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Aims: We compare the educational effects of role-play and discussion and gatekeeper training to develop an evidence-based suicide prevention education program for university students. Methods: Participants comprised 145 medical students. “Crisis-management, Anti-stigma and Mental Health Literacy Program for University Students” (CAMPUS) was designed and developed, which included a lecture and a parallel session for role-play or gatekeeper training. Students attended a lecture and were randomly assigned to the role-play group or gatekeeper training group. Questionnaires were filled before the module, immediately after the module, and three months after the program. Results: The role-play group learned more appropriate coping skills, whereas the gatekeeper training group improved their self-efficacy as gatekeepers. The students’ depressive state had decreased at three months after the program, along with the reduced suicide probability in students with suicide risk. Conclusions: Role-play and gatekeeper training evinced different educational effects. However, CAMPUS was comprehensively effective in preventing suicide in university students.

When clinicians are concerned about an increased risk of suicidality induced by antidepressants in young patients, mirtazapine is considered a suitable option because of its low risk of provoking suicidality and its sedative effect. However, mirtazapine often needs to be discontinued or the dose reduced because of drowsiness, especially in young persons. This study retrospectively compared the clinical effects of mirtazapine in 16 young university students to those in 16 elderly patients with depression. Drowsiness was the most frequent side effect, and was observed more often in the students. Greater numbers of students also had their doses reduced or stopped using mirtazapine specifically because of oversedation. Furthermore, the final dose of mirtazapine was much lower in the student group even though the therapeutic effects were similar to those in the elderly group, suggesting that lower doses of mirtazapine should be administered to young depressed patients as starting or maintenance doses to avoid sedation and achieve a minimal level of therapeutic efficacy.