Abstract

Mental health among higher education students is a growing public health concern in Chile, where 58 universities host a diverse student population facing significant academic and emotional challenges. This study aimed to determine the prevalence of suicidal risk, ideation, and attempts, as well as associated risk factors in Chilean university students. A cross-sectional study was conducted with 1511 participants (72.3% women, 27.7% men; mean age = 25.7 +/- 7.82 years), using a digital self-administered questionnaire that included the Okasha's Suicidality Scale (OSS), Depression, the Anxiety, and Stress Scale-21 items (DASS-21), the Emotional Exhaustion Scale (ECE), and sociodemographic variables. Logistic regression identified key factors associated with suicide attempts, such as being female (OR = 1.418, 95% CI [1.037, 1.939]), belonging to sexual minorities (OR = 2.539, 95% CI [1.899, 3.396]), being aged 26-30 (OR = 1.952, 95% CI [1.344, 2.836]), and being in the third year of university (OR = 1.483, 95% CI [1.097, 2.005]). Depression (OR = 7.065, 95% CI [5.307, 9.407]) and anxiety (OR = 1.895, 95% CI [1.400, 2.565]) were the strongest predictors, while substance use, including marijuana (OR = 2.107, 95% CI [1.620, 2.740]), cocaine (OR = 1.575, 95% CI [1.193, 2.078]), and non-prescribed antidepressants (OR = 6.383, 95% CI [1.524, 26.733]), significantly increased risk. These findings highlight the urgent need for targeted mental health interventions and policy actions in Chilean higher education to address post-pandemic increases in suicide-related behaviors.