Self-harm and suicidal behaviours among undergraduate students in Gandaki Province, Nepal: a cross-sectional study

Introduction: Self-harm and suicidal behaviours are major public health issues among adolescents. Suicide is considered the third cause of death among 15-29-year-old individuals worldwide. The study aimed to determine the prevalence of self-harm and suicidal behaviours among undergraduate students in Nepal and identify the sociodemographic, behavioural and psychological factors associated with these behaviours. Methods: A school-based cross-sectional study was conducted among undergraduates from four schools of Vyas Municipality, Nepal. The Deliberate Self-Harm Behaviour Scale and the General Health Questionnaire-28 were the standard tools used to measure self-harm and suicidal behaviour. Results: Among 538 participants, the prevalence of self-harm behaviour, suicidal ideation, plans and attempts was found to be 15.8% (n=85), 30.3% (n=163), 3.2% (n=17) and 1.9% (n=10), respectively. Relationship difficulty was significantly associated with self-harm (adjusted OR (AOR)=2.42, 95% CI 1.10 to 5.35, p=0.028), while relationship difficulty (AOR=3.29, 95% CI 1.44 to 7.54, p=0.005) and family mental health issues (AOR=4.69, 95% CI 1.64 to 13.47, p=0.004) were significantly associated with suicidal ideation. Conclusions: Relationship difficulty and family mental health issues are identified as major causes of the alarmingly high rates of self-harm and suicidal acts among Nepalese adolescents.