Introduction

Suicide is one of the major mental health concerns that is found in every society across the world [1]. Suicide is the intentional or deliberate act of killing own self [2]. Globally, suicide is the 15^th leading cause of death for all ages [3, 4]. Despite the commendable progress of human society in the 21^st century, one person dies due to suicide in every 40 seconds. Across the world nearly around 8 hundred thousand suicide cases are registered every year and out of them, 77% suicides occur in low -and -middle income countries [5]. It has been observed that with a suicide rate of 10.5/100,00 (for the world, it is 11.6/100,00), India reports a concerning suicide prevalence [6]. According to Indian National Crime Records Bureau (NCRB), the numbers of suicides in India in the years 2019 and 2020 reportedly increased by 10% and 8.7% compared to the previous years respectively [7]. Suicide among Indian adolescents constitutes a significant proportion of the total number of suicides every year in the country. In India population of adolescents is the largest as it constitutes one-fifth population in India [8].

Adolescence in India is defined as the age group ranging between 10–19 years [9]. Studies show that adolescents in India have consistently been highly vulnerable to suicide [10] due to the early onset of various complexities in their lives leading to ambiguity and lack of experience to handle pressure pushing them into the trap of quick escape and committing suicide [11]. In this phase, many physical and psychological developments including hormonal changes leading to adulthood occur [9]. Findings suggest suicide is the 4^th leading cause of death among the late adolescent age group [12]. According to NCRB 2020 report, 11396 adolescents (below 19 years of age) died due to suicide in the previous year [13]. More broadly, mental health conditions are a major risk factor in adolescent age group. According to UNICEF, an estimated 166 million adolescents (89 million boys and 77 million girls) had mental health conditions, which means one in seven adolescents experience mental health disorders [14]. So, in this context, it is crucial to ensure that adolescents are fully supported and cared for in all aspects of life, including their mental health and well-being so that they can smoothly lay a foundation for their healthy and productive adulthood.

To improve and break the cycle of adolescent suicide, there is a need of evidence-based study, and this proposed scoping review will fulfil this aspect by providing the knowledge about the pattern of suicide by focusing on the methods, time and location of suicide attempt which will help to devise suicide preventive strategies [15]. Our next objective is to analyze how suicide study is changing over time and analyze its trend which will help decision-makers to understand whether the current strategies are working or not [16]. Suicide risk factors are the things that has the potential to increase the chances of suicide hence understanding of the risk factors will help us to counteract the fact that suicide is a random act or is a result of just stress or depression [17]. Several studies evaluated adolescent anxiety [18], depression [19], and suicidal behavior [20] but no review, as per our knowledge, is available having explained the patterns, trends, and risk factors associated with suicidal behavior in Indian adolescents. Therefore, the planned scoping review aims to provide the patterns, trends, and major risk factors associated with suicidal behavior in Indian adolescents which can help further research and policy-making.

Objectives

The objectives of the planned scoping review are as follows:

• To map the patterns and trends of suicide among the adolescents of India.
• To understand the major risk factors associated with suicide among the adolescents of India.

Methods and analysis

In the present review, we aim to synthesis the evidence around selected objectives defining the patterns, trends and the major factors associated with suicide among the adolescents of India. Prior to defining the objectives and design of the study, we first checked for the availability and accessibility of any scoping review on suicidal status among the adolescent population of India in an online database and protocol registration website. We checked it on Figshare, Open Science Framework; consequently, we found that there is no previously published scoping review on suicide among adolescents of India, followed by which the present study was designed.

This study will be conducted according to the Arksey and O’Malley scoping review framework (Arksey and O’Malley, 2005) [21] and will also follow the recommendations on writing a scoping review given by the Joanna Briggs Institute Reviewers’ Manual [22] and Levac et.al [23]. The Arksey and O’Malley scoping review framework includes five stages to conduct a scoping review.

1. Identifying the research questions,
2. Identifying relevant studies,
3. Study selection,
4. Charting the data,
5. Collating, summarizing, and reporting results.

The research questions, search strategy and eligibility criteria will be conducted based on the Population, Concept and Context (PCC) strategy [22].

Discussion

Adolescents are very vulnerable to suicide in India which acts as a major public health challenge for the country. India has the largest adolescent population in the world having 253 million adolescents and if this large number of adolescents become safe, healthy, educated, and equipped with information and life skills then India will be benefited for development in the social, political, and economic context [25]. The incidence of adolescent suicidal behavior in India shows a rising trend day by day [26], hence the study of suicide in the Indian context holds a vital place.

The previous reviews conducted on suicidal behavior [27, 28] at national and local levels have focused more on the adult and older age groups hence they lack relevant data focusing majorly on adolescents. The accumulation and summarization of the information on the suicidal behavior of adolescents can be beneficial for a better understanding of the patterns and trends of suicidal behavior of Indian adolescents and it can also explain how the major risk factors influence the patterns and trends of suicide. This review will provide helpful information for further research as well as for the healthcare practitioners. This summarized finding at the national level will help to make better mental health awareness, to build confidence, to seek help and to provide proper medical services so that the suicide rate could be prevented to a greater extent and lives at risk of suicide would be saved.

Supporting information

Acknowledgments

We acknowledge that the man power in the research grant received from Indian Council of Medical Research (ICMR), New Delhi vide letter number Tribal/122/2020-ECD-II was utilized for the present scoping review covering one of the research aspects under this research grant.