INTRODUCTION
The subject of this article is suicide attempts among at-risk youth who, due to various emotional and beha-vioural problems, have dropped out of the mainstream education system and have been referred to special edu-cation centres.
A factor contributing to suicidal behaviours is undoubtedly the experience of severe life adversities. However, before such a tragic event as suicide occurs, various symptoms of an emerging crisis can often be observed. These include risky behaviours such as substance abuse and violence which may serve as coping mechanisms for problems, severe stress or suffering [1]. In general, such risky behaviours are perceived as incompatible with social norms and simultaneously pose a threat to the psychophysical and social development of children and adolescents. In Poland, young people experiencing such difficulties may be referred to educational institutions outside mainstream schools, namely Youth Sociotherapy Centres (YSCs) and Youth Correctional Centres (YCCs).
The formal grounds for referring young people to YSC and YCC are manifestations of social maladjustment. However, information obtained from YCC headmasters indicates that increasingly, the reasons for placing teenagers in these facilities involve serious mental health issues, including self-destructive behaviours such as self-harm, suicidal thoughts, and suicide attempts [2]. In the case of YCC, a teenager is placed in the facility pursuant to a court decision, whereas placement in YSC is based on the request of parents or legal guardians, supported by an opinion issued by a psychological and pedagogical counselling centre.
The source of the problems experienced by students in YSC and YCC is typically the family environment. Fami-lies of YSC/YCC youth often face multiple adversities, including unemployment, financial and housing difficulties, mental health issues, substance abuse, and criminal activity. Within intra-family relations, a serious concern is the disruption of bonds between parents and children, manifested in a lack of parental support, understanding, and acceptance, as well as violence, neglect, and failure to meet the child’s basic emotional and biological needs [3].
The risk factors associated with suicidal behaviour in young people identified in the literature are consistent with the experiences of YSC and YCC youth, their individual characteristics, and their family situations. These factors include, among others: depressive symptoms [4-9], sensation seeking [10], impulsivity [11, 12], psychoactive substances use [6-8, 12], involvement in or exposure to bullying and cyberbullying [11, 13], as well as disturbances in family relationships and violence against the child [11, 14]. On the other hand, research indicates that parental support and attachment [15-18], support and positive peer relationships [18], school connectedness [19], and religiosity [20] serve as protective factors against suicide.
Studies further suggest that the way adolescents spend their leisure time is an important factor associated with risky behaviours and mental health problems, including suicidal behaviours [21, 22].
The aim of this article is to identify the risk and protective factors associated with suicide attempts among adolescents under the care of YSC and YCC.
Methods
Sample selection and study implementation
A detailed description of the research methodology has been presented elsewhere [23]. In brief, the study was conducted in 2018 and involved students from randomly selected YSC and YCC in Poland.
Initially, 40% of all YSCs (30 facilities) and YCCs (35 facilities) were selected to participate in the project. Due to a lack of consent from directors or difficulties in obtaining parental consent in nine centres, as well as a lower-than-expected number of students in most faci-lities, the sample was supplemented with an additional 10 centres. Ultimately, young people from 25 YSCs and 39 YCCs took part in the study.
The number of students in each YSC ranged from 9 to 53, and in each YCC from 12 to 79. The survey questionnaire was completed by all students present at the centre on the day of the study who agreed to participate. A total of 2,063 students completed the survey, which constituted 76% of the eligible sample. However, the surveys collected from 333 respondents were excluded from the analysis due to significant missing data, inconsistent answers, or comments indicating that the research was not taken seriously.
The final sample consisted of 1,730 students. The surveys were administered by trained interviewers from outside the YSCs/YCCs, in accordance with procedures designed to ensure the anonymity of individual students, classes, and centres.
Measures
The frequency of suicide attempts was measured using a single-item measure as the dependent variable. Despite being assessed with only one item (using a 4-point response scale), the measure demonstrates satisfactory theoretical validity, as indicated by a moderately strong positive correlation with the depressive symptom scale (Spearman’s ρ = 0.460). The independent variables consisted of a set of psychosocial risk and protective factors reflecting adolescents’ individual characteristics, including personality traits, mental health problems, risky behaviours, and extracurricular interests/activities, as well as their social environment (family, peers, and the educational centre attended). Sociodemographic variables included gender (1 = ‘male’ and 2 = ‘female’) and family structure (1 = ‘living with both parents’ and 2 = ‘not living with both parents’). Detailed information on all variables included in the analysis is presented in Table 1.
