Abstract
Research on suicidal ideation among adolescents following bereavement remains relatively limited. This study aims to investigate the prevalence of suicidal ideation among adolescents using a psychological support hotline after experiencing the general death of a family member (not specifically suicide), and to explore the risk factors associated with suicidal ideation. This study recruited 850 adolescents (mean age 15 years; 558 female callers and 292 male callers) who sought help from a psychological support hotline due to the general death of a family member. They were then divided into a group with suicidal ideation and a group without suicidal ideation based on the presence or absence of suicidal thoughts. General demographic information, as well as levels of depression, grief, psychological distress, hopelessness, and suicide risk factors, were collected through standardized questionnaires and interviews. Logistic regression analysis was used to examine the risk factors for suicidal ideation among bereaved adolescents and the interactions between these risk factors. Among the 850 bereaved adolescents, 754 (88.7%) had suicidal ideation, while 96 (11.3%) did not. Severe helplessness (OR = 2.98, 95%CI:1.16–7.66), severe psychological distress (OR = 3.91, 95%CI:1.43–10.68), severity of depression (OR = 1.03, 95%CI:1.01–1.04), grief intensity (OR = 1.17, 95%CI:1.02–1.35), and history of suicide attempt (OR = 2.01, 95%CI:1.18–3.44) are identified as risk factors for suicidal ideation among bereaved adolescents. Depression severity and a history of suicide attempts among bereaved adolescents exhibited a positive additive interaction in relation to suicidal ideation. Compared with those with lower depression severity and no history of suicide attempts, bereaved adolescents with depression increased by 2SD (34.1 points) and a history of suicide attempts were more likely to report suicidal ideation(OR = 6.32, 95%CI:1.90–21.06). In the group of bereaved adolescents seeking help from the psychological support hotline, severe hopelessness, severe psychological distress, severity of depression, grief intensity, and a history of suicide attempts are risk factors for suicidal ideation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1038/s41598-026-41739-1.