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Background: Suicide is a major cause of death among young adults, and elucidating their experiences of suicidal behavior is important in suicide prevention. This study aimed to explore the factors related to suicidal ideation and behavior in college students. Students’ responses and coping strategies for distress caused by these factors were also explored.Methods: The study conducted semi-structured interview with 24 college students (mean age=21.3, 75% female) who were at elevated risk of suicide. The transcripts were analyzed based on the consensual qualitative research method.Results: The participants reported experiencing repeated frustrations in pursuing academic and career paths, as well as social isolation, conflict, or social comparison. In response to these stressors, they experienced negative emotions, such as depression and feeling of being a burden. Negative thoughts about the self and future also emerged. A lack of understanding of why they experienced distress and how to manage the distress led the participants to engage in maladaptive responses, such as avoidance. These factors contributed to increasing their risk of suicidal ideation and behavior. Meanwhile, the factors that deterred them from making a lethal suicide attempt were their lack of capability, their concern about their family and friends, and social support from the latter.Conclusions: Repeated frustration and interpersonal distress were major factors related to increased suicidal ideation and behavior in college students. Suicide prevention in young adults may benefit from addressing negative impact of these factors.