Examining the Unanticipated Adverse Consequences of Youth Suicide Prevention Strategies: A Literature Review with Recommendations for Prevention Programs

Kuiper, Nora; Goldston, David B.; Garraza, Lucas Godoy; Walrath, Christine; Gould, Madelyn S.; McKeon, Richard

doi:10.1111/sltb.12492

Cited by 14 publications

(10 citation statements)

References 44 publications

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“…By screening the reference lists of the included records, as well as of the identified reviews, we included another 3 records (62)(63)(64). We also identified 15 systematic reviews (9,33,(65)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76) reporting on AUCs of different PH interventions through the database searches. No additional records yielding systematic reviews were identified through searches of the reference lists.…”

Section: Resultsmentioning

confidence: 99%

Anticipating and assessing adverse and other unintended consequences of public health interventions: the (CONSEQUENT) framework

Stratil

Biallas

Movsisyan

et al. 2023

Preprint

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Despite the best intentions public health interventions (PHIs) can have adverse and other unintended consequences (AUCs). AUCs are rarely systematically examined when developing, evaluating or implementing PHIs. We used a structured, multi-pronged and evidence-based approach to develop a framework to support researchers and decision-makers in conceptualising and categorising AUCs of PHIs. We employed the "best-fit" framework synthesis approach. We designed the a-priori framework using elements of the WHO-INTEGRATE framework and the Behaviour Change Wheel. Next, we conducted a qualitative systematic review of theoretical and conceptual publications on the AUCs of PHIs in the databases Medline and Embase as well as through grey literature searches. Based on these findings, we iteratively revised and advanced the a-priori framework based on thematic analysis of the identified research. To validate and further refine the framework, we coded four systematic reviews on AUCs of distinct PHIs against it. The CONSEQUENT framework includes two components: the first focuses on AUCs and serves to categorise them; the second component highlights the mechanisms through which AUCs may arise. The first component comprises eight domains of consequences - health, health system, human and fundamental rights, acceptability and adherence, equality and equity, social and institutional, economic and resource, and ecological. The CONSEQUENT framework is intended to facilitate conceptualisation and categorising of AUCs of PHIs during their development, evaluation and implementation to support evidence-informed decision-making.

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Section: Resultsmentioning

confidence: 99%

Anticipating and assessing adverse and other unintended consequences of public health interventions: the (CONSEQUENT) framework

Stratil

Biallas

Movsisyan

et al. 2023

Preprint

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“…The second commissioned paper (Kuiper et al 2019) highlighted the importance of continuous evaluation of suicide prevention initiatives. Although the majority of suicide prevention programs do not have unanticipated negative effects, some notable exceptions have been documented.…”

Section: Position Papers Regarding Implementation Of Suicide Preventi...mentioning

confidence: 99%

The Garrett Lee Smith Memorial Act: A Description and Review of the Suicide Prevention Initiative

Goldston

Walrath

2023

Annu. Rev. Clin. Psychol.

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The Garrett Lee Smith (GLS) Memorial Act, continuously funded since 2004, has supported comprehensive, community-based youth suicide prevention efforts throughout the United States. Compared to matched communities, communities implementing GLS suicide prevention activities have lower population rates of suicide attempts and lower mortality among young people. Positive outcomes have been more pronounced with continuous years of implementation and in less densely populated communities. Cost analyses indicate that implementation of GLS suicide prevention activities more than pays for itself in reduced health care costs associated with fewer emergency department visits and hospitalizations. Although findings are encouraging, the heterogeneity of community suicide prevention programs and the lack of randomized trials preclude definitive determination of causal effects associated with GLS. The GLS initiative has never been brought fully to scale (e.g., simultaneously impacting all communities in the United States), so beneficial effects on nationwide suicide rates have not been realized. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 19 is May 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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“…Therefore, there has been a call to identify the most appropriate alternative suicide-related outcomes [ 23 , 24 ]. Although adverse effects have been reported [ 25 ], evaluation studies rarely explicitly assess unwanted side effects (USE) and serious adverse events (SAE) [ 11 ] raising doubts about the safety of prevention programs. Ultimately, the implementation of evidence-based programs is hindered by significant practical barriers, such as low acceptability and high costs [ 12 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

Addressing help-seeking, stigma and risk factors for suicidality in secondary schools: short-term and mid-term effects of the HEYLiFE suicide prevention program in a randomized controlled trial

Grosselli,

Knappe,

Baumgärtel

et al. 2024

BMC Public Health

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Background Suicidal ideation and suicide attempts present a serious public health concern among adolescents and young adults. School-based suicide prevention programs are a key tool for addressing this problem. However, more research is necessary to assess their effectiveness, acceptability, and safety. In response, the HEYLiFE suicide prevention program was developed to enhance help-seeking, reduce stigma towards suicidal peers and diminish risk factors for suicidality. This article presents the evaluation findings of the HEYLiFE program in German secondary schools. Methods We conducted a randomized-controlled trial measuring short-term pre-post within-group effects in the intervention group only and mid-term effects at 6-months-follow-up compared to a waitlist-control group. Schools were assigned randomly to the intervention or control group (no blinding). We recruited students ≥12 years of age. Primary outcomes were knowledge about suicidality, attitudes towards suicidality, stigma towards a suicidal peer, help-seeking intentions and behaviours, risk factors for suicidality. The data was analysed with linear mixed models and generalized linear mixed models. Results A total of N = 745 students participated (n = 353 intervention group, n = 392 control group). We observed favourable short-term effects on knowledge, attitudes towards suicidality and fear towards a suicidal peer. Unexpectedly, the program also led to an increase in desire for social distance and a decrease in prosocial emotions towards a suicidal peer. The mid-term effects of the program were exclusively favourable, resulting in enhanced attitudes towards help-seeking while protecting from a sharper rise in risk-factors for suicidality and from an increase in social distance. The program had more favourable effects on females and on students aged >13 years. The program was well-received by the students, and no serious adverse events were reported. Conclusions These findings demonstrate the effectiveness of the HEYLiFE universal suicide prevention program in addressing variables associated with suicidal ideation and suicide attempts among adolescents on the mid-term. The short-term negative effects on stigma and more negative effects on males should be addressed in the future. Future evaluation studies should examine its effects on suicidality and its effectiveness within populations at high risk. Trial registration The study was preregistered in the German Clinical Trials Register (registration number: DRKS00017045; registration date: 02/04/2019).

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Examining the Unanticipated Adverse Consequences of Youth Suicide Prevention Strategies: A Literature Review with Recommendations for Prevention Programs

Cited by 14 publications

References 44 publications

Anticipating and assessing adverse and other unintended consequences of public health interventions: the (CONSEQUENT) framework

Anticipating and assessing adverse and other unintended consequences of public health interventions: the (CONSEQUENT) framework

The Garrett Lee Smith Memorial Act: A Description and Review of the Suicide Prevention Initiative

Addressing help-seeking, stigma and risk factors for suicidality in secondary schools: short-term and mid-term effects of the HEYLiFE suicide prevention program in a randomized controlled trial

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