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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122 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 statusE-pub ahead of print - 13 Feb 2018


  • Students
  • suicidal behaviour
  • mental health


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