Table 1
Descriptive statistics of the dependent and independent variables
| Variables (number of items) | M (SD) | α | Sample item (type of scale used) | Source | ||
|---|---|---|---|---|---|---|
| Dependent variable | ||||||
| Frequency of suicide attempts (1) | 1.77 (1.10) | NA | Have you ever in your life tried to attempt suicide? Answers ranging from 1 to 4 (where 1 stands for ‘no’, 2 – ‘yes, once’, 3 – ‘yes, twice’, 4 – ‘yes, three or more times’). | Research team | ||
| Independent variables | ||||||
| Risk factors: Personality traits | ||||||
| Sensation seeking (4) | 2.66 (1.16) | 0.80 | In the last 6 months, how often have you done anything dangerous only for the thrill it causes? 5-point scale from 1 – ‘never’ to 5 – ‘very often’. | [24] | ||
| Impulsiveness (7) | 2.39 (0.54) | 0.70 | I act on impulse. 4-point scale from 1 – ‘never or rarely’ to 4 – ‘almost always or always’. | [25, 26] | ||
| Risk factors: Mental health | ||||||
| Depressive symptoms (4) | 2.11 (0.86) | 0.86 | In the last 7 days how often have you felt sad? 4-point scale from 1 – ‘never or rarely’ to 4 – ‘all the time’. | [27, 28] | ||
| Risk factors: Psychoactive substance and medicine use | ||||||
| Cigarette smoking (1) | 4.07 (1.52) | NA | Do you smoke cigarettes? 5-point scale from 1 – ‘no’ to 5 – ‘yes, every day’. | [29] | ||
| Alcohol related problems (8) | 2.62 (2.31) | NA | While under the influence of alcohol, how often during the past 12 months have you experienced the following? For example: Have you been drunk or hungover when you had something important to do, such as school-related tasks or household chores? Two answers to choose: 0 – ‘no’, 1 – ‘yes’. | [30, 31] | ||
| Marijuana/hashish use (1) | 3.90 (2.36) | NA | On how many occasions (if any) in the last 12 months have you used marijuana or hashish? 7-point scale from 1 – ‘I did not use’ to 7 – ‘40 times or more’. | [30, 31] | ||
| Novel psychoactive substance use (1) | 1.29 (0.45) | NA | On how many occasions (if any) in the last 12 months have you used boosters (slang name of NPS)? 7-point scale from 1 – ‘I did not use’ to 7 – ‘40 times or more’. | Research team | ||
| Medicine use (5) | 1/2.13 (1.28)2/1.84 (1.21)3/1.80 (1.38) | NA | How often in the last 30 days have you used medication for following problems: 1) headache, 2) stomach ache, 3) negative emotional states (a combined indicator that includes medications taken for difficulties falling asleep, nervousness, depression, or low mood). 7-point scale from 1 – ‘I did not use’ to 7 – ‘40 times or more’. | [23] | ||
| Risk factors: Experiencing various form of violence | ||||||
| Bulling (1) | 2.97 (1.04) | NA | How often in the last 12 months have you experienced bullying? 4-point scale from 1 – ‘every day or almost every day’ to 4 – ‘never’. | [32, 33] | ||
| Cyberbullying (1) | 1.49 (0.84) | NA | Have you ever been in a situation where one or more people from your school, class, or online community regularly bullied you via the Internet or a cell phone for an extended period, causing you suffering and making it difficult for you to defend yourself? 4 point scale from 1 – ‘did not happen’ to 4 – ‘it happened 4 times or more’. | [34] | ||
| Domestic conflicts and violence (5) | 1.79 (0.73) | 0.86 | Family members get angry at each other. 4 point scale: 4-point scale from 1 – ‘it does not happen’ to 4 – ’often’ | [23, 35] | ||
| Risk factors: Using various forms of violence | ||||||
| Bullying against peers (1) | 1.94 (0.98) | NA | How often in the last 12 months have you been involved in physical or psychological violence against other students? 4-point scale from 1 – ‘every day or almost every day’ to 4 – ‘never’. | [32, 33] | ||
| Cyberbullying against peers (1) | 1.57 (0.93) | NA | Have you ever, either by yourself or as part of a group, regularly harassed a schoolmate via the Internet or mobile phones over a period of time, making it difficult for them to defend themselves? 4 point scale from 1 – ‘never’ to 4 – ‘it happened 4 times or more’. | [34] | ||
| Independent variables cont. | ||||||
