Suicide is the second leading cause of death for youth aged 10-24 in the United States. In response to the high rate of youth suicide, the issue has gained national attention and, as a result, state governments have created legislation regarding youth suicide prevention. States hold the power to instruct their schools in how to address suicide prevention, but little research has explored the relationship between state laws about school-based suicide prevention and schools' actual practice of suicide prevention. The current study examined this relationship by surveying a nationally representative sample of high school principals to determine the answers to four primary research questions: (1) Do public high school principals in the United States know what their state's laws are regarding suicide prevention in schools?, (2) How is suicide prevention addressed in high schools across the United States? What do suicide prevention programs look like in practice, and do they align with the five best practices for suicide prevention set forth by Kalafat (2003): having policies and procedures in place for handling a suicidal student, providing student education, school staff training, community gatekeeper training, and parent training?, (3) Are there variables (i.e., principals' demographics, school characteristics, principals' attitudes toward suicide and suicide prevention, principals' history of suicide contacts) associated with principals' knowledge of state laws?, and (4) Are there variables (i.e., principals' demographics, school characteristics, principals' attitudes toward suicide and suicide prevention, principals' history of suicide contacts) associated with suicide prevention programs' comprehensiveness? Results indicated that only about 25% of principals (N=656) accurately identified their states' laws about suicide prevention in schools, and 66.1% reported that their schools' suicide prevention programs are in complete compliance with their states' laws. Overall, few differences emerged in principals' knowledge of state laws between states with more and less stringent laws. However, significant differences emerged when comparing the degree of program comprehensiveness depending on the stringency of states' laws such that principals in states with the most stringent laws reported having the most comprehensive suicide prevention programs. Few variables were significantly related to principals' knowledge of state laws. However, having funding, perceived support, student socioeconomic status, and having a student in their current school die by suicide were all significantly related to suicide prevention program comprehensiveness. Ultimately, these results suggest that laws can positively impact suicide prevention programming in school when they are required, funding and support are important for comprehensive programming, and having an incident of suicide in a school is associated with stronger suicide prevention programming. Implications for policy, practice, and research are discussed.
