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ABSTRACT
Background: Suicidal behaviour among adolescents and young adults remains a major public health concern. In sub-Saharan Africa, however, qualitative work that captures both youth and caregiver perspectives is still limited. This study explored the lived experience of suicidal behaviour and the perceived triggers and responses to it among young people and their caregivers in a tertiary facility in Nairobi, Kenya.
Methods: This qualitative in-depth study involved young people aged 13–24 years attending the Youth Centre at Kenyatta National Hospital, together with a subset of their caregivers. Recruitment used purposive and snowball sampling until saturation was reached. Semi-structured interviews were audio-recorded, transcribed verbatim, translated by consensus where necessary, and analysed thematically with NVivo. Descriptive questionnaire data were used to characterise the sample and contextualise the findings.
Findings: The narratives were consistent with socioecological, stress-diathesis, and interpersonal perspectives, showing how individual vulnerability interacted with relational strain, digital exposure, and socioeconomic adversity. Youth described suicidal thoughts and behaviours as usually emerging gradually after cumulative distress. Perceived triggers included school and work pressure, family conflict, relationship breakdown, social media comparison and cyberbullying, poverty, and psychosocial or health-related stressors such as depression, substance use, trauma, and abuse. Caregivers were generally sympathetic, but many reported uncertainty and low confidence in responding to suicidal behaviour. The findings point to the need for integrated interventions that address mental illness, family systems, stigma, access to care, and broader socioeconomic vulnerability.
Conclusion: Suicidal behaviour in this setting reflected the interaction of personal and structural disadvantage rather than a single precipitating event. Prevention should combine youth-friendly mental health care, caregiver psychoeducation, family involvement, school-based support, and community-level action on poverty, stigma, and service access.