Background: This study aimed to estimate the prevalence of suicidal behaviors, i.e. suicidal ideation (SI), suicidal plan (SP), and suicidal attempt (SA) among adolescents with a focus on parental and peer support in eight South-East Asian countries including Bangladesh, Bhutan, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka and Thailand. Method: Data were drawn from Global School-based Student Health Survey (GSHS) covering 42,888 adolescents aged 11–17 years. Weighted prevalence of SI, SP, and SA along with country specific prevalence was computed and binary logistic regression was used to identify associated risk factors. Results: Among 42,888 adolescents 19,113 (44.9%) were males and 23,441 (55.1%) females. Overall prevalence of SI, SP and SA is 9.10%, 10.42% and 8.54%, respectively. Myanmar demonstrated the lowest SI (1.07%) and SP (0.18%) whereas lowest SA was found in Indonesia (3.79%). Maldives had the highest prevalence of SI, SP and SA which were 14.13%, 19.02% and 13.38% respectively. Overall suicidal behaviors were associated with being female [AOR: SI-1.26 (1.06,1.50), SP-1.34 (1.14,1.57)], high levels of sedentary behavior [AOR: SI-2.08 (1.62,2.66), SP-1.86 (1.49,2.32), SA-1.96 (1.45,2.64)], involvement in physical fighting [AOR: SI-1.30 (1.07,1.58), SP-1.37 (1.14,1.65), SA-1.50 (1.17,1.90)], being seriously injured [AOR: SI-1.40 (1.17,1.67), SP-1.44 (1.22,1.69), SA-1.74 (1.39,2.17)], being bullied [AOR: SI- 1.68 (1.39,2.02), SP-1.34 (1.12,1.60), SA-1.88 (1.50,2.36)], feeling lonely (most of time or always) [AOR: SI-3.41(2.60,4.46), SP-1.92 (1.48,2.47), SA-2.25 (1.62,3.13)], lack of parental support (never checking homework) [AOR: SI-1.59 (1.25,2.02), SP-1.52 (1.22,1.90)] and not having close friends [AOR: SI-2.19 (1.66,2.89), SP-2.26 (1.74,2.94), SA-4.23 (3.10,5.78)]. Conclusion: Though prevalence of suicidal behaviors varies, a range of cross-cutting risk factors exists that warrant further examination. We recommend focusing on strengthening parental and peer support, targeted programs addressing physical activity, bullying, loneliness and mental-health of adolescents.
