Suicidal ideation and its associated factors among secondary students in Nepal

Purpose This study aimed to assess the prevalence of suicidal ideation and attempts among adolescent students in Waling Municipality, Syangja District, Nepal and identify associated psychosocial and demographic factors. It focused on emotional distress, school environment and interpersonal experiences such as breakups and violence. Design/methodology/approach A school-based cross-sectional quantitative study was conducted among 183 students (grades 9–12) using a structured self-administered questionnaire. Participants were selected through multistage stratified random sampling. Data were analyzed using descriptive statistics, chi-square tests and logistic regression to identify predictors of suicidal ideation. Findings Suicidal ideation was reported by 13.1% of adolescents. Female students and those from non-Brahmin/Chhetri ethnic groups were more likely to report suicidal ideation. Adolescents experiencing emotional distress and those exposed to negative school environments also had a higher likelihood of ideation. A poor school environment significantly reduced the odds of suicidal ideation (AOR = 0.062, p = 0.003), whereas participation in volleyball or basketball markedly increased the odds (AOR = 15.5, p = 0.003). Prior suicide attempts and frequent depressive episodes strongly heightened the risk of suicidal ideation. Research limitations/implications The cross-sectional design limits causal inferences. Data from a single municipality and reliance on self-reports may affect generalizability and accuracy. Practical implications Findings support school-based mental health interventions, educator training and efforts to improve school climate. The study highlights adolescent mental health as a public health priority in Nepal, emphasizing the need for stigma reduction, supportive environments and community engagement. Social implications This research highlights the urgent need to address adolescent mental health as a public health priority in Nepal. The findings suggest that stigma, lack of emotional support and insufficient mental health infrastructure contribute to suicidal ideation among adolescents. By drawing attention to the role of school environment, the study promotes a holistic, community-based approach to mental well-being. Empowering adolescents through safe spaces, emotional expression and accessible psychosocial support could help mitigate suicide risks. Raising awareness among parents, schools and policymakers is crucial to fostering a supportive ecosystem for adolescents in both rural and urban Nepalese settings. Originality/value This is one of the few Nepalese studies exploring diverse psychosocial factors of adolescent suicidal ideation, providing actionable insights for educators, health professionals and policymakers.