Effectiveness of school-based preventive programs in suicidal thoughts and behaviors: A meta-analysis

Area of Science:

• Adolescent mental health
• Public health interventions
• Suicidology

Background:

• Suicidal thoughts and behaviors (STBs) in adolescents remain a significant public health concern despite prevention efforts.
• School-based programs offer broad reach for suicide prevention, but their effectiveness, especially when targeting risk factors, requires further evaluation.

Purpose of the Study:

• To systematically evaluate the effectiveness of school-based suicide prevention programs.
• To determine if programs targeting known risk factors for STBs are equally effective as general prevention strategies.

Main Methods:

• A systematic literature search was conducted across major electronic databases.
• Multivariate random effects meta-regression analyses were performed on data from 11 primary studies (N=23,230).
• Outcomes assessed included suicidal ideation and behaviors at post-test and follow-up (3-12 months).

Main Results:

• Small, significant post-test effect sizes were found for both suicidal ideation (g=0.15) and behaviors (g=0.30).
• Targeting risk factors did not significantly modify effect size for ideation, suggesting equal effectiveness.
• Effects at follow-up were also significant but small; however, few studies targeted known risk factors, limiting firm conclusions.

Conclusions:

• School-based suicide prevention demonstrates potential efficacy within three months post-intervention, with sustained effects possible.
• Current evidence is limited by heterogeneity and a scarcity of studies investigating interventions that target specific risk factors for STBs.
• Further research with larger sample sizes is crucial to draw definitive conclusions on targeted school-based suicide prevention strategies.