Objective: The purposes of this study were: 1) to determine the effectiveness of suicide postvention programs on suicide attempts and suicide as well as grief symptoms, mental distress, and mental health broadly defined; and 2) to investigate their cost-effectiveness.Methods: Computerized database searches (PubMed, PsycINFO, Cinahl, Cochrane Database, Crisis and Suicide & Life-Threatening Behavior) were performed in September 2009 to obtain evaluations of suicide postvention programs and in February 2010 (Centre for Research and Dissemination Database, Cochrane Database of Systematic Reviews, PubMed, PsycINFO, and Cinahl) to obtain cost-effectiveness analyses of bereavement programs. Hand searches of relevant articles and reviews were also conducted. Publications were included in the analysis if they described an evaluation/costeffectiveness analysis of a suicide postvention program, provided data, and were published in English-language peer-reviewed journals. There was no restriction on publication date. Studies were excluded if they were narrative systematic reviews or dissertations or if they described a postvention program but provided no evaluation. Because very few cost-effectiveness analyses were identified, articles describing "costs" of bereavement programs were also included. Studies were evaluated for quality using Centres for Evidence-Based Medicine Levels of Evidence, and for program effectiveness using Office of Justice Programs "What Works Repository" Analytic Framework. Results:Of the 49 studies of suicide postvention programs retrieved, 16 met inclusion criteria for evaluation of study quality and evidence of effectiveness. Three target populations for postvention programs were identified: school-based, family-focused, and community-based. No protective effect of any postvention program could be determined for number of suicide deaths or suicide attempts from the available studies. Few positive effects of school-based postvention programs were found. One study reported negative effects of a suicide postvention. Gatekeeper training for proactive postvention was effective in increasing knowledge pertaining to crisis intervention among school personnel. Outreach at the scene of suicide was found to be helpful in encouraging survivors to attend a support group at a crisis centre and seek help in dealing with their loss. Contact with a counseling postvention for familial survivors (spouses, parents, children) of suicide generally helped reduce psychological distress in the short term. There was no statistical analysis of community-based suicide postvention programs; however media guidelines for reporting of suicide and suicide attempts have been adopted by mental health organizations in numerous countries. No analyses of cost-effectiveness of suicide postvention programs were found. Conclusion:Recommendations to provide guidance to policy-makers, administrators and clinicians are presented and directions for future research are outlined.

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Adolescence is a critical period for the promotion of mental health and the treatment of mental disorders. Schools are well-positioned to address adolescent mental health. This paper describes a school mental health model, “School-based Pathway to Care,” for Canadian secondary schools that links schools to primary care providers, mental health services, and the wider community, enabling them to address youth mental health in a collaborative manner. The model highlights the fundamental role of mental health literacy, gatekeeper training, and education/health system integration in improving adolescent mental health, and enhancing learning environments and academic outcomes.L’adolescence constitue une période critique pour la promotion de la santé mentale ainsi que le traitement des désordres mentaux. En ce sens, les écoles sont bien placées pour s’attaquer aux problèmes de santé mentale vécus par les adolescents. Cet article trace le portrait d’un modèle de santé mentale en milieu scolaire, le modèle “School-based Pathway to Care”, modèle déployé au sein d’écoles secondaires canadiennes. Celui-ci met en lien les établissements scolaires avec les institutions fournissant des soins de santé de base et des services de santé mentale. Ce faisant, il permet aux différents intervenants de collaborer, s’attaquant ainsi ensemble aux problématiques de santé mentale des jeunes. Ce modèle souligne l’importance de la littérature portant sur la santé mentale, de la formation des surveillants et de l’intégration des systèmes d’éducation et de santé dans l’amélioration de la santé mentale des adolescents, des environnements scolaires et des résultats académiques

Enhancement of mental health literacy is a mental health promotion strategy that may be effective at destigmatizing mental illness and increasing self-seeking behavior. Transitions is a mental health literacy program intended to heighten students' awareness and discussion of mental health problems and promote help-seeking behaviors. Transitions was launched in Nova Scotia in 2007 and distributed to 8,000 students. Transitions has since been launched nationally and is in the process of launching internationally. A follow-up study indicated over 95% of students felt they could relate to Transitions and enjoyed reading it, and 40% discussed Transitions with a friend.

Objective: To determine whether students with self-reported needs for mental health support used school-based health centres (SBHCs) for this purpose.Method: A secondary analysis was conducted on self-reported data collected from 1629 high school students from Cape Breton, Nova Scotia. Descriptive statistics and logistic regression analyses were employed to determine the influence of sex, grade, sexual orientation, socioeconomic status (SES), school performance, social involvement, and health risk-taking behaviours on need for mental health support and use of SBHC for that purpose.

From the students' description of community pharmacy-based care of people with lived experience of mental illness, significant issues exist with current practices and behaviours. Advancing the role of pharmacists and pharmacy students to meet the needs of people with mental illness will require strategies to address multifactorial influences on behaviour.

Objective: To synthesize the literature on youth suicide risk factors (RFs) and prevention strategies (PSs); evaluate quality of information regarding youth suicide RFs and PSs found on selected Canadian websites; determine if website source was related to evidence-based rating (EBR); and determine the association of website quality indicators with EBR. Methods:Five systematic reviews of youth suicide research were analyzed to assemble the evidence base for RFs and PSs. The top 20 most commonly accessed youth suicide information websites were analyzed for quality indicators and EBR. Univariate logistic regression was conducted to determine if quality indicators predicted statements supported by evidence (SSEs). Multivariate analysis was used to calculate adjusted odds ratios for SSEs and quality indicators.Results: Only 44.2% of statements were SSEs. The 10 most highly ranked websites contained almost 80% of the total statements analyzed, and one-half had a negative EBR. Compared with government websites, nonprofit organization websites were more likely (OR 1.45, 95% CI 0.66 to 3.18), and personal and media websites were less likely (OR 0.62, 95% CI 0.26 to 1.47), to have a positive EBR. Crediting of an author (AOR 2.65, 95% CI 1.34 to 5.28), and recommendation to consult a health professional (AOR 2.08, 95% CI 1.18 to 3.68), increased the odds of SSEs. Conclusions:Fundamental to addressing youth suicide is the availability of high-quality, evidence-based information accessible to the public, health providers, and policy-makers. Many websites, including those sponsored by the federal government and national organizations, need to improve the evidence-based quality of the information provided.Can J Psychiatry. 2009;54(9):596-604. Clinical Implications· The Internet is an important source of health information for adults and youth, particularly for stigmatized illnesses like mental disorders. · However, web-based information sources should be approached with caution because in this study more than one-half of the statements regarding youth suicide made on popular Canadian websites were not supported by the evidence base. · Authoritative mental health organizations in Canada should create and advertise the availability of evidence-based web information pertaining to youth suicide. Limitations· This analysis was restricted to Canadian websites dealing with issues of suicide in non-Aboriginal populations. · This analysis does not consider website design. Future studies should integrate users and their website selection criteria (for example, design) into a broader analysis. · The Internet is an ever-changing medium. It is possible that our results are not representative of the information currently accessed by people searching for information about youth suicide.

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