Suicide prevention programs in the schools: A review and public health perspective

The purpose of this article is to provide a comprehensive review of school-based suicide prevention programs from a public health perspective. A literature review of empirical studies examining school-based suicide prevention programs was conducted. Studies were required to contain information pertaining to the implementation and outcomes of a school-based program designed to address suicidal behaviors among children and youth. A total of 13 studies was identified. Most of the studies (77%) were classified as universal suicide prevention programs (n = 10), with the remaining studies classified as selected suicide prevention programs (n =3). Studies were coded based on key methodological features of the Task Force on Evidence-Based Interventions in School Psychology Procedural and Coding Manual (Kratochwill & Stoiber, 2002). The highest methodology ratings were obtained by two universal suicide prevention programs (Klingman & Hochdorf, 1993; LaFromboise & Howard-Pitney, 1995) and one selected prevention program (Randell, Eggert, & Pike, 2001), although the selected suicide prevention programs demonstrated proportionally more key methodological features than the universal suicide prevention programs. However, only 2 of the 13 studies reviewed demonstrated strong evidence for statistically significant effects on primary outcome measures. Very few studies provided promising evidence of educational/clinical significance (7.6%), identifiable components linked to statistically significant primary outcomes (23.1%), and program implementation integrity (23.1%). Furthermore, no studies provided evidence supporting the replication of program effects. The implications of these results for practice are discussed as well as needs for future research.