Perceptions of Adolescents, Teachers and Parents towards Causes and Prevention of Suicide in Secondary School Students in Chiang Mai

Main Article Content

Surachai Chaniang
Warunee Fongkaew
Hunsa Sethabouppha
Sumalee Lirtmunlikaporn
Karen G Schepp



                 Adolescent suicide has become a major public health concern worldwide, including in Thailand. This qualitative descriptive study explored the perceptions of adolescents, teachers and parents towards causes and prevention of suicide in secondary school students in Chiang Mai. Purposive sampling was used to select 40 adolescents for focus group discussions, and in-depth interviews were conducted with 4 parents and 3 school teachers, from October 2014 to February 2015. The data were analyzed using content analysis.  

                  The categories of this study were two-fold: 1) the causes of adolescent suicide which could be summarized into four sub-categories, namely parents' expectations, lack of skills to confront problems, feeling lonely from inadequate support, and lack of parental skills, and 2) Prevention of adolescent suicide, which had four sub-categories, namely cultivating self-esteem, parental support and caring, peer support, and supportive school environments. The findings of this study could help as evidence for developing a suicide prevention program for Thai secondary school students and should help parents, teachers and school nurses to understand the emotional needs of adolescents better.











Article Details

How to Cite
Chaniang S, Fongkaew W, Sethabouppha H, Lirtmunlikaporn S, Schepp KG. Perceptions of Adolescents, Teachers and Parents towards Causes and Prevention of Suicide in Secondary School Students in Chiang Mai. PRIJNR [Internet]. 2018 Dec. 19 [cited 2022 Oct. 4];23(1):47-60. Available from:
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Author Biography

Surachai Chaniang, RN, PhD Candidate, Faculty of Nursing, Chiang Mai University, Thailand and Lecturer, Boromarajonani College of Nursing Nakhon Phanom, Nakhon Phanom University, Thailand


1.Calear AL, Brewer JL, Batterham PJ, Mackinnon A, Wyman PA, LoMurray M, et al. The Sources of Strength Australia Project: study protocol for a cluster randomised controlled trial. Trials. 2016;17(1):349

2. Swartz KL, Kastelic EA, Hess SG, Cox TS, Gonzales LC, Mink SP, et al. The effectiveness of a school-based adolescent depression education program. Health Education & Behavior. 2010;37(1):11-22.

3. Kann L. Youth risk behavior surveillance—United States, 2015. MMWR Surveillance Summaries. 2016;65.

4. Kittiteerasack P. Trends and assessment of suicidal behavior. Journal of Science and Technology [Internet] 2012. [Cited 2014, Oct27] at tstj/ article/view/12636/11364) (in Thai)

5. Rungsang B, Chaimongkol N. The Prevalence of Suicidal Ideation among High School Students in Thailand and Its Potential Related Risk Factors. Thai Pharmaceutical and Health Science Journal. 2017;12(1):31-5.

6. Tittabut J. Situation analysis of adolescent attempted suicide in Chaiprakarn District, Chiang Mai Province, Thailand: Chulalongkorn University; 2011.

7. Whitlock J, Wyman PA, Moore SR. Connectedness and suicide prevention in adolescents: pathways and implications. Suicide and life-threatening behavior. 2014;44(3):246-72.

8. Andriessen K, Krysinska K. Railway suicide in Belgium 1998–2009. Crisis. 2012.

9. Tasai S, Reuchutakuln P, Thumamaporn W. Stress and Stress Coping of the High School Students in Changwat Songkhla. Journal of Education (Prince of Songkhla University at Pattani Campus). (2009); (2): 101-114. (in Thai).

10. Ministry of Education. Education in Thailand [Internet]. 2010 [cited 2017 Nov 9]. Availible from http:// en.

11. Thanoi W, Phancharoenworakul K, Thompson EA, Panitrat R, Nityasuddhi D. Thai adolescent suicide risk behaviors: testing a model of negative life events, rumination, emotional distress, resilience and social support. Pacific Rim Int J Nurs Res. 2010;14(3):187-202.

12. Boonyamalik P. Epidemiology of adolescent suicidal ideation: Roles of perceived life stress, depressive symptoms, and substance use: Johns Hopkins University; 2005.

13. Nintachan P. Resilience and risk taking behavior among Thai adolescents living in Bangkok. (Unpublished doctoral dissertation) Virginia Commonwealth University, Richmond, VA. 2007.

14. Peltzer K, Pengpid S. Suicidal ideation and associated factors among school-going adolescents in Thailand. International journal of environmental research and public health. 2012;9(2):462-73.

15. Chaimongkol N, Deoisres W, Wongnam P. Suicidal Ideation among Thai Adolescents: An Empirical Test of a Causal Model. Pacific Rim International Journal of Nursing Research. 2017;21(2):97-107.

16. Thompson EA, Mazza JJ, Herting JR, Randell BP, Eggert LL. The mediating roles of anxiety, depression, and hopelessness on adolescent suicidal behaviors. Suicide and Life-Threatening Behavior. 2005;35(1):14-34.