| Protective factors: Social environment (family, peers, YSC/YCC facility) | ||||||
| Parental support (8) | 3.17 (1.20) | 0.90 | My mother enjoys hearing about what I say. 5 point scale from 1 – ‘not true/false’ to 5 – ‘very true’. | [36, 37] | ||
| Positive relationship with peers (6) | 2.99 (0.68) | 0.94 | Is it easy for you to make friends and stay connected with your peers? 4-point scale from 1 – ‘definitely not’ to 4 – ‘definitely yes’. | [38] | ||
| Social climate at the YSC/YCC (12) | 2.69 (0.61) | 0.89 | I like my YSC/YCC. 4-point scale from 1 – ‘definitely not’ to 4 – ‘definitely yes’. | Research team elaboration based on the OntarioStudent Drug Survey Question- naire [32] | ||
| Other protective factors | ||||||
| Religious commitment (1) | 2.31 (0.91) | NA | How important is faith (religion) in your life? 4-point scale from 1 – ‘not important at all’ to 4 – ‘very important’. | [39] | ||
| Forms of leisure activities (5) | 1/2.13 (1.27)2/3.55 (1.22)3/3.28 (1.35)4/3.02 (1.27)5/1.96 (1.08) | NA | On average, how many hours a day do you spend on the following activities: 1) playing computer games, 2) listening to music, 3) using the Internet for non-school-related activities, 4) engaging in personal interests or hobbies, 5) reading books for pleasure? 5-point scale from 1 – ‘0 hours’ to 5 – ‘5 hours or more’. | [40] | ||
| Participation in organised or unorganised after- school activities (3) | 1/1.91 (1.07)2/1.76 (0.94)3/2.59 (1.14) | NA | How many hours per week do you spend on: 1) organised sport activities, 2) organised extracurricular activities other than sports, 3) various unorganised forms of physical activity? 5-point scale from 1 – ‘0 hours’ to 5 – ‘8 hours or more’. | [40] | ||
Data analysis
Differences in the prevalence of suicide attempts were analysed using the chi-square test. Hierarchical linear regression was employed to examine the relationship between the frequency of suicide attempts and a set of risk and protective factors, despite the fact that the distribution of the dependent variable deviated significantly from a normal distribution. However, the values of kurtosis (–0.252) and skewness (1.125) were within acceptable limits for this type of statistical analysis. Additionally, no evidence of collinearity was observed among the independent variables, as the VIF values for all analysed variables were below 2.
In the first stage of the analysis, correlations between the frequency of suicide attempts and the independent variables were examined using Spearman’s test. In the second stage, all independent variables that were found to be significant in the correlation analyses were entered into the regression model in three steps: (1) sociodemographic variables, (2) risk factors (positively correlated with suicide attempts), and (3) protective factors (negatively correlated with suicide attempts). At this stage, the independent variables were introduced to the model using the forward selection method. This approach made it possible to identify a set of independent variables that were significantly associated with the dependent variable – the frequency of suicide attempts.
Finally, in the third stage of regression analysis, the following variables were included in the model:
sociodemographic variables: gender and family structure;
risk factors: sensation-seeking tendencies, depressive symptoms, the ongoing use of medication for stomach ache and negative emotional states, exposure to peer bullying and cyberbullying, family conflict and violence, and leisure activities (listening to music);
protective factors: religious commitment and leisure activities (playing computer games).
The following variables (parental support, positive peer relationship, social climate at the YSC/YCC, parti-ci-pation in organised or unorganised after-school acti-vities, use of novel psychoactive substances, use of marijuana/hashish, alcohol-related problems, cigarette smoking, perpetration of bullying and perpetration of cyberbullying were not used in the final regression analyses.
