Objective  To analyze temporal trend and related factors of self-harm and suicide behaviors among high school students in Haidian district of Beijing and to provide evidences for effective intervention on suicide in adolescents.

  Methods  We collected data on 22 604 high school students from 5 waves of National Surveillance on Adolescents′ Health Risk Behaviors conducted in 2008, 2010, 2012, 2014, and 2016. The students were selected at 21 high schools in Haidian district of Beijing with multistage random cluster sampling and were asked to complete a self-administered anonymous questionnaire survey.

  Results  Of the high school students surveyed, 13.65% reported ever having intentional self-harm behavior and more junior students than senior students (14.57% vs. 13.08%) reported the behavior, with a significant difference (χ² = 10.81, P = 0.001). For all the students, 12.25%, 6.46%, and 2.33% reported ever having serious suicide ideation, suicide planning, and suicide attempt; significantly more girl students reported ever having serious suicide ideation than the boy students (χ² = 42.85, P = 0.001) but there was no significant gender difference in reported rate of suicide attempt. The proportion of students reporting ever having suicide attempt was obviously low in the survey of 2016 than that of the students surveyed in 2008 (1.54% vs. 2.62%) and the proportion fluctuated slightly between 2012 and 2014. Of the students with suicide ideation, 22.99%, 15.05%, and 7.93% attributed their suicide ideation to academic performance stress, family event, and lovesick, respectively. Of the students with suicide attempt or self-harm behaviors, 73.75% did not seek for help. The results of multivariate logistic regression analysis indicated that the risk factors of suicide behaviors included ever running away from home, drunkenness, loneliness, unhappiness due to study stress, being a vocational high school student, smoking, sexual behavior, and being assaulted by a lover among senior high school students; while, among junior high school students, ever running away from home, gambling, loneliness, unhappiness due to study stress, and beating others in a fighting were risk factors of suicide behaviors; ever running away from home was a stronger risk factor for all the students and being assaulted by a lover was a stronger risk factor for senior high school students.

  Conclusion  The prevalence of suicide attempt among high school students in Haidian district of Beijing is slightly lower than among the students in other regions and presents a decreasing trend. Screening and early psychological intervention on risk factors may play important role in suicide prevention among the students.