Authors' objectives: This report aims to assess the evidence on the efficacy/effectiveness of current suicide prevention programs for children and youth.

Authors' results and conclusions: The Canadian Association for Suicide Prevention reported in 1994 that some 70,000 to 100,000 young people per year attempted suicide to varying degrees. In 1997, suicide was the second leading cause of death for children aged 10 to 14 years and for adolescents aged 15 to 19 years. In response to the increase of youth suicide starting in the 1950s, numerous suicide prevention programs have been developed and expanded since the early 1970s. Although extensive attempts have been made to prevent youth suicide, there is a lack of published research on suicide prevention programs. Two recent systematic reviews evaluated the evidence from a large number of studies to determine the risk factors associated with youth suicidal behaviour. High rates of psychiatric illness and the presence of co-morbid mental disorders primarily characterize young people at highest risk of suicide. Risk factors for complete suicide and attempted suicide are not identical although there is substantial overlap. The rationale for introducing curriculum-based education programs is that the majority of suicidal youth come to the attention of their peers rather than adults. Ten primary studies and two systematic reviews were identified that evaluated school-based suicide prevention programs. No Canadian studies to determine the effectiveness of suicide prevention program for children and youth have been published since 1991.

Authors' recommendations: The suicide prevention programs varied considerably in content, frequency, duration, and delivery making it difficult to draw general conclusions across studies. The programs objectives varied as well and even comparison of programs with similar objectives was not possible because of the dissimilarities within the programs themselves. Few primary studies on the efficacy/effectiveness of suicide prevention programs for children and youth were rated high for methodological quality in terms of their study design, control of confounding factors and testing of validity and reliability of the outcome measurement tools. Two studies using similar approaches for risk stratification provided consistent and encouraging evidence on the effects of the prevention programs in youth at high risk. These studies indicated significant changes in depression, hopelessness, stress, anxiety and anger within the groups. One of studies found an increase in self-esteem and networks support. One study on suicide prevention awareness programs for the general population of students indicated a significant improvement in knowledge and attitude. Two studies evaluated changes in behavioural and coping strategies in the general population. One study noted lowered suicidal tendencies, improved ego identity, and coping ability with a greater effect in females. The other study identified a reduction in suicide risk, such as improved awareness of distress-coping skill, and other positive changes. Two studies published before 1991 indicated that harm may result when students attend a suicide prevention program. All of the primary studies since 1991, except for one, either failed to evaluate the program for harmful effects or showed that no harmful effects were found. The potential for harmful effects indicated in the one study were not verified in a follow up study. Most often the significant finding of change due to the prevention programs were within the groups (pre/post changes) rather than significant differences between the control and experimental groups. Thus, the overall findings of this review suggest that there is insufficient evidence to either support or not to support curriculum-based suicide prevention programs in schools. The generalizability of the results from these studies to the Alberta context is at question since most of the studies were conducted in the United States and their school demographics appear to be different from those in Canada.

Authors' methods: Systematic review

Project Status: Completed

Year Published: 2002

URL for published report: http://www.ihe.ca/advanced-search/efficacy-of-suicide-prevention-programs-for-children-and-youth

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Institute of Health Economics

Contact Address: 1200, 10405 Jasper Avenue, Edmonton, Alberta, Canada, T5J 3N4. Tel: +1 780 448 4881; Fax: +1 780 448 0018;

Contact Name: djuzwishin@ihe.ca

Contact Email: djuzwishin@ihe.ca

Copyright: <p>Alberta Heritage Foundation for Medical Research (AHFMR)</p>