Due to significant gender differences in the prevalence of suicide attempts, regression analyses were conducted both for the entire sample and separately for girls and boys. The multiple imputation (MI) method was applied to handle missing data in the regression analysis [41]. All ana-lyses were carried out using the IBM SPSS Statistics 29.0 software package.
Results
Study participants
Most of the study participants were boys (67.2%), reflecting the actual gender distribution in YSC/YCC faci-lities. Additionally, most respondents (66.9%) reported living in single-parent families [25]. This indicates signi-ficant differences between YSC/YCC youth and students attending mainstream schools, where approximately 77% are raised in two-parent households [42].
Table 2 presents data on suicide attempts among the respondents. Overall, 39.8% of young people in the YSC/YCC had attempted suicide. Of these, 8.7% had attempted suicide twice, and 14% had attempted suicide three or more times. Girls were significantly more likely to have attempted suicide (60% vs. 30%, p = 0.001). Notable gender differences were also observed in the frequency of suicide attempts. Among boys, the largest group consisted of those who had attempted suicide once (15.9%), whereas among girls, the largest group consisted of those who had attempted suicide three or more times (25.9%). This difference reflects the higher recurrence of suicide attempts among girls compared to boys within this high- risk population. No statistically significant differences were found between youth in YSC versus YCC facilities, nor between younger and older adolescents.
Table 2
The lifetime suicide attempts among Youth Sociotherapy Centre (YSC) and Youth Correctional Centre (YCC) students
Correlational analyses
Preliminary analyses revealed that correlation coefficients between the frequency of suicide attempts and the independent variables ranged from 0.10 to 0.26, indicating a weak relationship between these variables. Only the correlation between the frequency of suicide attempts and depressive symptoms was higher (Spearman’s ρ = 0.46), indicating a relationship of moderate strength (data not shown in the table).
Regression analyses
The results for the full sample (Table 3) indicate that all three blocks of variables entered into the hierarchical linear regression model – sociodemographic variables, risk factors, and protective factors – made statistically significant contribution to explaining the frequency of suicide attempts. The model accounted for approxi-mately 31% of the variance in suicide attempts. After controlling for sociodemographic variables, significant risk factors for suicide attempts among YSC/YCC students included depressive symptoms, sensation-seeking, experiences of cyberbullying, the ongoing use of medication for negative emotional states and stomach aches, and exposure to domestic conflict and violence. Interestingly, listening to music during leisure time also emerged as a risk factor. In contrast, religious involvement and playing computer games appeared to reduce the risk of suicide attempts.
Table 3
Hierarchical linear regression results predicting frequency of lifetime suicide attempts among youth attending Youth Sociotherapy Centre (YSC) and Youth Correctional Centre (YCC) (N = 1706)
Among boys (Table 4) the three blocks of variables included in the hierarchical linear regression model – sociodemographic variables, risk factors, and protective factors – made a statistically significant contribution to explaining suicide attempts. The model accounted for approximately 22% of the variance in suicide attempts among boys. Detailed results showed that the risk of suicide attempts among boys increased with higher levels of depressive symptoms, sensation-seeking, experiences of cyberbullying, and the ongoing use of medication for stomach aches. Listening to music during leisure time was also identified as a risk factor. Religious involvement and playing computer games were associated with a reduced risk of suicide attempts among boys.
Table 4
Hierarchical linear regression results predicting frequency of lifetime suicide attempts among boys attending Youth Sociotherapy Centre (YSC) and Youth Correctional Centre (YCC) (N = 1145)
Among girls (Table 5) only two blocks of variables included in the hierarchical linear regression model – socio-demographic variables and risk factors – made a statis-ti-cally significant contribution to explaining suicide attempts. The model accounted for approximately 30% of the variance in suicide attempts among girls. Detailed results showed that the risk of suicide attempts among girls increased with higher levels of depressive symptoms, sensation- seeking, experiences of bullying and cyberbullying, the ongoing use of medication for negative emotional states, and exposure to domestic conflict and violence. None of the factors included in the regression model appeared to offer protection against suicide attempts among girls.
