Consistent with other studies we found that compared to

Consistent with other studies, we found that compared to males, females were more likely to have suicidal ideation and suicidal plan (McKinnon et al., 2016; Sharma, Nam, Kim & Kim, 2015; Swahn et al., 2012). A study of suicidality in street children and adolescents in Ghana showed a highly significant difference between the proportion of females reporting suicidal plans and attempts compared to their male counterparts (Oppong Asante, 2015). As argued by Blumenthal and Kupfer (1990), the female preponderance of suicidal ideation and planning may be linked to females’ higher tendency of engaging in both covert and overt help-seeking behaviour, plus their higher score on affective disorders, compared to males. In low-and middle-income countries, it A 779 Supplier has been observed that adolescent girls are more prone to suicidal behaviour (and negative mental health outcomes, more generally) notably because of rigid gender norms and discrimination (Petroni, Patel, & Patton, 2015; WHO, 2014e). Although rigid gender norms and discrimination (e.g., unequal chore burdens, caretaking responsibilities, sexual abuse and exploitation exclusion from education, employment, and decision making etc.) have negative effects on both adolescent boys and girls, the effects are much more telling on girls, constraining their opportunities and aspirations (Petroni et al., 2015). Our study showed an association between suicidal behaviour (ideation, plan and attempts) and anxiety and loneliness. The transition from childhood to adolescence, which is accompanied by physical and psychological challenges such as depression, anxiety and loneliness have been linked to suicidal behaviours in other studies (McKinnon et al., 2016; Swahn et al., 2012, Shilubane et al., 2014). Blum and Nelson-Mmari (2004) in their study to examine the principal causes and influences of morbidity and mortality among young people throughout the world, indicated that there are myriad of psychological and mental health problems that could lead to suicidal behaviours in young people. Even though 16.0% and 18.4% of the participants reported feeling anxiety and loneliness respectively, in the multivariate analysis only anxiety increased the odds of suicidal behaviour, even after controlling for other variables. This suggests that those who follow through more readily with the suicide are those with feelings of anxiety and not necessarily those with feelings of loneliness. Unlike other studies (e.g. Page & West, 2011; Randall et al., 2014; Swahn et al., 2012; Wilson et al., 2012), Codon study did not find substance use as a risk factors for suicidal ideations, plans and attempts. The lack of the relationship between substance use and suicidal behaviour is surprising but this could be attributed to social desirability effect where the participants provided socially desirable responses to the items on substance use because of the strong abhorrence of adolescent drug and substance use within the Ghanaian society (Owusu, 2008). The relationship between hunger/food insecurity and suicide has not been explored in literature particularly among adolescents. However, a systematic review of studies on the prevalence of child mental health problems in sub-Saharan Africa showed that low subjective socio-economic status, poverty, or insufficient food are the most significant risk factors for poor mental health (Cortina et al., 2012). Job loss and chronic unemployment have been found to be risk factors for suicidal ideations and attempts among young adults in Ghana (Adinkrah, 2011; Osafo et al., 2015). In the US, studies have clearly shown that food deprivation among adolescents does not only lead to dysthymia but also thoughts of death, a desire to die and attempted suicide (Alaimo, Olson & Frongillo, 2002; McIntyre, Williams, Lavorato, & Patten, 2013). In this study, perhaps adolescent’s inadequate access to food may have led to heightened emotional responsiveness and increased irritability and distraction, leading to suicidal behaviours.