Effectiveness of school-based preventive programs in suicidal thoughts and behaviors: A meta-analysis

Mandy W.M. Gijzen*, Sanne P.A. Rasing, Daan H.M. Creemers, Rutger C.M.E. Engels, Filip Smit

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

20 Citations (Scopus)
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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.

Original languageEnglish
Pages (from-to)408-420
Number of pages13
JournalJournal of Affective Disorders
Early online date30 Oct 2021
Publication statusPublished - 1 Feb 2022

Bibliographical note

Funding Information:
This study was funded by Trimbos Institute and GGZ Oost Brabant. GGZ Oost Brabant received funding from the municipalities of Asten, Deurne, Geldrop-Mierlo, Gemert-Bakel, Helmond, Laarbeek, and Someren.

Publisher Copyright:
© 2021


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