Effectiveness of school-based preventive programs in suicidal thoughts and behaviors: a meta-analysis
Open accessAbstract
BACKGROUND: Suicidal thoughts and behaviors (STBs) among adolescents have hardly decreased despite preventative efforts. School-based prevention programs could have a great reach, yet suicide prevention is not an easy topic to address. To increase acceptability of school-based suicide prevention, it is important to evaluate whether programs that target known risk factors of STBs, such as depression, could be equally effective. METHODS: We conducted a systematic literature search in major electronic databases. Outcomes were suicidal ideation and behaviors. Multivariate random effects meta-regression-analyses were conducted. RESULTS: Eleven primary studies met the inclusion criteria, totalling 23,230 participants. The post-test effect size was small for both suicidal ideation (g = 0.15) and suicidal behaviors (g = 0.30). Meta-regression indicated that targeting known risk factors of STBs was not a significant modifier of effect size for ideation, indicating equal effectiveness. However, it was significant modifier of effect for behaviors, but only one intervention targeted know risk factors. Effects at follow-up (3-12 months) were also significant but small for both outcomes. LIMITATIONS: Substantial heterogeneity between studies was noted. Only few and small sample size studies could be included that targeted known risk factors of STBs. Therefore, these results should be interpreted with caution. CONCLUSIONS: School-based prevention of STBs shows some promise within three months post-test assessments, and potentially also have effects that are sustained over time. More studies are needed to make conclusions regarding school-based interventions that target risk factors of STBs.
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Similar to our conclusions, authors of Gijzen 2022 note considerable heterogeneity and that there are few and small trials.
“Similar to our conclusions, authors note considerable heterogeneity and that there are few and small trials.”
From Prevention of self-harm and suicide in young people up to the age of 25 in education settings (2024) · cites this paper as Gijzen 2022
The Main findings and Strengths and limitations sections report substantial heterogeneity. Strengths and limitations also says that only three studies of upstream interventions were identified and that these had relatively small samples. The claim omits that restriction: the paper does not characterize all included trials as few and small. (LLM, conf=0.88)
Experimental — accuracy not yet measuredGijzen 2022 had broader inclusion criteria than our review.
“Therefore, again, Gijzen 2022 had broader inclusion criteria than our review”
From Prevention of self-harm and suicide in young people up to the age of 25 in education settings (2024) · cites this paper as Gijzen 2022
Section 2.1 lists Gijzen’s inclusion criteria, and Section 4.2 says the meta-analysis included upstream interventions that previous reviews had left out. That supports broader inclusion relative to some previous reviews, but our copy does not establish that its criteria were broader than those of the citing authors’ review. No page numbers are available in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measured
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- f7450. · DOI · Paper page
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Richardson, R., Connell, T., Foster, M., Blamires, J., Keshoor, S., Moir, C., & Zeng, I. S. (2024) · Journal of Youth and Adolescence · doi:10.1007/s10964-024-01969-w · Cited by 105 · see citing works
“The reviews by Gijzen et al. (2022) and Marraccini and Brier (2017) offer insight into existing school interventions and school connectedness, which have proven effective and may contribute to future interventions for suicidality and self-harm in schools.”
BackgroundPrevention of self-harm and suicide in young people up to the age of 25 in education settings
Sharma, V., Marshall, D., Fortune, S., Prescott, A. E., Boggiss, A., Macleod, E., Mitchell, C., Clarke, A., Robinson, J., Witt, K. G., et al. (2024) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013844.pub2 · Cited by 11 · see citing works
- Authors
- Gijzen, M. W. M., Rasing, S. P. A., Creemers, D. H. M., Engels, R. C. M. E., & Smit, F.
- Affiliations
- Trimbos Institute (NL)
- Radboud University Nijmegen (NL)
- Erasmus University Rotterdam (NL)
- Corresponding author
- Gijzen, Mandy W.M.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2022-02
- Volume
- 298
- Issue
- Pt A
- Pages
- 408-420
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W3209418269
- Cited by
- 61
- References
- 88
- Citations by year
- 2026: 9 · 2025: 11 · 2024: 27 · 2023: 7 · 2022: 6 · 2020: 1
- FWCI
- 1.63
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, cc-by)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, cc-by)
- Pure Amsterdam UMC (submittedVersion, cc-by)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Social Sciences › Health › Gun Ownership and Violence Research
- Keywords
- school-based prevention, suicidal ideation, suicidal behavior, suicide prevention, adolescents, depression, risk factors, intervention effectiveness, sustained effects
- MeSH terms
- Adolescent, Humans, Preventive Health Services, Schools, Suicide, Suicide, Attempted, Suicidal Ideation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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