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<p>Despite growing recognition of adolescent suicide as a public health concern in Ghana, little is known about how young people transition from suicidal thoughts to attempts. Understanding this progression is critical for developing timely and culturally appropriate interventions. This qualitative study examined the psychological, social, and environmental factors that precipitate the transition from suicidal ideation to suicide attempts among Ghanaian secondary school students, with particular attention to how these pathways align with or diverge from established theoretical frameworks. In-depth semi-structured interviews were conducted with 20 Ghanaian adolescents (ages 12–19) in the Greater Accra Region who had experienced suicidal ideation or attempts. Participants were recruited through purposive sampling from secondary schools. Data were analyzed using reflexive thematic analysis, employing both inductive coding to capture participants lived experiences and deductive analysis to examine alignment with Joiner’s Interpersonal Psychological Theory of Suicide Behavior (IPTSB). Five major themes emerged: (1) emotional intensification—particularly anger—as a primary catalyst; (2) social isolation characterized by active concealment of distress; (3) compound environmental stressors including family conflict, academic pressure, and financial difficulties; (4) gender-specific triggers reflecting cultural norms around masculinity and femininity; and (5) rapid, crisis-driven transitions rather than gradual progression. 70% of participants reported emotional distress as a trigger, 55% cited social isolation, and 45% described family conflicts. Notably, participants described rapid transitions from ideation to attempt during acute emotional states, challenging the acquired capability hypothesis central to IPTSB. These findings suggest that adolescent suicidality particularly in non-Western contexts may operate through different mechanisms than adult models predict. Prevention strategies must move beyond detection-based approaches to universal emotional literacy programs, address structural determinants of distress, and recognize culturally specific emotional expressions of suicide risk. Policies that exacerbate adolescent vulnerability, such as punitive responses to teenage pregnancy, require urgent reform.</p>

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The Breaking Point: Psychological and Socioecological Triggers of Suicide Attempt in Adolescents

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月19日

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  • Enoch Kordjo Azasu,
  • Erasmus Azasu,
  • Elizabeth Ali,
  • Marcus Larnyoh

摘要

Despite growing recognition of adolescent suicide as a public health concern in Ghana, little is known about how young people transition from suicidal thoughts to attempts. Understanding this progression is critical for developing timely and culturally appropriate interventions. This qualitative study examined the psychological, social, and environmental factors that precipitate the transition from suicidal ideation to suicide attempts among Ghanaian secondary school students, with particular attention to how these pathways align with or diverge from established theoretical frameworks. In-depth semi-structured interviews were conducted with 20 Ghanaian adolescents (ages 12–19) in the Greater Accra Region who had experienced suicidal ideation or attempts. Participants were recruited through purposive sampling from secondary schools. Data were analyzed using reflexive thematic analysis, employing both inductive coding to capture participants lived experiences and deductive analysis to examine alignment with Joiner’s Interpersonal Psychological Theory of Suicide Behavior (IPTSB). Five major themes emerged: (1) emotional intensification—particularly anger—as a primary catalyst; (2) social isolation characterized by active concealment of distress; (3) compound environmental stressors including family conflict, academic pressure, and financial difficulties; (4) gender-specific triggers reflecting cultural norms around masculinity and femininity; and (5) rapid, crisis-driven transitions rather than gradual progression. 70% of participants reported emotional distress as a trigger, 55% cited social isolation, and 45% described family conflicts. Notably, participants described rapid transitions from ideation to attempt during acute emotional states, challenging the acquired capability hypothesis central to IPTSB. These findings suggest that adolescent suicidality particularly in non-Western contexts may operate through different mechanisms than adult models predict. Prevention strategies must move beyond detection-based approaches to universal emotional literacy programs, address structural determinants of distress, and recognize culturally specific emotional expressions of suicide risk. Policies that exacerbate adolescent vulnerability, such as punitive responses to teenage pregnancy, require urgent reform.