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 Danuta Wasserman, a professor of psychiatry at the Karolinska
Institute in Sweden, said the program was likely successful because
students “felt that the power of mastering their feelings, coping
with stress and choosing solutions was in their hands and not
decided or forced by adults.”
Suicide is the third leading cause of death between the ages of 10
and 24, according to the U.S. Centers for Disease Control and
Prevention (CDC). Suicide attempts are even more common, with some
research suggesting that 4 to 8 percent of high school students try
to kill themselves each year, the CDC says.
Those most at risk have a history of suicide attempts, mental
illness or substance abuse, or a family history of mental illness
and access to lethal methods.
In 10 European countries, Wasserman's team randomly assigned 168
high schools - with more than 11,000 students overall - to provide
one of three suicide prevention programs, or no program at all.
The three programs took different approaches. One program, called
Question, Persuade, and Refer, focused on training teachers and
administrators to recognize kids at risk. A second, the Youth Aware
of Mental Health Program, targeted all students with lectures,
role-playing exercises and education about mental health and suicide
risk. A third program used mental health professionals to screen
at-risk pupils who were referred to them.
The researchers compared the number of suicide attempts by students
as well as reports of suicidal thoughts after three months of having
the programs in place, and again after a year.
At three months, none of the programs showed a significant effect.
After a year, however, schools with the Youth Aware of Mental Health
program had half as many suicide attempts and reports of suicidal
ideation as the comparison schools with no intervention. The other
two programs showed much smaller differences from the
no-intervention schools.
In schools with the Youth Aware of Mental Health program, 14
students attempted suicide over the course of the year, and 15
students reported having suicidal thoughts. In the no-intervention
schools, there were 34 suicide attempts and 31 reports of suicidal
thoughts.
In schools with the faculty-focused program, there were 22 suicide
attempts and 29 reports of suicidal thinking among students. In the
program that used screening by professionals, there were 20 suicide
attempts and 22 reports of suicidal thoughts.
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Dr. David Brent, a child and adolescent psychiatrist at Western
Psychiatric Institute and Clinic in Pittsburgh wrote an editorial on
the new study in The Lancet. He told Reuters Health that education
about suicide, and early detection and treatment, are two important
aspects of effective prevention programs, and the Youth Aware of
Mental Health program meets both standards.
Wasserman said the universal prevention model used in that program
is effective because it offers treatment before students show
outward signs of risk, and it does not stigmatize anyone.
Prediction is very difficult because so many suicide attempts are
impulsive, Brent said in an email.
He said one weakness of the study is its exclusion of students who
had recently attempted suicide, so it is unclear how well the
programs would have worked for students at the highest risk.
Despite these reservations, Brent said he has faith in such programs
and that “suicidal behavior is preventable in adolescents through a
school-based intervention protocol.”
U.S. schools offer several programs that focus on suicide
prevention, he said, and the University of Southern Florida
publishes a booklet full of resources on effective school-based
suicide prevention called The Guide (http://bit.ly/186FMwO).
Wasserman urges parents to advocate for programs like Youth Aware of
Mental Health and to convince school authorities that “the health of
young people is important.”
SOURCE: http://bit.ly/1L3NEhX The Lancet, online January 8, 2015.
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