Positive‐Themed Suicide Prevention Messages Delivered by Adolescent Peer Leaders: Proximal Impact on Classmates' Coping Attitudes and Perceptions of Adult Support

Abstract

Developing science-based communication guidance and positive-themed messages for suicide prevention are important priorities. Drawing on social learning and elaboration likelihood models, we designed and tested two positive-focused presentations by high school peer leaders delivered in the context of a suicide prevention program (Sources of Strength). Thirty six classrooms in four schools (N=706 students) were randomized to: (a) peer leader modeling of healthy coping, (b) peer leader modeling plus audience involvement to identify trusted adults, or (c) control condition. Students’ attitudes and norms were assessed by immediate post-only assessments. Exposure to either presentation enhanced positive coping attitudes and perceptions of adult support. Students who reported suicide ideation in the past 12 months benefited more than non-suicidal students. Beyond modeling alone, audience involvement modestly enhanced expectations of adult support, congruent with the elaboration likelihood model. Positive peer modeling is a promising alternative to communications focused on negative consequences and directives and may enhance social-interpersonal factors linked to reduced suicidal behaviors.

Depression Education As Primary Prevention

“…This pilot evaluation confirms that RTTAAD can improve knowledge and attitudes on depression and help-seeking among youth, and these outcomes are consistent with the features of other interventions in the depression awareness/suicide prevention literature (Klimes-Dougan, Klingbeil, & Meller, 2013;Petrova et al, 2015;Swartz et al, 2017;Whitlock, Wyman, & Moore, 2014). These initial findings show that RTTAAD is a promising intervention that merits further investigation, particularly for high school-age youth.…”

“…With depression being one of the primary mental health issues associated with suicide, and many youth reporting that stigma presents a major barrier to seeking help for depression, education in schools is viewed as a key component in preventing youth suicide (Petrova, Wyman, Schmeelk-Cone, Pisani, 2015;Pisani et al, 2012;Ruble, Leon, Gilley-Hensley, Hess, & Swartz, 2013;Surgenor et al, 2016;Swartz et al, 2010). By offering depression education as a primary prevention strategy for youth, and addressing depression through school programs, a larger segment of the youth population can be reached (Bevan et al, 2017).…”

Teen Depression, Stories of Hope and Health: A Promising Universal School Climate Intervention for Middle School Youth

“…Depression education in schools is viewed as one key component involved in preventing youth suicide by decreasing stigma and engaging in early intervention (e.g. Clement et al, 2015;Petrova et al, 2015;Ruble et al, 2013;Surgenor, Quinn, & Hughes, 2016). By making social-emotional learning (SEL) programs in middle and high schools feature depression education, adolescents and their school community can learn both about depression and also engage in new help-seeking behaviors within their school context to increase student access to mental health services (Pisani et al, 2012;Kelly, Raines, Stone, & Frey, 2010;Surgenor, Quinn, & Hughes, 2016).…”

“…By making social-emotional learning (SEL) programs in middle and high schools feature depression education, adolescents and their school community can learn both about depression and also engage in new help-seeking behaviors within their school context to increase student access to mental health services (Pisani et al, 2012;Kelly, Raines, Stone, & Frey, 2010;Surgenor, Quinn, & Hughes, 2016). As will be detailed in the following section, TDSHH incorporates many of the best practices in depression education and has extensively reviewed the literature to identify these key practices (Klimes-Dougan, Klingbeil, & Meller, 2013;Petrova et al, 2015;Surgenor, Quinn, & Hughes, 2016;Whitlock, Wyman, & Moore, 2014) in order to amplify student voice in the components of the intervention.…”

Efficacy of Web-Based Collection of Strength-Based Testimonials for Text Message Extension of Youth Suicide Prevention Program: Randomized Controlled Experiment

“…The effectiveness of peer-to-peer public health messaging strategies is congruent with peer-to-peer influences on behavior [10]. For youth with acute distress and with numerous risk factors for suicide, social modeling of emotional regulation strategies could slow or reverse a negative trajectory or prevent impulsive attempts to escape painful emotions [11,12]. A crucial barrier to technological extensions of these so-called ‘opinion leader’ interventions is the challenge of helping peer leaders to deliver effective messages to peers remotely.…”