Correlates of Suicide Ideation and Attempt among Youth Living in the Slums of Kampala

While suicidal behavior is recognized as a growing public health problem world-wide, little is known about the prevalence and risk factors for suicidal behaviors among street and slum youth in Africa, and in Uganda, specifically. The number of youth who live on the streets and in the slums of Kampala appears to be growing rapidly, but their mental health needs have not been documented, which has hampered resource allocation and service implementation. This study of youth, ages 14-24, was conducted in May and June of 2011, to assess the prevalence and correlates of suicidal behavior. Participants (N = 457) were recruited for a 30-minute interviewer-administered survey through eight drop-in centers operated by the Uganda Youth Development Link for youth in need of services. Bivariate and multivariate logistic regression analyses were computed to determine associations between psychosocial correlates and suicide ideation and suicide attempt. Reporting both parents deceased Adj. OR = 2.36; 95% CI: 1.23-4.52), parental neglect due to alcohol use (Adj. OR = 2.09; 95% CI: 1.16-3.77), trading sex for food, shelter or money (Adj. OR = 1.95; 95% CI: 1.09-3.51), sadnesss (Adj. OR = 2.42; 95% CI: 1.20-4.89), loneliness (Adj. OR = 2.67; 95% CI: 1.12-6.40) and expectations of dying prior to age 30 (Adj. OR = 2.54; 95% CI: 1.53-4.23) were significantly associated with suicide ideation in multivariate analyses. Parental neglect due to alcohol use (Adj. OR = 2.04; 95% CI: 1.11-3.76), sadness (Adj. OR = 2.42; 95% CI: 1.30-7.87), and expectations of dying prior to age 30 (Adj. OR = 2.18; 95% CI: 1.25-3.79) were significantly associated with suicide attempt in multivariate analyses. Given the dire circumstances of this vulnerable population, increased services and primary prevention efforts to address the risk factors for suicidal behavior are urgently needed.