Suicidal ideation and planning among Palestinian middle school students living in Gaza Strip, West Bank, and United Nations Relief and Works Agency (UNRWA) camps

The goal of this study was to identify the prevalence and correlates of suicidal thinking among Palestinian middle school students by using complex samples analysis to explore data about suicidal ideation and suicidal planning in the past year from 14,303 students in grades 7, 8, and 9 (roughly ages 13–15 years) who participated in the Global School-based Student Health Survey (GSHS) in 2010 in the Occupied Palestinian Territory (OPT) and United Nations Relief and Works Agency (UNRWA) refugee camps. We also analyzed data from the seven other GSHS-participating countries from the Eastern Mediterranean region: Iraq, Jordan, Kuwait, Lebanon, Morocco, Tunisia, and the United Arab Emirates. The overall prevalence of suicidal ideation and/or planning was 25.6%. Males were more likely than females to report suicidal thinking. The health behaviors and exposures most strongly associated with suicidal thinking were marijuana use, having no close friends, tobacco use, loneliness, worry-induced insomnia, food insecurity, and being the victim of a bully. Being involved in physical fights and attacks, skipping school, and perceptions of limited parental support were also associated with suicidal thinking. The prevalence of suicidal thinking among Palestinian adolescents was higher than the rates in the other GSHS-participating countries, pointing toward a need for improved access to adolescent mental health services.