AUTHOR=Bukuluki Paul , Wandiembe Symon , Kisaakye Peter , Besigwa Samuel , Kasirye Rogers TITLE=Suicidal Ideations and Attempts Among Adolescents in Kampala Urban Settlements in Uganda: A Case Study of Adolescents Receiving Care From the Uganda Youth Development Link JOURNAL=Frontiers in Sociology VOLUME=Volume 6 - 2021 YEAR=2021 URL=https://www.frontiersin.org/journals/sociology/articles/10.3389/fsoc.2021.646854 DOI=10.3389/fsoc.2021.646854 ISSN=2297-7775 ABSTRACT=Background: There is an increasing recognition that suicide and suicidal ideation is problem in sub-Saharan Africa. One of the studies in Uganda in 2007 showed that suicidal ideation among youth in rural areas is as high as 21.6%. Suicidal ideation and attempts are likely higher among youth living in the slums. The COVID-19 pandemic may exacerbate risk factors for suicidality. Methods: We employed a case study design, taking a case study of adolescents currently under the care of Uganda Youth Development Link (UYDEL). The data were collected from 219 female and male adolescents (13-19 years) recruited from slums in Kampala city and Wakiso district. The data were collected in August 2020 as part of monitoring and evaluation data by the social workers. A Poisson regression model with robust variance was used to assess for risk factors associated with suicidality. Results: The prevalence of suicidal ideation in past four weeks and attempt within the past six months among the adolescents was 31.1% (95%CI: 24.8, 38.0%) and 24.2% (95%CI: 18.7, 30.4%), respectively. Suicidal attempts were similar among the adolescent boys and girls (25.4% vs. 23.7%) but higher among host community adolescents than refugees (25.0% vs. 13.3%). The most stressful precursors of suicidal ideation or attempt included financial difficulties (59.5%), family breakdown or conflicts (37.4%) and trauma (23.1%). Prevalence of suicidal ideation in past 4 weeks was significantly higher among respondents with moderate psychological distress (Prevalence Ratio (PRR)=2.74; 95%CI: 0.96, 7.84) and severe psychological distress (PRR = 4.75; 95%CI: 1.72, 13.08) but lower among adolescents who knew where to obtain professional psychological care (PRR=0.51; 95%CI: 0.30, 0.87). Similarly, suicidal attempts were significantly higher among respondents with moderate psychological distress (PRR=4.72; 95%CI: 1.01, 12.03) and severe psychological distress (PRR = 11.8; 95%CI: 4.66, 32.37), and who abuse drugs or substances (PRR=2.13; 95%CI: 1.13, 4.01). Conclusion: Suicidal ideation is a major public health issue among adolescents living in urban settlements. Psychological distress due to financial difficulties, unemployment and family breakdown are major facilitators of suicidality among adolescents in urban poor settlements. Interventions aimed at preventing adolescent suicide in urban areas should incorporate these risk factors.