Suicide Ideation and Psychosocial Distress Among Refugee Adolescents in Bidibidi Settlement in West Nile, Uganda

Abstract BackgroundThis study investigated the factors associated with suicidal ideation and psychological distress among 281 Sudanese refugees (aged 10-19 years) in Uganda. Adolescents refugees have been reported among the groups vulnerable to mental health and psychosocial challenges including suicidal ideations and attempts. MethodsThe analysis is based on cross-sectional secondary data collected as part of the implementation of a project on sexual and reproductive health in refugee settlements. Data were collected in July 2020. We estimated the prevalence of psychological, distress and suicidal ideation, and the associated profiles. Odds ratios and their 95% Confidence Intervals based on a logistic regression model were used to assess the effect of different potential factors on the risk profiles for suicidal ideation and psychological distress. ResultsThe prevalence of psychological distress (on KS-6 scale) was estimated to be 12.3% (95%CI: 8.7, 16.7%). This was dominated by lack of hope in the future - at 11.6% (95%CI: 8.1, 15.9%). Suicide ideation within the past four weeks was reported by 5.3% (95%CI: 3.0, 8.6%) of the respondents while suicide attempt in the last six months was reported by 0.7% (95%CI: 0.1, 2.5%). Both psychological distress and suicide ideations are more common among girls than boys, 11.6% vs. 2.6% and 18.6% vs. 9.2%, respectively. Suicidal ideation and distress are also less likely among adolescents with friends or family members with whom they can confide in. At univariate level, girls and very young adolescents, (OR=0.16; 95%CI: 0.05, 0.50) and (OR=0.39; 95%CI: 0.14, 1.05), respectively. At multivariate analysis, the risk for suicide ideation was low among male adolescents (aOR= 0.16; 95%CI: 0.05, 0.52) and adolescents with a friend or family members they can confide in (aOR=0.14; 95%CI: 0.04, 0.50). Similarly, the risk for psychological distress is low among male adolescents (aOR= 0.51; 95%CI: 0.23, 1.02), older adolescents as compared to those aged 10-12 years (aOR= 0.12; 95%CI: 0.04, 0.40), and adolescents with a friend or family members they can confide in (aOR=0.33; 95%CI: 0.11, 0.96).ConclusionBoth suicidal ideation and psychological distress are very high among the female adolescents. Familial and individual interventions, particularly those focused on encouraging emotional expression and familial cohesion will be potentially useful for female adolescents who have a high risk of suicide.