A meta-analysis of suicide prevention programs for school-aged youth

Brann, Kristy L.; Baker, Derek K.; Smith-Millman, Mills; Watt, Sarah; DiOrio, Courtney A.

doi:10.1016/j.childyouth.2020.105826

Cited by 31 publications

(32 citation statements)

References 52 publications

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“…Publication bias was not an issue, supported by nonsignificant moderator analyses of the adapted Egger’s Regression Test and the consistency of the magnitude of crude SA and SI effects, with effects adjusted for characteristics including demographics, baseline STBs, and mental health treatment. Selection bias was limited through synthesising all available follow‐up and relevant intervention effects in retained studies, and extends previous meta‐analyses synthesising PSSP effects, which have retained only the intervention follow‐up at postintervention (Brann et al., 2021) and longest‐term (Hofstra et al., 2020; Robinson et al., 2018) or conducted separate meta‐analyses based on follow‐up timeframe and omitted PSSP intervention arms (Pistone et al., 2019).…”

Section: Discussionmentioning

confidence: 99%

“…Meta‐analytic evidence of PSSP effectiveness for reducing adolescent STBs is currently limited: syntheses of studies employing cluster randomised trial (CRT) designs, demonstrating school‐based suicide prevention effectiveness on SI included samples engaging in interventions as children (Pistone, Beckman, Eriksson, Lagerlof, & Sager, 2019) and containing young adults (Pistone et al., 2019; Robinson et al., 2018). Recent meta‐analyses including PSSP interventions demonstrate small composite effects of reduced STBs postintervention based on randomised (Gijzen et al., 2022) and non‐randomised (Brann, Baker, Smith‐Millman, Watt, & DiOrio, 2021) studies. Rigorous composite effects of PSSP effectiveness on adolescent STBs based on CRTs are needed, consistent with recommendations that randomised and non‐randomised studies are generally synthesised separately, particularly when additional sources of heterogeneity associated with CRT designs would likely interact with the intervention, which is the case when schools and classrooms are randomisation units in PSSP research (Borenstein, Hedges, Higgins, & Rothstein, 2011; Donner & Klar, 2002).…”

Section: Introductionmentioning

confidence: 99%

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Research Review: The effect of school‐based suicide prevention on suicidal ideation and suicide attempts and the role of intervention and contextual factors among adolescents: a meta‐analysis and meta‐regression

Walsh

McMahon

Herring

2022

Child Psychology Psychiatry

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Background Globally, suicide is the fourth highest cause of adolescent mortality (Suicide: https://www.who.int/news-room/fact-sheets/detail/suicide). The effects of post‐primary school‐based suicide prevention (PSSP) on adolescent suicidal thoughts and behaviours (STBs) have not been comprehensively synthesised. We aim to estimate the population effect for PSSP interventions on adolescent STBs and explore how intervention effects vary based on intervention and contextual moderators. Methods Searches of PsycINFO, Medline, Education Source, ERIC, Web of Science, and the Cochrane Central Register of Controlled Trials identified cluster randomised trials examining the effectiveness of PSSP on adolescent STBs. The Cochrane Risk of Bias tool assessed bias. Crude and adjusted back‐transformed odds ratios (ORs) were calculated. Multilevel random‐effects models accounted for dependencies of effects. Univariate meta‐regression explored variability of intervention and contextual moderators on pooled effects. Results There were 19 and 12 effects for suicidal ideation (SI) and suicide attempts (SA). Compared with controls, interventions were associated with 13% (OR = 0.87, 95%CI [0.78, 0.96]) and 34% (OR = 0.66, 95%CI [0.47, 0.91]) lower crude odds reductions for SI and SA, respectively. Effects were similar for adjusted SI (OR = 0.85, 95%CI [0.75, 0.95]) and SA (OR = 0.72, 95%CI [0.59, 0.87]) models. Within‐study (0.20–9.10%) and between‐study (0–51.20%) heterogeneity ranged for crude and adjusted SA models and SI heterogeneity was 0%. Moderator analyses did not vary SA effects (ps > .05). Conclusions This meta‐analysis contributes to the PSSP evidence‐base by demonstrating that PSSP targeting STBs as both primary intervention outcomes and with other health and well‐being outcomes reduced SI and SA among 33,155 adolescents attending 329 schools, compared to controls. The number needed to treat estimates suggests the potential of reducing the incidence of SA and SI in one adolescent by implementing PSSP in 1–2 classrooms, supporting PSSP as a clinically relevant suicide prevention strategy. Although moderator analyses were nonsignificant and contained a small number of trials, larger SA effect sizes support particular effectiveness for interventions of a duration of ≤1 week, involving multiple stakeholders and with a 12‐month follow‐up.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Research Review: The effect of school‐based suicide prevention on suicidal ideation and suicide attempts and the role of intervention and contextual factors among adolescents: a meta‐analysis and meta‐regression

