"It's a sin against God": Understanding how Ghanaian adolescents frame suicide as sin, taboo, and crime

Suicide remains a significant public health concern among adolescents in Ghana, yet limited research exists on how young people conceptualize suicide within their cultural context. This study aimed to examine how Ghanian high school students conceptualize suicide in relation to religious, cultural, and legal frameworks that shape their understanding. This descriptive qualitative study was conducted as part of the 2024 Ghana Youth Mental Health Survey. Twenty junior high school students were purposively selected from rural, peri-urban, and urban schools across four major regions to ensure diverse representation. In-depth, semi-structured cognitive interviews were conducted in English. Data was analyzed using Braun and Clarke's approach, with multiple coders contributing to thematic development and refinement. Participants described suicide through four overlapping constructs: as a sin, taboo, mental health issue, and crime. Religious framings emphasized divine ownership of life, biblical teachings, and spiritual consequences. Cultural perspectives focused on shame, communal identity, and ancestral values. Others associated suicide with criminality and police involvement. Across interviews, students expressed coexisting views, drawing from diverse belief systems to explain suicide occurrence and treatment. Ghanaian adolescents do not conceptualize suicide in singular terms. Their understandings are shaped by the interplay of religious, cultural, psychological, and institutional narratives. Suicide prevention must be grounded in these lived meanings and avoid one-size-fits-all approach. Preventive strategies should engage religious leaders, affirm community values, reduce mental health stigma, and provide safe spaces for adolescents to alleviate distress. Addressing the nuanced logics adolescents draw upon is essential to designing interventions that resonate with their realities.