simplifying assumption that the logistic regression coefficients of the common mental disorders represented causal effects on nonfatal suicidal behaviour. Twelve-month prevalence of suicidal ideation, plan, and attempt were 40.9%, 22.3%, and 3.9%, respectively. Increased risk was associated with identifying as Black, female and reporting an atypical sexual orientation. Of the six common mental disorders, major depressive disorder and generalised anxiety disorder were associated with all dimensions of nonfatal suicidal behaviour, bipolar spectrum disorder with increased risk of ideation and plan, attention-deficit/hyperactivity disorder with ideation, and alcohol use disorder with suicide plan. Population attributable risk analysis suggests that treating common mental disorders could yield absolute reductions in suicide ideation, plan, and attempt of 17.0%, 55.0% and 73.8%, respectively. Pragmatic trials are needed to evaluate the effects on nonfatal suicidal behaviour of identifying and treating students with a prior history of common mental disorder early in their university careers.

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Section: Discussionsupporting

confidence: 82%

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confidence: 99%

Reducing nonfatal suicidal behaviour among university students: actuarial analysis of potential effects of treating common mental disorders

Bantjes

Breet

Löchner

et al. 2020

South African Journal of Psychology

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“…Among those who accessed mental healthcare, 52.0% made use of psychotropic medication, 47.3% received psychotherapy, and 5.4% sought treatment from a traditional healer for their mental health problems. Elsewhere we have reported on the prevalence and sociodemographic correlates of common mental disorders in this sample [26], and on the epidemiology of non-fatal suicidal behaviour [27]. Below we present an analysis of factors associated with utilisation of mental healthcare in this sample.…”

Section: Sample Characteristicsmentioning

confidence: 96%

Inequality and mental healthcare utilisation among first-year university students in South Africa

Bantjes

Saal

Löchner

et al. 2020

Int J Ment Health Syst

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Background: Addressing inequalities in mental healthcare utilisation among university students is important for socio-political transformation, particularly in countries with a history of educational exclusion. Methods: As part of the WHO World Mental Health International College Student Initiative, we investigated inequalities in mental healthcare utilisation among first-year students at two historically "White" universities in South Africa. Data were collected via a web-based survey from first-year university students (n = 1402) to assess 12-month mental healthcare utilisation, common mental disorders, and suicidality. Multivariate logistic regression models were used to estimate associations between sociodemographic variables and mental healthcare utilisation, controlling for common mental disorders and suicidality. Results: A total of 18.1% of students utilised mental healthcare in the past 12 months, with only 28.9% of students with mental disorders receiving treatment (ranging from 28.1% for ADHD to 64.3% for bipolar spectrum disorder). Of those receiving treatment, 52.0% used psychotropic medication, 47.3% received psychotherapy, and 5.4% consulted a traditional healer. Treatment rates for suicidal ideation, plan and attempt were 25.4%, 41.6% and 52.9%, respectively. In multivariate regression models that control for the main effects of mental health variables and all possible joint effects of sociodemographic variables, the likelihood of treatment was lower among males (aOR = 0.57) and Black students (aOR = 0.52). An interaction was observed between sexual orientation and first generation status; among second-generation students, the odds of treatment were higher for students reporting an atypical sexual orientation (aOR = 1.55), while among students with atypical sexual orientations, the likelihood of mental healthcare utilisation was lower for first-generation students (aOR = 0.29). Odds of treatment were significantly elevated among students with major depressive disorder (aOR = 1.88), generalised anxiety disorder (aOR = 2.34), bipolar spectrum disorder (aOR = 4.07), drug use disorder (aOR = 3.45), suicidal ideation (without plan or attempt) (aOR = 2.00), suicide plan (without attempt) (aOR = 3.64) and suicide attempt (aOR = 4.57). Likelihood of treatment increased with level of suicidality, but not number of mental disorders. Conclusion: We found very low mental healthcare treatment utilisation among first-year university students in South Africa, with enduring disparities among historically marginalised groups. Campus-based interventions are needed to

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“…Age emerged as one of the most prominent demographic features, especially the transition stage from school to university (Conley et al, 2014). Female students were more at risk for suicide attempts than male students (Bantjes et al, 2019; Hong et al, 2018; Loftis et al, 2019; Miletic et al, 2015; Sivertsen et al, 2019). However, Bantjes, Breet, Saal, Lochner, Roos, Taljaard, Mortier, Auerbach, Bruffaerts, Kessler, and Stein (2020) report a significantly lower likelihood of males seeking professional treatment than females, placing them at greater risk of suicide attempts.…”

Section: Risk Factorsmentioning

confidence: 94%

“…In recent years, suicide has been identified as one of the top five mental health problems among university students across the world (World Health Organization, 2019). Recent findings in South Africa by Bantjes et al (2019) confirm that out of 1402 first-year South African students, 46.4% had suicidal ideations, 26.5% planned suicide, and 8.6% attempted suicide. Suicide ideation is exacerbated by risk factors such as a stressful university life often compounded by broken relationships, loss of loved ones, family mental health history, and feelings of failure which generally contribute to depression and other comorbid mental illnesses among students (Mortier et al, 2018).…”

Section: Introductionmentioning

confidence: 90%

Suicidal behaviour among university students: a systematic review

Pillay

2021

South African Journal of Psychology

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A systematic literature review was conducted to explore worldwide prevalence studies on student suicide, the risks and protective factors related to student suicide, and university-based interventions to combat it. The search of four major databases identified 60 studies published in peer-reviewed academic journals between 2015 and 2020. Majority of these publications were from the United States, followed by China and the United Kingdom. Studies in South Africa and the African Continent as a whole were limited in terms of meeting the selection criteria of the review. The findings indicate that most of the publications ranged from describing suicide risk factors innate to students, such as their demographic and mental health features, to social and university stressors. Although the studies on protective factors were limited, several psychological, social, and behavioural elements to prevent student suicide were identified. I adopted the Three-Step Theory of suicide to discuss the implications of the findings by presenting several campus-based strategies to combat student suicides.

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Epidemiology of non-fatal suicidal behavior among first-year university students in South Africa

Cited by 21 publications

References 27 publications

Reducing nonfatal suicidal behaviour among university students: actuarial analysis of potential effects of treating common mental disorders

Reducing nonfatal suicidal behaviour among university students: actuarial analysis of potential effects of treating common mental disorders

Inequality and mental healthcare utilisation among first-year university students in South Africa

Suicidal behaviour among university students: a systematic review

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