A Two-Panel Delphi Study on Risk Factors of Adolescent Suicide in South Korea

This study aimed to identify and reach a consensus on factors contributing to adolescent suicidality following biopsychosocial model. The research was conducted in three stages: (1) literature review and school counselor interview on self-harm and suicidal risk factors in the adolescent population; (2) development of a list of risk factors (3) Delphi survey on counselor panel and adolescent panel. Three rounds of the Delphi questionnaire were conducted for each panel. Results discovered that there was consensus between the counselors and adolescents as well as counselor and adolescent exclusive risk factors. Both panels agreed on ‘psychiatric difficulties,’ ‘guilt,’ ‘perceived burdensomeness,’ ‘feeling worthlessness,’ ‘powerlessness,’ ‘hopelessness,’ ‘acquired capability for suicide,’ ‘positive expectations of death,’ ‘lack of meaning in life,’ ‘absence of alternatives to self-harm,’ ‘loneliness,’ ‘impulsivity,’ ‘exposure to problematic parenting,’ ‘family conflict,’ ‘domestic abuse,’ ‘experience of school violence’ ‘bullying or being out casted’, ‘loss of reliance’ and ‘economic hardship.’ Counselor panel exclusive consensus represented the importance of a broad range of risk factors, while adolescents suggested risk factors using expressions that specifically and delicately revealed internal experiences. The consented risk factors could enhance adolescent suicide prevention, as they were validated by the key stakeholders, the adolescents in crisis, and their counselors.