Suicide is a leading cause of death among youth in Canada. Limited evidence suggests that having multiple chronic health conditions increases the risk of suicidality. However, no studies have investigated correlates of suicidality among youth with co-occurring physical and mental or neurodevelopmental disorders (i.e., multimorbidity).

Data come from 3535 youth, aged 15–17 years enrolled in the 2019 Canadian Health Survey on Children and Youth with 1041 reporting multimorbidity. Responses to survey questions were provided by youth in each household. Three outcomes related to suicidality are analyzed: past-year hopelessness, past-year suicidal ideation, and lifetime suicide attempt. Sociodemographic, family, and community factors were included in regression models.

Hopelessness (44.4 %), suicidal ideation (27.6 %), and suicide attempts (18.7 %) were commonly reported among youth with multimorbidity. Females (OR = 2.84 [1.93, 4.19]), youth reporting victimization (OR = 1.11 [1.07, 1.16]), and youth whose parent/guardian reported poor mental health (OR = 3.98 [2.16, 7.30]) were more likely to report hopelessness. Females (OR = 2.04 [1.32, 3.14]), girls attracted to girls (OR = 5.89 [1.85, 18.80]), and youth attracted to more than one gender (OR = 3.48 [1.72, 7.84]) were more likely to report suicidal ideation. Females (OR = 3.53 [2.08, 5.99]), boys attracted to boys (OR = 5.54 [1.09, 28.17]), youth attracted to more than one gender (OR = 2.57 [1.34, 4.93]), and youth whose parent/guardian reported poor mental health (OR = 2.72 [1.35, 5.50]) were more likely to report a suicide attempt.

Findings reinforce the need for continued screening, early interventions and person/family-centred approaches to integrated physical-mental/neurodevelopmental care for youth with multimorbidity. Further, targeted support for youth with non-heterosexual orientations experiencing mental health challenges are needed.