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Suicide prevention programs in school – what’s new?

Summary: Highlights from research on peer based Gatekeeper training, including concerns regarding “untowards” effects.

There are challenges that have been identified regarding the delivery of suicide prevention messages to adolescents in school. These include vulnerable adolescents experiencing “untoward” effects following exposure to messages aimed to reduce suicidal behaviours (Klimes-Dougan 2009). Evidence suggested vulnerable adolescents and those experiencing suicidal ideation could experience an increase in distress and reduced likelihood to help seek as a result of exposure to certain kinds of messages (Petrova 2015).

vulnerable adolescents and those experiencing suicidal ideation could experience an increase in distress

Health promotion and safety programs generally have had mixed results depending on the method of delivery, the kind of message and target audience. In relation to suicide prevention programs with adolescents in schools, not all programs have demonstrated efficacy in changing behaviour or long term positive outcomes.

American researchers Petrova and colleagues (2015) reported that some school programs can support change in adolescent attitudes regarding suicidality but fail to change behaviours including help seeking. Petrova et al. (2015) sought to evaluate a peer delivered program specifically regarding positive behavioural change and increased help seeking behaviour. Petrova et al. (2015) found that programs that were delivered using a peer education and engagement model demonstrated positive outcomes. Programs modelled adaptive, functional and help seeking attitudes and norms, increasing these behaviours and attitudes in students/peers, including those who were vulnerable to suicidal ideation or behaviour. This is in contrast to other models where there potentially damaging outcomes were identified (Klimes-Dougan 2009). Behavioural change in Petrova’s research was noted as significant over a five month period whereby adolescents were comfortable in not only identifying trusted adults but also acting on those adaptive attitudes in help seeking over time.

Petrova and associates emphasised the risks inherently involved in delivering suicide prevention programs to adolescents (including those at risk) when the programs have not been examined for efficacy. Indeed, the risk is not just about ineffective program outcomes but whether the program outcomes are deleterious or damaging. Petrova and colleagues findings are extremely important in this regard.


Klimes-Dougan, B., Youan, C., Lee, S., & Houri, A. (2009) Suicide prevention with adolescents: considering potential benefits and untoward effects of public service announcements. Crisis, Vol.30, pp.128-135.

Petrova, M., Wyman, P., Schmeelk-Cone, K. & Pisani, A. (2015) Positive-themed suicide prevention messages delivered by adolescent peer leaders: Proximal impact on classmates’ coping attitudes and perceptions of adult support. Suicide & Life Threatening Behaviour, Vol.45(6), pp.651-663

First published 31 January 2016

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