Prevalence and correlates of 30-day suicidal ideation and intent: Results of the South African National Student Mental Health Survey


  • J Bantjes Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa; Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, South Africa; Boston College, Chestnut Hill, USA
  • MJ Kessler Boston College, Chestnut Hill, USA
  • X Hunt Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, South Africa
  • RC Kessler Department of Health Care Policy, Harvard Medical School, Boston, USA
  • DJ Stein SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, South Africa



Suicide, Students


Background. Although suicide prevention is recognised as a priority among university students in South Africa (SA), it is unclear what
proportion of students require urgent indicated interventions and what the characteristics are of these students.
Objective. To assess the prevalence and sociodemographic correlates of 30-day suicidal ideation, frequency of ideation and self-reported intention to act on ideation in the next year among a national sample of SA university students.
Methods. Self-report cross-sectional data were collected online from students (N=28 268) at 17 universities across SA as part of the national student mental health survey. Students reported suicidal ideation in the past 30 days, frequency of ideation and intention to act on ideation in the next year. Data were weighted within institutions by gender and population group, and across the four main types of universities (historically white, historically disadvantaged, technical and distance learning) to correct for response rate discrepancies. Prevalence was estimated with these weighted in the total sample and across types of universities. Poisson regression with robust error variances was used to investigate associations of sociodemographic characteristics with ideation and intention to act on suicidal ideation. Results are reported as relative risks (RRs) with design-based 95% confidence intervals (CIs).
Results. Thirty-day prevalence of suicidal ideation was 24.4% (standard error (SE) 0.3), with 2.1% (SE 0.1) and 4.1% (SE 0.1), respectively,
reporting suicidal ideation all/almost all the time, or most of the time. A total of 1.5% (SE 0.1) of respondents reported being very likely to act on their suicidal ideation, while 3.9% (SE 0.2) were somewhat likely, 8.7% (SE 0.2) were not very likely and 85.8 (SE 0.5) either reported no suicidal ideation or that they were not at all likely to act on this ideation. Risk of suicidal ideation with high intent in the total sample was elevated among females (RR 1.9, 95% CI 1.3 - 2.7) and gender non-conforming students (RR 4.3, 95% CI 1.4 - 13.0) relative to males, black African students compared with white students (RR 3.6, 95% CI 1.9 - 7.1), students whose parents did not progress to secondary school compared with students whose parents had a university education (RR 1.6, 95% CI 1.0 - 2.5) and sexual minority students compared with heterosexual students (RR 1.9, 95% CI 1.3 - 2.6). Among students with 30-day ideation (controlling for frequency of ideation), only two of these predictors of high intent remained significant: identifying as black African (RR 2.7, 95% CI 1.4 - 5.1), and having parents with less than secondary education (RR 1.5, 95% CI 1.0 - 2.1).
Conclusion. Scalable suicide prevention interventions are needed to reach the large number of SA students who report suicidal ideation with intent.


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How to Cite

Bantjes J, Kessler M, Hunt X, Kessler R, Stein D. Prevalence and correlates of 30-day suicidal ideation and intent: Results of the South African National Student Mental Health Survey. S Afr Med J [Internet]. 2023 Mar. 8 [cited 2024 Jun. 15];113(4). Available from:

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