Background:
Suicidal ideation, defined as thoughts, ideas and the desire to commit suicide, is becoming a major public health problem among adolescents. Indeed, suicidal ideation is known as a key predictor of future suicide risk.

Objective:
This study aims to determine the prevalence and risk factors associated with suicidal ideation among adolescents in Malaysia.

Methods:
This study used data from the 2013 Malaysian adolescent health risk behavior (MyAHRB) study, a cross-sectional school survey conducted in Peninsular Malaysia among school-going adolescents aged 16–17 years (n=2789). Logistic regression analysis was used to determine the risk factors associated with suicidal ideation among Malaysian adolescents.

Results:
The overall prevalence of suicidal ideation among the adolescents was 6.2%. The prevalence was significantly higher among females than males (7.6% vs. 4.7%; p=0.002). Multivariate regression analysis revealed that adolescents who were females [odds ratio (OR)=2.02; 95% confidence interval (CI): 1.40–2.92] or of Indian ethnicity (OR=2.32; 95% CI: 1.35–3.98) were more likely to report suicidal ideation. Loneliness (OR=2.54; 95% CI: 1.57–4.11), anxiety or worry (OR=2.70; 95% CI: 1.70–4.31), no close friends (OR=2.71; 95% CI: 1.43–5.14), and lack of supportive peers (OR=1.69; 95% CI: 1.15–2.47) were identified as risk factors for adolescents’ suicidal ideation. Adolescents who ever had sexual intercourse (OR=2.70; 95% CI: 1.48–4.92) and had been in a physical fight (OR=2.45; 95% CI: 1.62–3.70) were also reported to have higher risks of suicidal ideation.

Conclusion:
This study provides evidence on risk factors associated with suicidal ideation among Malaysian adolescents. Targeted mental health and health risk behavioral interventions for high-risk adolescents are recommended.