Walking, running, or cycling to school could protect high school-aged children from considering or attempting suicide in Samoa, according to a global study undergoing peer review.

New research based on data from the Global School-based Student Health Survey (G.S.H.S.) found adolescents who walked or cycled to school were 18 per cent less likely to have thought about or tried to commit suicide, with results from Samoa showing high rates of suicidal ideation and low rates of actively travelling to school.

The researchers, who span several countries, say their study shows walking or cycling to school could prevent suicide attempts that come from poor mental health, but that more research needs to be done on active school travel and other effects on mental health.

The G.S.H.S. is an international surveillance project conducted by the World Health Organisation and the Centre for Diseases Control and Prevention.  

In Samoa, the Ministry of Health conducted the survey in 2011 of 2,418 school-age children, using a questionnaire the children filled out themselves. The W.H.O. says the results of the questionnaire cannot be interpreted as summary statistics of the age group.

The results reveal a high prevalence of suicidal thoughts, plans, and attempts, compared with a low rate of either walking or cycling to school in Samoa.

According to the questionnaire results, 66.8 per cent of the 1,932 students who answered the question had seriously considered suicide in the last year, and 60.2 per cent of 2,042 students had made a plan to do it.

The final question, which had the largest valid answer rate (2,259 students) reveals 21.7 per cent of students attempted suicide once, 18.1 per cent attempted two or three times, and 12.1 per cent had tried six or more times in the last year.

When it comes to physical activity, the questionnaire instead asks about the last seven days. 

Out of 2,175 students, the majority (27.8 per cent) said they had not spent any time in the last week being physically active for at least an hour, with 19.4 per cent saying they had exercised for an hour just once in the last week.

The majority of students also said they had not walked or cycled to school (37.3 per cent), with just 11.9 per cent saying they had walked or cycled every day for the last week. 

A further 26.3 per cent students had walked or cycled to school once or twice in the week, and 24.2 per cent had done so between three and six days of the week.

The questionnaire also asked how many days in the current school year had the student attended a physical education class: 60 per cent had either not attended any, or had attended just one class. 

Papalii Carol Ah-Chong, CEO of Faataua le Ola said based on her organisations data for 2011, the figures seem too high.

According to F.L.O., seven adolescents between 12 and 18 years old attempted suicide and five did commit suicide in 2011. While the organisation does not collect information on thoughts or plans of suicide, Papalii is cautious about the figures.

She did say that exercise in all forms has proven benefits for mental wellness.

“Physical activity, sports, it’s very important and within the schools I think they have been pretty good at pushing sports as an activity to stimulate the mind. 

“It stimulates their creative juices, stimulates their mind and brings them out of whatever depressive moods they get in.

“A lot of kids too, they don’t get that opportunity within the home environment, so they look forward to all these sports activities within the school that can help them.”

But counselling services are limited and few schools have the resources to offer counselling or mental health support to their students, Papalii said.

As for whether more students could walk or cycle to school, the distance and safety mean it is not an option for many, she said.

Research author Professor Liye Zou, who is the Director of the Exercise and Mental Health Laboratory and Associate Dean of the School of Psychology at Shenzhen University said the relationship between actively getting to school and mental health is rarely investigated, which is why he and colleagues researched the topic.

“Our research team is interested in examining associations between lifestyle behaviors (physical activity, calorie restriction, and mindfulness) and mental health. 

“Active travel is a unique physical activity type for children and adolescents, especially for people living in low and middle-income nations, but as a part of a healthy lifestyle, its association with mental health has been rarely investigated.

“More recent data is urgently needed to further confirm the finding, so the findings should be cautiously interpreted,” he said.

The researchers chose to investigate 34 lower and middle-income countries, assuming wealthier countries would have more cars, making children less likely to walk or cycle to school. 

Dr. Zou said that because theirs is the first study to look at active school travel and suicide attempts among these countries, there is not enough other material to compare their findings to, and he calls for more research on the topic.

He also acknowledged the wide-ranging reasons for poor mental health in the countries studied that may “inflate” the high figures of suicide attempts.

“Indeed, owing to multiple countries’ socioeconomic conditions, available resources, healthcare leadership and political situations, their investments in mental health policies and programs may vary considerably.

“If some countries lacked mental health policies and services, adolescents in those countries are likely to have poorer mental health and wellbeing, which in turn, may inflate the prevalence of suicide attempts.”

There was also no data that said exactly what the “active” mode of travel was, rather a yes or no question to whether the student walked or cycled to school. The two different timeframes in the questions over suicide (over the last year) and school travel (over a week) also would have affected the research.

Because the questionnaire was self-reported, the researchers also noted the risks of recall and reporting biases. 

As well as the Exercise and Mental Health Laboratory, School of Psychology, Shenzhen University, the researchers are from the Institute for Sport and Health, Victoria University, Melbourne, the Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, the Centre for Intelligent Healthcare, Coventry University, Coventry, the Depression Clinical and Research Program, Massachusetts General Hospital, Boston and the Psychology Department, Nottingham Trent University, Nottingham, UK