Table 5
Hierarchical linear regression results predicting frequency of lifetime suicide attempts among girls attending Youth Sociotherapy Centre (YSC) and Youth Correctional Centre (YCC) (N = 561)
Discussion
Risk factors
The factor most strongly associated with suicide attempts was the presence of depressive symptoms. The significance of this factor has been confirmed by numerous studies conducted in Poland and other countries, both among adolescents and adults [6, 8, 9, 18, 43]. Most young people with suicidal ideation, plans, or attempts have experienced a mental health disorder during their lifetime, with depression showing the strongest association with suicidal behaviour [8]. The importance of mental health problems as a risk factor is further supported by findings indicating a relationship between suicide attempts and the ongoing use of medication. Previous analyses of medicine use among YSC/YCC youth suggest that the ongoing use of medication for problems such as pain or negative emotional states (i.e. difficulties falling asleep, nervousness, depression, and low mood) is much more prevalent among students attending these institutions than among youth in mainstream schools [44, 45]. Unfortunately, we have not collected information about the specific medications taken by the respondents in the present study. Yet, it is known that a considerable proportion of YSC/YCC students are diagnosed with mental disorders and may receive prescribed medication [2, 3].
In regression analyses conducted separately for boys and girls, the association between the use of medication for negative emotional states and suicide attempts turned out significant only among girls. In contrast, among boys, a significant association was found between suicide attempts and the ongoing use of medication for stomach ache. This finding may be explained in terms of somatization disorders – i.e., physical complaints such as abdominal pain for which no organic cause can be identified [46]. Research has shown that somatization disorders often co-occur with mental health conditions such as anxiety and depression [46]. It is possible that boys may manifest these problems through physical symptoms, such as stomach ache.
Our analyses also confirmed the relationship between suicide attempts and sensation seeking, which had been also documented in other studies. This association is explained in the literature by means of the Interpersonal Psychological Theory of Suicide [10, 11, 15], according to which, a suicide attempt is preceded by the desire to die and the acquired capability to engage in suicidal behaviour. The desire to die arises from two psychological states persisting over time: the perception of being a burden to others, and low sense of belonging or experience of alienation from one’s family, friends, or other signi-ficant individuals. The acquired capability for suicide refers to a reduced fear of pain, injury, or death, which develops through repeated direct or indirect exposure to painful and dangerous experiences, leading to gradual habituation, increased pain tolerance, and diminished fear of death [15]. Individuals with high sensation seeking tendencies often engage in risky behaviours, which, in turn, makes them particularly vulnerable to such experiences. As a result, they may acquire the capability to take their own life, thereby increasing the risk of suicidal behaviour [10].
In this context, it is worth emphasizing that students in YSCs and YCCs are predominantly young people from families experiencing serious difficulties and dysfunc-tional relational patterns. In some cases, children have been abandoned by their biological or adoptive parents [3], which can be considered an act of profound alienation that, according to the aforementioned theoretical framework, can contribute to suicidal behaviour.
The present analyses did not confirm a relationship between suicide attempts and impulsivity. However, previous research has yielded inconclusive results, and in models that account for mental health disorders, the association between impulsivity and suicidal behaviour has not always been found significant [10].
Similarly, regression analyses did not confirm the importance of psychoactive substance use as a factor influencing the frequency of suicide attempts among YSC/YCC youth, despite numerous studies showing that substance use significantly increases the risk of suicidal behaviour [6-8, 12]. However, as indicated by a review of studies on suicidal behaviour among youth in contact with the juvenile justice system, the relationship between substance use and suicidal behaviour in this population is not consistent [48].
Previous analyses have shown that students in YSCs and YCCs – i.e., young people, some of whom have been in contact with the justice system – are significantly more likely to use alcohol, cigarettes, and illegal drugs than their peers in mainstream schools [49]. The high pre-valence of substance use and related problems reduces the predictive value of this factor among justice-involved youth, although it still contributes to a higher incidence of suicidal behaviour [48].
Regression analyses revealed that experiencing bullying and cyberbullying is a significant risk factor for suicide attempts among students in YSCs and YCCs. This finding is supported by numerous studies demonstrating a strong association between exposure to violence and suicidal behaviour. Importantly, as in the present analyses, this relationship remains significant even after controlling for variables such as depression and other symptoms of mental health disorders [11].
