A Systematic Review of School-Based Interventions Aimed at Preventing, Treating, and Responding to Suicide- Related Behavior in Young People

Robinson, Jo; Cox, Georgina; Malone, Aisling; Williamson, Michelle; Baldwin, Gabriel; Fletcher, Karen; O’Brien, Martin

doi:10.1027/0227-5910/a000168

Cited by 248 publications

(174 citation statements)

References 78 publications

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“…This finding is supported by studies that reported a recent decline in suicide rates [48][49][50] and attempts 51 among Canadian and American youth. Though there is no conclusive evidence for the efficacy of various efforts in preventing suicide, 52 some strategies, including physician education and certain school-based strategies, show promise in reducing suicidal behaviours. 46,47,50,53 Continued effort in suicide prevention, rigorous research into the efficacy of prevention programs, and improved interventions targeting mental illness in adolescents is crucial for improving the mental health of Canadian adolescents.…”

Section: Resultsmentioning

confidence: 99%

Time trends in symptoms of mental illness in children and adolescents in Canada

McMartin

Kingsbury

Dykxhoorn

et al. 2014

CMAJ

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Interpretation:With the exception of hyperactivity, the prevalence of symptoms of mental illness in Canadian children and adolescents has remained relatively stable from 1994/95 to 2008/09. Conflicting reports of escalating rates of mental illness in Canada may be explained by differing methodologies between studies, an increase in treatment-seeking behaviour, or changes in diagnostic criteria or practices. AbstractResearch CMAJ, December 9, 2014, 186(18) E673 Methods Study designThis study used data from the National Longitudinal Survey of Children and Youth, which involves a population-based cohort of Canadian children and adolescents followed prospectively every 2 years by Statistics Canada since 1994/95. 14 The cohort is considered nationally representative, with the exception of children living on First Nations reserves or Crown lands, in institutions and in some remote regions. This study was designed to collect information about multiple aspects of child health and development. The follow-up rate for the National Longitudinal Survey of Children and Youth from cycle 1 (1994/95) to cycle 8 (2008/2009) was 61%.15 Further details about the cohort, including study design and response rates (mostly above 80% at each wave), are described elsewhere. 14,15 The survey included numerous assessments related to child and adolescent mental health. The behaviour scale was adapted from questionnaires used in the Montreal Longitudinal Survey and the Ontario Child Health Study, which were designed to identify children who would most likely qualify for a psychiatric diagnosis based on symptom criteria for the revised 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders. 16 This scale has been used in previous studies of child and adolescent adjustment, and has shown good psychometric properties. 17,18 In each cycle, participants aged 10 years or older were asked to self-report the frequency of various feelings and behaviours in the past week, with 3 possible responses ranging from "never or not true" to "often or very true." Each item was assigned a score of 0 to 2 (higher scores indicating a greater degree of mental health problems). Questionnaires were completed on paper, at home in a private setting, and sealed in envelopes to ensure confidentiality.Composite scores were created by summing item scores on each of 4 subscales relevant to adolescent mental illness: conduct disorder (6 items, e.g., "I kick or hit other people my age"), hyperactivity (7 items, e.g., "I am impulsive, I act without thinking"), indirect aggression (5 items, e.g., "When I am mad at someone, I say bad things behind his/her back"), and symptoms of depression/anxiety (7 items, e.g., "I am not as happy as other people my age" and "I worry a lot"). 19 The same items were collected at each cycle, with the exception of 1 hyperactivity item and 1 depression/anxiety item, which were dropped in cycle 4. In the interest of comparability over time, these items were not included in composite scores. All items comprising the final scale...

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Section: Resultsmentioning

confidence: 99%

Time trends in symptoms of mental illness in children and adolescents in Canada

McMartin

Kingsbury

Dykxhoorn

et al. 2014

CMAJ

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“…Generell kunnskap om psykiske vansker som angst og depresjon, personlig og profesjonell erfaring som kan bidra til økt trygghet i rollen, bevissthet om egne holdninger til selvmord samt indre motivasjon for å hjelpe, blir alle vurdert som relevante kvaliteter for å inneha en slik funksjon (King & Smith, 2000). Opplaeringen vektlegger kunnskap og ferdigheter i å kunne identifisere elever med forhøyet risiko for selvmord eller selvskading, gjennomføre avdekkende samtaler, og utrede omfang og alvorlighetsgrad for eventuelt å kunne henvise til profesjonell helsehjelp (Robinson et al, 2013;De Silva, Parker, Purcell, Callahan, Liu & Hetrick, 2013). Både teoretisk kunnskap og praktiske ferdigheter må innarbeides og innøves gjennom hele kjeden av formidling.…”

Section: Portvaktmodellen Og «Train-the-trainer»unclassified

Gatekeeper-modellen i skolen - erfaringer fra et pilotprosjekt om selvmordsforebygging

Milde¹,

Norevik²

2017

Suicid.

