title: Adolescent Suicide: A Review of School-Based Suicide Prevention in Middle and High School Settings
Creators: name: Alberico, Stephanie Anne
Publisher: name: Utah State University
Year: 2000

description: Suicide has been named a leading cause of death for 15 to 24 year-olds and it is evident that this public health concern warrants specific attention. The purpose of this paper was to review school-based suicide prevention programs. Prior to this review, background information on suicide including prevalence rates and general information on suicide is presented. It has been determined that adolescent males are four times as likely than females to complete suicide while females are twice as likely to attempt suicide. The most common methods of adolescent suicide completion are firearms and explosives while the most common mean of adolescent attempted suicide is ingestion of pills. Finally, the risk factors or precursors that have been found to be the most salient in predicting suicidal risk are psychopathology, precipitating events, behavioral characteristics, family and parental dysfunction, and contagion effects. This literature review describes the structure and examines the effectiveness of school-based suicide prevention programs. Directions for future research are also provided. Even though several of the reviewed school-based prevention programs are implemented frequently in school systems, research regarding their effectiveness with ethnically diverse adolescents and their impact on actual adolescent suicide rates is lacking. The primary school-based prevention programs which are reviewed include suicide education for students, in-service training for school personnel, and education for media professionals. Suicide education targeted toward students has received both positive and negative reviews in terms of its effectiveness in changing student attitudes, and increasing knowledge and help seeking behaviors. Education for school personnel is a promising prevention program as evaluations regarding its effectiveness to impact school staff knowledge, attitudes, and help seeking behaviors are positive. Limited research exists which examines the effectiveness of providing the media with education in order to prevent a contagion effect. However, this prevention effort is suggested frequently in the literature on school-based suicide prevention and appears to have merit. The secondary prevention approaches reviewed in this paper include crisis hotline services and multi- stage screening. Investigations of crisis hotline efficacy are somewhat inconclusive. However, some evidence demonstrates that crisis hotlines can decrease suicide rates among frequent users - young Caucasian females. The few evaluations of multi-stage screening programs which exist are primarily psychometric in nature but are promising suggesting that these instruments would be appropriate to use in multiple stage screening programs. Psychotherapy for suicidal adolescents is briefly examined as well in the section on secondary prevention approaches. Several crisis management techniques are reviewed, and suggestions for working with suicidal individuals are provided. Common therapeutic approaches to use with suicidal adolescents are also highlighted. Finally, implications for school psychologists and other school-based practitioners with regard to the development and implementation of prevention programs and postvention procedures are provided.