However, the present research indicates a stronger association between suicide attempts and cyberbullying than with traditional bullying. Moreover, among boys, the association between experiencing bullying and suicide attempts was found to be non-significant. Other studies likewise suggest that the risk of suicidal behaviour is higher in cases of cyberbullying compared to traditio-nal bullying [11, 13]. One explanation offered in the lite-rature relates to the specific characteristics of cyberbullying: the anonymity of the perpetrator, the rapid spread and persistent availability of harmful content, difficulties in removing such content, its wide dissemination, the potential for continuous harm regardless of location or time of day, and the diverse forms it may take [34, 50].
Cyberbullying is associated with violations of dignity and privacy, social rejection, and emotional suffering, and as a result, it can induce feelings of hopelessness that are linked to suicidal behaviour in youth [13, 51]. Additio-nally, young people who have experienced cyberbullying are less likely to report it or seek help compared to those who have experienced traditional forms of bullying [13]. Perpetrating cyberbullying is also considered a risk factor for suicidal behaviour, although not to the same extent as experiencing this form of violence [9, 13].
In the group of girls, an association was found between suicide attempts and exposure to domestic conflict and violence. This finding, confirmed in other studies, indicates that dysfunctional family relationships, including parental substance use and physical, psychological, and sexual violence against children, are significant risk factors for suicidal behaviour in adolescents [11, 52]. In contrast, this association was not observed among boys. This difference is likely related to gender differences in responses to domestic conflict. Indeed, studies suggest that girls respond to family conflict with mood disorders, including suicidal ideation [53].
A risk factor associated with suicide attempts among YSC/YCC youth, especially boys, was listening to music during leisure time. While this finding may be surprising, research suggests that musical preferences can be related to youth’s mental health. It is known that listening to certain genres of music, such as heavy metal, rock, or blues, may be associated with risk behaviours and mental health problems, including suicidal tendencies [22, 54]. In the analyses presented here, the relevance of this factor to suicide attempts was marginal, indicating that this issue warrants further research.
Protective factors
The results of the present study indicate that a protective factor against suicide attempts among YSC/YCC youth is religious commitment, understood as the importance of religion in a young person’s life. Other studies also confirm that religion can serve as a potential protective factor against suicidal behaviour by shaping – among other things – moral beliefs against taking one’s own life and fostering a sense of belonging to a particular religious community. Faith can also be a source of hope, helping individuals make sense of suffering, while prayer may serve as a coping mechanism in the context of suicidal ideation [20].
However, the relationship between religion and suicide risk is complex and ambiguous. In some circumstances, religion can also be a potential risk factor, particularly when religious beliefs become a source of guilt, feelings of distance from God, or a sense of rejection by the religious community [20]. Further research is needed to explain why this factor was found to be significant only among boys.
Regression analyses did not confirm that factors related to the participants’ social environment, i.e., good relationships with peers and a positive social climate within the YSC/YCC facilities, are significant protective factors against suicidal behaviour. However, other studies have shown that school connectedness – which includes, among other things, good relationships among all members of the school community, a sense of care and respect from teachers and educators, and a sense of safety at school (defined in this study as a positive social climate within the YSC/YCC) – is an important protective factor against suicidal behaviour [19].
There was also no evidence in this study to support the role of parental support as a protective factor. This is likely due to the limited parental support received by young people attending YSC/YCC. Indeed, research shows that YSC/YCC youth rate the level of support from their parents much lower than adolescents attending mainstream schools [21].
The finding regarding the protective role of computer games is noteworthy. On the one hand, excessive gaming is seen as a potentially self-destructive way of coping with life’s difficulties. On the other hand, participation in such games provides a sense of power and autonomy and enhances self-esteem [55]. Low self-esteem is known to be one of the factors contributing to suicidal behaviour among young people [11]. In the present study, computer games turned out to be a protective factor only among boys. This may be because boys play computer games more often than girls and, moreover, they tend to use gaming as a way to make friends [55]. Social support is undoubtedly a protective factor against suicidal beha-viour [15].
In sum, the present study supports previous research demonstrating associations between suicidal attempts and mental health problems, personality traits such as sensation seeking, experiences of peer and domestic violence, and the protective role of religious involvement.
