Breaking the silence on suicide among pre-adolescent children.

Globally, the rising burden of suicide among pre-adolescent children is a pressing clinical problem for mental health practitioners. Over 90% of the world's youth live in low- and middle-income countries, where suicide is the second-leading cause of death among children and youth. Literature about completed suicide in Ugandan children below 10 years of age is limited, although there is a growing body of research predominantly from high-income countries. We present the only available literature in Uganda about pre-adolescent suicide as reported in press-media reports. We utilized the multilevel risk framework to discuss the multi-sociocultural perspective regarding child rearing, the role of childhood trauma, the evolving digital environment, and legal and policy frameworks. We discussed challenges to the practice of Child and Adolescent psychiatry in Uganda, where childhood mental health disorders continue to receive limited attention in clinical practice. We recommend future research efforts to develop a robust methodology to better understand pre-adolescent suicide. Implementation of actionable interventions like school-based suicide screening, community gatekeeper trainings, and child helplines are key. Intersectoral collaborations among diverse stakeholders are essential for co-creating actionable and evidence-based preventive interventions that place the community at the centre.