Long-term Results from the Empowering a Multimodal Pathway Toward Healthy Youth Program, a Multimodal School-Based Approach, Show Marked Reductions in Suicidality, Depression, and Anxiety in 6,227 Students in Grades 6–12 (Aged 11–18)

Abstract

Here, we report on findings from a 15-month follow-up of a school-based program called Empowering a Multimodal Pathway Toward Healthy Youth (EMPATHY). This was primarily intended to reduce suicidal thinking in pre-teens, adolescents, and youth students aged 11–18 in middle schools (Grades 6–8) and high SCHOOLS (Grades 9–12). It also aimed to reduce depression and anxiety. The EMPATHY multimodal program consisted of repeated data collection, identification of a high-risk group, a rapid intervention for this high-risk group including offering supervised online cognitive behavioral therapy (CBT) program, a universal CBT intervention for those in Grades 6–8, a variety of interactions with trained staff (“Resiliency Coaches”), and referral to external medical and psychiatric services where appropriate. There were four time-points at which assessments were made: baseline, 3, 7, and 15 months. Here, we report cross-sectional findings over 15 months in a total of 6,227 students who were assessed at least once during the study period. Additionally, we report longitudinal findings from the 1,884 students who completed all 4 assessments. Our results found highly statistically significant decreases in suicidality rates, with the percentage of the total school population who were actively suicidal decreasing from 4.4% at baseline (n = 143 of 3,244) to 2.8% at 15 months (n = 125 of 4,496) (p < 0.001). There were also highly statistically significant reductions in depression and anxiety scores at each time-point. Thus, Mean Depression scores at baseline for the entire student population were 3.73 ± 3.87 (n = 3,244) at baseline and decreased to 3.22 ± 3.52 (n = 4,496) (p < 0.001). Since most students were not depressed, whole population changes such as this may indicate impact in many areas. In the longitudinal analysis of students who completed all four assessments, there were also highly statistically significant improvements in depression and anxiety scores at all time-points. For example, depression scores decreased from a mean of 3.43 ± 3.67 (n = 1,884) at baseline to 2.95 ± 3.53 (n = 1,884) at 15-months (p < 0.001), while the number who were actively suicidal decreased from 69 to 37. These results suggest that school-based multimodal programs, utilizing a combination of interventions, can have meaningful benefits across entire school populations.

After the Fort McMurray wildfire there are significant increases in mental health symptoms in grade 7–12 students compared to controls

“…The Fort McMurray survey also included a demographics questionnaire, which was somewhat different from the Red Deer one. Full details of the EMPATHY project are available [24, 25]. In this paper, we focus on the six questionnaires that were used in both the communities of Fort McMurray and Red Deer, using Red Deer as a control population.…”

“…In this paper, we focus on the six questionnaires that were used in both the communities of Fort McMurray and Red Deer, using Red Deer as a control population. Ethics considerations for data collection in the Red Deer EMPATHY project have been described in detail previously [24, 25] but were similar to those for the Fort McMurray data collection. The EMPATHY program itself was approved by the Health Research Ethics Committee of the University of Alberta on December 5th, 2013, ethics protocol number Pro00041063.…”

“…This data was compared to a sample of grade 7–12 students from Red Deer, Alberta who participated in a previously-conducted study “Empowering a Multimodal Pathway Towards Healthy Youth” (EMPATHY) in 2014. The EMPATHY study included the same mental health questionnaires [24, 25]. The Red Deer, Alberta student population served as the non-disaster impacted control group.…”

The Role of Technology and the Continuum of Care for Youth Suicidality: Systematic Review

“…The final sample included 26 studies ( Table 1 ) [ 34 - 59 ]. Although various professional disciplines were represented (ie, social work, medicine, public health), over half (n=16) of the first authors held a doctoral degree in psychology.…”

Prevalence and Associated Factors of Suicidality in Japanese Adolescents: Results from a Population-based Questionnaire Survey

“…Our respondents may have been concerned about confidentiality and stigma, which can prevent young people from seeking help. Two studies have used a school-based education program, including Internet-based cognitive behavioral therapy, to improve suicidality in young people: one study found a significant effect, but the other found no effect [34,35]. Such trials may be an effective way of helping young people access help-seeking behavior.…”