Strengths and limitations of the study
The cross-sectional nature of the study does not allow for conclusions about cause-and-effect relationships. Moreover, the study included adolescents exhibiting significantly higher levels of risky behaviours and mental health problems compared to those from mainstream schools, which limits the generalizability of the results. However, the study involved a large, randomly selected sample of young people residing and studying in YSC and YCC facilities, providing a solid basis for drawing conclusions about risk and protective factors associated with suicide attempts in this high-risk population. To the best of our knowledge, this is the only study conducted to date in Poland that includes such a large sample of residents from YSC/YCC facilities.
An important limitation of the study is the method used to measure the frequency of suicide attempts. The study employed an anonymous, self-administered questionnaire containing only one question about the number of suicide attempts (if any) participants had made in the past. As a result, detailed information on the history of suicide attempts among YSC/YCC youth is lacking. It is unclear how many of these attempts were non-suicidal self-injurious behaviours or cries for help without an actual intent to end one’s life, and how many required medical interventions due to a serious threat of death.
Furthermore, it is unknown at which stage of the suicidal process the participants were at the time of the study – for example, whether they were currently experiencing suicidal thoughts or intentions. The lack of more detailed data on participants’ suicidal behaviours did not allow for a more precise determination of the relationships with the examined risk and protective factors.
In addition to the question about suicide attempts, the survey included questions about substance abuse, mental health problems, and other sensitive topics that may have made some participants apprehensive about disclosing their answers to YSC/YCC staff. For this reason, a pilot study was conducted prior to the national survey to assess the reception and comprehension of the survey questions by potential respondents and to ensure that the questions did not compromise participants’ sense of safety. The surveys were administered by interviewers from outside the YSC/YCC facilities, and participants were assured of the anonymity and confidentiality of their responses before completing the surveys.
The present study was conducted prior to the occurrence of potential traumatic events that may have had both direct (the outbreak of the COVID-19 pandemic in 2020) and indirect (the onset of the full-scale war in Ukraine in 2022) effects on suicidal behaviours among youth in YSC/YCC. To the best of our knowledge, no institution responsible for supervising these facilities has systematically or continuously collected relevant data in this area. Available data from the Centre for Education Development, an agency of the Ministry of National Edu-cation, gathered during the pandemic period (March 20, 2020 – June 25, 2021) and limited to YCC facilities, indicate that a minority – i.e., one in three centres – reported an increase in mental health problems among their students, including internalizing problems such as depression, anxiety disorders, and acute stress reactions (information obtained via personal communication with Marta Paluch, Centre for Education Development). However, the impact of these problems on suicidal behaviours among youth in YSC/YCC remains difficult to determine.
Conclusions
The study presented here is another analysis of data collected from youth belonging to a group at increased risk of various mental health problems. Our previous studies have focused on risky behaviours, including substance use, aggressive and illegal behaviour, and use of medication [44, 45, 49, 56]. Research has also been published on factors associated with internalizing problems among these youth, such as depressive symptoms and other emotional difficulties [21]. The present study focuses specifically on suicidal attempts. The results indicate that YSC/YCC youth are at particular risk for suicidal behaviour, with at least one suicide attempt confirmed by 30% of boys and 60% of girls.
Previous suicide attempts are considered one of the strongest risk factors for subsequent attempts [14, 15, 57]. Therefore, YSC and YCC staff should be trained to carry out suicide prevention measures, including the early identification of young people experiencing mental health crises and the provision of appropriate support and assistance. The results of this study indicate that exposure to bullying and cyberbullying is one of the risk factors for suicidal behaviour. Implementing bullying and cyberbullying prevention programs, as well as intervening, when necessary, should also be key components of efforts to prevent suicidal behaviour among YSC/YCC youth.
The findings also indicate a lack of or limited protective effect of factors that could mitigate the risk of suicidal behaviour. In this context, the absence of a signi-ficant influence of parental support is noteworthy. It is also concerning that, in the case of girls, no protective factors emerged to counterbalance the negative impact of the identified risk factors.
Nevertheless, the findings confirm the protective role of religiosity among boys, as it may foster a sense of belonging and contribute to a greater sense of meaning in life. As a practical implication, it would be advisable to consider strengthening initiatives aimed at building posi-tive bonds between young people – both boys and girls attending YSC/YCC facilities – and the staff of these institutions. Such initiatives may offer opportunities that foster self-esteem and support the development of positive, empowering relationships with supportive adults.