Walsh

McMahon

Herring

2022

Child Psychology Psychiatry

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“…Thus, young women can engage in activities that give them back a sense of contribution and meaning and allow them to re-construct relationships based on trust, affection and care. Some other participants then point to the importance of suicide prevention programs held at school or in universities and that might be based more on awareness raising on the issue of suicide [57] or on specific potential risk factors for suicide such as problematic media usage [47], which can give rise to phenomena such as nomophobic behaviors or cyber-bullying, which have been shown to have detrimental effects on mental health [58]. Finally, in line with recent attempts to move to web-based suicide prevention interventions [59], some participants point to the importance of taking advantage of the widespread usage of ICTs and using that as a possible venue for suicide prevention.…”

Section: Discussionmentioning

confidence: 99%

Suicide Prevention: University Students’ Narratives on Their Reasons for Living and for Dying

Testoni

Piol

Leo

2021

IJERPH

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Social isolation and loneliness are increasing in our contemporary western society and seem to correlate with suicide in adolescents and young adults. Social Workers are a potential resource to create such initiatives and projects that promote inclusion and cohesion within communities, a protective factor against suicide. Sixty-two Social Work BA students participated in a Death Education course based on education on suicide prevention. Participants carried out two activities. First, they were invited to complete two written semi-structured interviews on young people’s reasons for living and dying. Second, they were invited to design suicide prevention interventions targeted at their peers and adolescents. Data were analyzed qualitatively within the Thematic Analysis framework. As regards the first activity, four main themes were identified: (1) Internet and social media; (2) social isolation and loneliness; (3) the importance of proximal relationships; and, (4) the importance of networking between proximal relationships, educational institutions and mental health services. Whereas, as for suicide prevention interventions, three main ideas were identified: (1) suicide prevention through community and networking between services; (2) academic institutions: high schools and universities; and, (3) suicide prevention through new technologies. To conclude, Death Education as education on suicide prevention can offer young people a space in which to voice their and their peers’ reasons for living and dying and to reflect upon their contribution to suicide prevention as students and as future professionals.

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“…Three primary approaches, when used together, have the potential to reduce suicidal behaviors: (1) prevention, implementation of upstream interventions that support mental health promotion, foster the development of healthy coping strategies and connectedness among the entire school community, and encourage help-seeking when mental health concerns arise; (2) early identification, to identify students who may be at risk for suicide and establish clear protocols for how to respond when a student is identified as being at risk; and (3) response, to adopt strategies to connect students at risk for suicide with evidence-based, culturally appropriate care and respond to the needs of the school community when a student dies by suicide. In this chapter we provide an overview of the evidence in these areas but refer readers to recent reviews and meta-analyses (Brann et al, 2020;Singer et al, 2019) for more detailed discussions of the evidence regarding specific school-based suicide prevention programs and the strengths and limitations of each.…”

Section: A Comprehensive Strategy For School-based Suicide Preventionmentioning

confidence: 99%

Effective Suicide Prevention and Intervention in Schools

Ayer

Nickerson

Grumet

et al. 2022

SpringerBriefs in Psychology

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Schools are increasingly relied upon to foster students’ social-emotional development and address mental health concerns. Schools can also play an important role in their communities by identifying and responding to youth at risk for suicide. In this chapter, we summarize existing research on suicide prevention in schools, highlight promising programs and practices, and provide recommendations for how school personnel, researchers, practitioners, and policymakers can advance science and practice and ultimately prevent youth suicide.

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A meta-analysis of suicide prevention programs for school-aged youth

Cited by 31 publications

References 52 publications

Research Review: The effect of school‐based suicide prevention on suicidal ideation and suicide attempts and the role of intervention and contextual factors among adolescents: a meta‐analysis and meta‐regression

Research Review: The effect of school‐based suicide prevention on suicidal ideation and suicide attempts and the role of intervention and contextual factors among adolescents: a meta‐analysis and meta‐regression

Suicide Prevention: University Students’ Narratives on Their Reasons for Living and for Dying

Effective Suicide Prevention and Intervention in Schools

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