Multi-modal approach to preventing suicide in schools: a regionally-based UK pilot study

Despite emerging evidence for the effectiveness of school-based suicide prevention programmes worldwide, there are few being implemented in the United Kingdom, and they have not been tested. Cultural transferability of school-based interventions cannot be guaranteed, and adaptations may be required. We aimed to conduct a pilot study of the Australian Multi-Modal Approach to Preventing Suicide in Schools (MAPSS) programme, to assess its feasibility and acceptability for delivery in the UK, and the potential for a future trial. MAPSS consists of three components: a universal workshop, screening to identify at-risk students, and a targeted intervention for students at-risk.

A pilot study following a mixed-method explanatory design was conducted. A pre/post-test quantitative design was used with Year 10 students (aged 14-15 years) from two secondary schools in Northwest England (N = 417). Participants were assessed at three timepoints using online quantitative surveys. A qualitative process evaluation was conducted with 24 students and professionals.

MAPSS was generally considered to be acceptable and feasible, although there were issues with student engagement and logistics regarding delivery in schools. There were no issues with safety and missing data were within acceptable limits. Pre/post-test analyses indicated significant improvements in depression, hopelessness, and suicide literacy scores after the universal component. Pre/post-test analyses for at-risk students indicated that suicide ideation and quality of life scores were significantly higher after participating in the targeted component. Qualitative data demonstrated a strong perceived need for suicide prevention efforts in schools, with MAPSS thought to help increase awareness and identify students who were at-risk that schools had not previously been aware of.

MAPSS is potentially appropriate to deliver in UK schools and may be beneficial for students, although requires further testing. A larger trial is considered feasible and is required to explore the utility and potential effectiveness of MAPSS. However, further work is needed to refine and adapt the intervention before a future trial can take place, with consideration of the logistical and staffing pressures within schools, and to facilitate student uptake and engagement.