Suicidal Thoughts and Behaviors Among First-Year College Students: Results from the WMH-ICS Project

Philippe Mortier, Randy Auerbach, Jordi Alonso, Jason Bantjes, Corina Benjet, Pim Cuijpers, David Ebert, Jennifer Greif Green, Penelope Hasking, Matt Nock, Siobhan M. O'Neill, Stephanie Pinder-Amaker, Nancy Sampson, Gemma Vilagut, Alan Zaslavsky, Ronny Bruffartes, Ron Kessler

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183 Citations (Scopus)


College entrance may be a strategically well-placed “point of capture” for detecting late adolescents with suicidal thoughts and behaviors (STB). However, a clear epidemiological picture of STB among incoming college students is lacking. We present the first cross-national data on prevalence as well as socio-demographic and college-related correlates for STB among first-year college students.

Web-based self-report surveys were obtained from 13,984 first-year students (response rate 45.5%) across 19 colleges in eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States).

Lifetime prevalence of suicidal ideation, plans, and attempts was 32.7%, 17.5%, and 4.3%, respectively. Twelve-month prevalence was 17.2%, 8.8%, and 1.0%, respectively. About 75% of STB cases had onset before the age of 16 years (Q3 = 15.8), with persistence figures in the range 41-53%. About half (53.4%) of lifetime ideators transitioned to a suicide plan; 22.1% of lifetime planners transitioned to an attempt. Attempts among lifetime ideators without plan were less frequent (3.1%). Significant correlates of lifetime STB were cross-nationally consistent and generally modest in effect size (median adjusted OR [aOR] = 1.7). Non-heterosexual orientation (aOR range 3.3-7.9) and heterosexual orientation with some same-sex attraction (aOR range 1.9-2.3) were the strongest correlates of STB, and of transitioning from ideation to plans and/or attempts (aOR range 1.6-6.1).

The distribution of STB in first-year students is widespread, and relatively independent of socio-demographic risk profile. Multivariate risk algorithms based on a high number of risk factors are indicated to efficiently link high-risk status with effective preventive interventions.
Original languageEnglish
Number of pages12
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number4
Early online date13 Feb 2018
Publication statusPublished online - 13 Feb 2018


  • Students
  • suicidal behaviour
  • mental health


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