Mediating Role of Depression in the Relationship between Substance Use and Suicide Proneness among Adolescents in Underserved Communities in Pakistan

Substance use in children and adolescents is a growing concern among health professionals in Pakistan. This study examined the mediating role of depression between substance use and suicide proneness among adolescents (aged 12 years to 18 years) from underserved communities. Participants were recruited from different places in Karachi, Pakistan using a convenience sampling technique. The Life Attitude Schedule (LAS), Centre for Epidemiologic Studies Depression Scale (CES‑D) and Drug Abuse Screening Test-10 (DAST‑10) were used in Urdu language. Findings revealed that substance use significantly predicted depressive symptoms, which in turn significantly increased suicide proneness. The direct effect of substance use on suicide proneness remained significant, while the indirect effect through depression was also significant, indicating partial mediation. These findings underscore the significance of understanding social, emotional and cognitive domains of children and adolescents, and designing and implementing evidence-based prevention interventions to build resilience which serves as buffer against the mental health issues and other risky behaviours among in vulnerable adolescents. Further, this study signifies how parents can help their children in delaying to use of substance and reducing the risk of mental health problems and suicide among adolescents from underserved communities.