Suicidal ideation, attempts and help-seeking behaviors among adolescent girls in, Southwest Ethiopia: a community-based cross-sectional study

Abstract Background Suicide poses a significant global health challenge and is a leading cause of death among adolescent girls. Although suicidal ideation and attempts are known to increases sharply during female adolescence, and help-seeking behaviors are especially rare in low-income countries, no studies have been conducted on this population in Ethiopia. This study aimed to assess the magnitude, factors related to suicidal ideation and attempts, and help-seeking behaviors. Methods A community-based cross-sectional study was carried out in Illu Abba Bor Zone, involving 847 participants selected through multistage cluster sampling. Data, collected using interviewer-administered WHO Composite International Diagnostic Interview (CIDI) and General Help-Seeking Questionnaires, were analyzed using SPSS Version 26.0. Bivariate and multivariate analyses were performed to identify factors associated with the outcomes. Results Of the 847 sampled girls, 810 participated, yielding a response rate of 95.6%. The prevalence of suicidal ideation, suicidal plan and attempts was 25.3%, 19.8%, and 16.1%, respectively. Their help-seeking behaviors for suicidality were 14.6%. Risk factors for suicidal ideation included experiencing gender-based violence (AOR = 3.68, 95% CI: 1.94, 6.46), anxiety (AOR = 2.04, 95% CI: 1.42, 4.21), food insecurity (AOR = 1.93, 95% CI: 1.19, 3.48), and premenstrual dysphoric disorder (AOR = 3.54, 95% CI: 1.78, 6.21). For suicidal attempts, associated factors were depression (AOR = 3.14, 95% CI: 2.01, 6.52), gender-based violence (AOR = 4.56, 95% CI: 2.12, 9.34), social phobia (AOR = 1.84, 95% CI: 1.27, 3.13), and a family history of suicide (AOR = 2.14, 95% CI: 1.41, 3.65). Conclusions Findings indicate that one in four adolescent girls experienced suicidal ideation, one in six made attempts, but rates of help-seeking behaviors were low. Immediate intervention is crucial; it is essential to design and implement comprehensive, multi-level strategies targeting suicide prevention. Promoting community mental health, help-seeking behaviors for suicidality, and reducing violence against girls are vital steps needed to tackle mental health issues.