17. Tusaie K, Puskar K, Sereika SM. A predictive and moderating model of psychosocial resilience in adolescents. Journal of Nursing Scholarship. 2007;39(1):54-60.

18. Kleiman EM, Liu RT. Social support as a protective factor in suicide: Findings from two nationally representative samples. Journal of affective disorders. 2013;150(2):540-5.

19. Randell BP, Wang W-L, Herting JR, Eggert LL. Family factors predicting categories of suicide risk. Journal of Child and Family Studies. 2006;15(3):247-62.

20. De Luca SM, Wyman P, Warren K. Latina adolescent suicide ideations and attempts: Associations with connectedness to parents, peers, and teachers. Suicide and Life-Threatening Behavior. 2012;42(6):672-83.

21. LeCloux M, Maramaldi P, Thomas K, Wharff E. Family Support and Mental Health Service Use Among Suicidal Adolescents. Journal of Child and Family Studies. 2016; 25(8):2597-606.

22. Stone DM, Crosby AE. Suicide prevention: state of the art review. American Journal of Lifestyle Medicine. 2014; 8(6):404-20.

23. Kerr DC, Preuss LJ, King CA. Suicidal adolescents’ social support from family and peers: Gender-specific associations with psychopathology. Journal of abnormal child psychology. 2006;34(1):99-110.

24. Shilubane HN, Bos AE, Ruiter RA, Borne B, Reddy PS. High school suicide in South Africa: teachers’ knowledge, views and training needs. BMC public health. 2015; 15(1): 245.

25. Robinson J, Cox G, Malone A, Williamson M, Baldwin G, Fletcher K, et al. A systematic review of school-based interventions aimed at preventing, treating, and responding to suicide-related behavior in young people. Crisis. 2013.

26. Ciffone J. Suicide prevention: An analysis and replication of a curriculum-based high school program. Social Work. 2007;52(1):41-9.

27. Strunk CM, Sorter MT, Ossege J, King KA. Emotionally troubled teens’ help-seeking behaviors: An evaluation of surviving the teens® suicide prevention and depression awareness program. The Journal of School Nursing. 2014;30(5):366-75.

28. Wyman PA, Brown CH, Inman J, Cross W, Schmeelk-Cone K, Guo J, et al. Randomized trial of a gatekeeper program for suicide prevention: 1-year impact on secondary school staff. Journal of consulting and clinical psychology. 2008;76(1):104.

29. Wyman PA, Brown CH, LoMurray M, Schmeelk-Cone K, Petrova M, Yu Q, et al. An outcome evaluation of the Sources of Strength suicide prevention program delivered by adolescent peer leaders in high schools. American journal of public health. 2010;100(9):1653-61.

30. Thompson EA, Eggert LL, Randell BP, Pike KC. Evaluation of indicated suicide risk prevention approaches for potential high school dropouts. American Journal of Public Health. 2001;91(5):742.

31. Tang TC, Jou SH, Ko CH, Huang SY, Yen CF. Randomized study of school-based intensive interpersonal psychotherapy for depressed adolescents with suicidal risk and parasuicide behaviors. Psychiatry and Clinical Neurosciences. 2009; 63(4):463-70.

32. Jordan JR, McMenamy J. Interventions for suicide survivors: A review of the literature. Suicide and life-threatening behavior. 2004;34(4):337-49.

33. Kaesornsamut P, Sitthimongkol Y, Williams RA, Sangon S, Rohitsuk W, Vorapongsathorn T. Effectiveness of the BAND intervention program on Thai adolescents’ sense of belonging, negative thinking and depressive symptoms. Pacific Rim Int J Nurs Res. 2012;16(1):29-47.

34. Vuthiarpa S, Sethabouppha H, Soivong P, Williams R. Effectiveness of a school-based cognitive behavioral therapy program for Thai adolescents with depressive symptoms. Pacific Rim Int J Nurs Res. 2012;16(3):206-21.

35. Lambert VA, Lambert CE. Editorail: Qualitative descriptive research: An acceptable design. Pacific Rim Int J Nurs Res. 2012; 16(4): 255-6.

36. Miles MB, Huberman AM. Qualitative data analysis: An expanded sourcebook: sage; 1994.

37. Lincoln SY, Guba EG.Naturalistic inquiry. Newbury Park: Sage Publication; 1985.

38. Sukhawaha S, Arunpongpaisal S, Hurst C. Development and psychometric properties of the Suicidality of Adolescent Screening Scale (SASS) using Multidimensional Item Response Theory. Psychiatry research. 2016;243:431-8.

39. Page RM, Yanagishita J, Suwanteerangkul J, Zarco EP, Mei-Lee C, Miao N-F. Hopelessness and loneliness among suicide attempters in school-based samples of Taiwanese, Philippine and Thai adolescents. School psychology international. 2006;27(5):583-98.

40. Ang RP, Huan VS. Relationship between academic stress and suicidal ideation: Testing for depression as a mediator using multiple regression. Child psychiatry and human development. 2006;37(2):133.

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