The mediating roles of self-compassion and growth mindset among the relationships between multifaceted factors with youth suicidality in Hong Kong

Background Previous studies have found protective roles of self-compassion, and growth mindset in youth suicidality. This study aimed to understand the mediating roles between self-compassion and growth mindset and the impacts of intra-individual, behavioural, family, and school risk factors on youth suicidality. Methods A school-based survey was conducted in four primary schools and 11 secondary schools across Hong Kong. Binary logistic regression and path analysis were conducted to examine the mediation and moderation effects on multi-factors in youth suicidality. Results 4832 children and adolescents of whom 27.31% (Suicidal ideation, SI: n=1311), 16.92% (Suicidal plan, SP: n=786), 7.17% (Suicidal attempt, SA: n=333), and 11.93% (Non-suicidal self-injury, NSSI: n=555) reported experiencing suicidal ideation, plan, attempt, and NSSI, respectively. Enjoying school lowered suicide risk by about 19% (SP: adjusted odds ratios (AOR)=0.81, 95% confidence interval (CI)=0.67-0.97, p =.02; SA: AOR=0.65, 95%CI=0.50-0.84, p =.001), while preferring online classes raised risk by 30% (SP: AOR=1.3, 95%CI=1.08-1.57, p =.005). Over 2 hours daily on TV, social media, and video games increased suicidal thoughts by 19-41% (from AOR=1.19, 95%CI=1.00-1.42, p =.046 to AOR=1.41, 95%CI=1.18-1.69, p <.001). Over 2 hours on social media raised suicide attempts by 61% (AOR=1.61, 95%CI=1.26-2.05, p <.001). Primary school students spending over 2 hours on social media had 3.26-times higher plans (AOR=3.26, 95%CI=1.50-7.04, p =.003) and 4.16-times higher attempts (AOR=4.16, 95%CI=1.65-10.46, p =.002). Self-compassion reduced risk by 42-64% (SA: AOR=0.58, 95%CI=0.45-0.76, p <.001; NSSI: AOR=0.36, 95%CI=0.29-0.45, p <.001), while fixed mindset increased risk by 3-4% (SI: AOR=1.03, 95%CI=1.02-1.04, p <0.001; SP: AOR=1.04, 95%CI=1.03-1.05, p <0.001). Conclusions Focus shall be on promoting self-control, self-compassion, openness to novelty, adaptive coping, social skills, and family involvement for youth suicide prevention.