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SAMMENDRAGSuicidal atferd og selvskading utgjør et alvorlig folkehelseproblem og omfatter de fleste aldersgrupper fra skolebarn til eldre. Det er sjeldent at barn under 14 år tar sitt eget liv, men det finnes evidens hos unge voksne for at tanker om å ta sitt eget liv har debutert allerede i tidlig skolealder. Selvskading er langt hyppigere og har størst forekomst i tenårene og tidlig 20-årene. Skolen er den arenaen som møter flest barn og unge. Økt fokus på psykisk helse i skolen stiller krav til tiltak samt kompetanse blant skolepersonell. Risiko for selvmord eller selvskading blant elever er til stede ved alle skoler i landet. Opplevelse av tap, som når familiemedlemmer tar sitt eget liv, gir en status som etterlatt, og det er en økt selvmordsrisiko blant ungdommer etter foreldres selvmord. Dette krever ekstra ivaretagelse og oppfølging i skolehverdagen. Skolepersonell kan gjennom kompetanseheving iverksette forebyggende tiltak. Denne artikkelen tar for seg erfaringer med gatekeeper eller portvaktmodellen i grunnskolen og dens nytteverdi. Et gjennomført pilotprosjekt ved 16 skoler har ført til opprettelse av et nettverk med skolepersonell som ressurspersoner. 14 skoleansatte som har gjennomført kurs og opplaering i selvmordsforebygging har blitt kartlagt for kunnskap om og ferdigheter i selvmordsforebygging samt holdninger til selvmord gjennom fokusgruppeintervju. Resultatene viser nytteverdi av implementering av portvaktmodellen i skolen i form av økt kunnskap om, og opplevelse av bedre ferdigheter i, å håndtere selvmordsatferd. Kompetansehevingsprogram i selvmordsforebygging bør utvides på et regionalt og nasjonalt nivå.

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“…It should be noted that there is a lack of consensus as to whether non-suicidal selfharm behaviour should be included in reviews that focus on suicidal behaviour (Halicka and Kiejna, 2015). The Robinson review also suggested that there was limited evidence that school-based interventions reduce suicidal behaviour and ideation itself (Robinson et al, 2013). Universal prevention approaches demonstrated some effects, while indicated prevention interventions showed promise (Robinson et al, 2013) and require further evaluation.…”

Section: Direct Intervention For Adolescent Suicidalitymentioning

confidence: 99%

“…The Robinson review also suggested that there was limited evidence that school-based interventions reduce suicidal behaviour and ideation itself (Robinson et al, 2013). Universal prevention approaches demonstrated some effects, while indicated prevention interventions showed promise (Robinson et al, 2013) and require further evaluation.…”

Section: Direct Intervention For Adolescent Suicidalitymentioning

confidence: 99%

“…A later systematic review was conducted by the same researchers, of schoolbased postvention, prevention and early interventions for suicide, suicide ideation, suicide attempts or self-harm (intention not specified) (Robinson et al, 2013). This review found that gatekeeper interventions, i.e., interventions designed to improve the capacity of professionals and paraprofessionals to work with suicidal teenagers, showed promise for increasing knowledge and improving attitudes, while screening programmes successfully identified students at risk (Robinson et al, 2013). It should be noted that there is a lack of consensus as to whether non-suicidal selfharm behaviour should be included in reviews that focus on suicidal behaviour (Halicka and Kiejna, 2015).…”

Section: Direct Intervention For Adolescent Suicidalitymentioning

confidence: 99%

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The treatment of suicidality in adolescents by psychosocial interventions for depression: A systematic literature review

Devenish

Berk

Lewis

2016

Aust N Z J Psychiatry

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BackgroundThe World Health Organization's (WHO, 2014) first world suicide report identifies suicide as the second leading cause of death in 15-to 29-year-olds. Suicide behaviour consists of death by suicide (self-inflicted and intentional killing of oneself), suicide attempts (self-injurious behaviour with the intent to cause death) and suicidal ideation (persistent, serious thoughts of suicide). Such behaviour can be conceptualized as a continuum, and here, we refer to all these AbstractObjective: Given depression is a significant risk factor for suicidal behaviour, it is possible that interventions for depression may also reduce the risk of suicide in adolescents. The purpose of this literature review is to determine whether psychological interventions aimed to prevent and/or treat depression in adolescents can also reduce suicidality. Methods:We conducted a systematic review of psychological interventions aimed to prevent and/or treat depression in adolescents in which outcomes for suicidality were reported, using five databases: PsycINFO, Embase, Medline, CINAHL and Scopus. Study quality was assessed using the Cochrane Collaboration's tool for assessing risk of bias.Results: A total of 35 articles pertaining to 12 treatment trials, two selective prevention trials and two universal prevention trials met inclusion criteria. No studies were identified that used a no-treatment control. In both intervention and active control groups, suicidality decreased over time; however, most structured psychological depression treatment interventions did not outperform pharmaceutical or treatment as usual control groups. Depression prevention studies demonstrated small but statistically significant reductions in suicidality. Limitations:Analysis of study quality suggested that at least 10 of the 16 studies have a high risk of bias. Conclusive comparisons across studies are problematic due to differences in measures, interventions, population differences and control groups used. Conclusions:It is unclear whether psychological treatments are more effective than no treatment since no study has used a no-treatment control group. There is evidence to suggest that Cognitive Behavioural Therapy interventions produce pre-post reductions in suicidality with moderate effect sizes and are at least as efficacious as pharmacotherapy in reducing suicidality; however, it is unclear whether these effects are sustained. There are several trials showing promising evidence for family-based and interpersonal therapies, with large pre-post effect sizes, and further evaluation with improved methodology is required. Depression prevention interventions show promising short-term effects.

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A Systematic Review of School-Based Interventions Aimed at Preventing, Treating, and Responding to Suicide- Related Behavior in Young People

Abstract: The most promising interventions for schools appear to be gatekeeper training and screening programs. However, more research is needed.

Cited by 248 publications

References 78 publications

Time trends in symptoms of mental illness in children and adolescents in Canada

Time trends in symptoms of mental illness in children and adolescents in Canada

Gatekeeper-modellen i skolen - erfaringer fra et pilotprosjekt om selvmordsforebygging

The treatment of suicidality in adolescents by psychosocial interventions for depression: A systematic literature review

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