Exploring factors contributing to suicide and suicide attempts among adults aged 20 to 45 years in Ikelenge Central, Ikelenge District, Zambia: a phenomenological study

Abstract Background: Suicide remains an important public health problem worldwide and in Zambia, yet there is still limited published evidence from rural settings on how community members understand the causes of suicide and suicide attempts, the support offered after such events, and the interventions people see as most useful for prevention. This study explored factors contributing to suicide and suicide attempts among adults aged 20 to 45 years in Ikelenge Central, Ikelenge District, Zambia, together with the support offered by stakeholders and the interventions preferred by community members. Methods: A qualitative phenomenological study was conducted in Ikelenge Central among adults aged 20 to 45 years who had either survived a suicide attempt or had a family experience of suicide or attempted suicide. Purposive sampling was used, and in-depth interviews were conducted with 13 participants using a semi-structured interview guide. Data were analysed thematically. Ethical approval was obtained from the Lusaka Apex Medical University Biomedical Research Ethics Committee, and study clearance was obtained from the Zambia National Health Research Authority, with district authorisation granted before data collection in accordance with the National Health Research Act No.2 of 2013. Results: Participants described suicide and suicide attempts as arising from several interlinked pressures rather than one single cause. The main contributing factors identified were social factors such as parent-child conflict, family conflict, marital breakdown and intimate partner conflict; economic factors such as poverty, debt and unemployment; psychological factors such as depression, psychosis, post-traumatic stress disorder and alcohol misuse; physiological factors such as chronic illness, HIV, cancer and COVID-19; biological factors such as family history or genetic predisposition; and environmental factors such as easy access to means of suicide. Support offered after suicide attempts or suicide-related events included hospital management, bereavement assistance, financial literacy training and integrated care from different stakeholders. Participants proposed stronger mental health services, better emergency preparedness, economic and vocational support, and wider community sensitisation as practical prevention measures. Conclusion: Suicide and suicide attempts in Ikelenge Central were understood as the outcome of overlapping social, economic, psychological, biological, physiological and environmental pressures. Community-informed prevention should therefore combine mental health care, social support, livelihood strengthening, and local awareness efforts rather than relying on one narrow response.