This is the first known prospective study of child suicidal behavior in sub-Saharan Africa. Aims were to determine whether (1) cumulative exposure to adverse childhood experiences (ACEs) predicts later suicidality and(2) heightened risks are mediated by mental health disorder and rug/alcohol misuse. Longitudinal repeated interviews were conducted 1 year apart (97% retention) with 3,515 adolescents aged 10-18 years in South Africa (56% female; 5 ACEs (cumulative odds ratio OR, 2.46; confidence interval CI, 1.00e6.05); for suicide planning, from 2.4% to 12.5% (cumulative OR, 4.40; CI, 2.08e9.29); and for suicide ideation, from 4.2% to 15.6% (cumulative OR, 2.99; CI, 1.68e5.53). Preventing and mitigating childhood adversities have the potential to reduce suicidality. Among adolescents already exposed to adversities, effective mental health services may buffer against future suicidality.
Human Sciences Research Council (Sat,) studied this question.