A systematic review of school-based interventions aimed at preventing, treating, and responding to suicide-related behavior in young people.

BACKGROUND:
Suicide, in particular among young people, is a major public health problem, although little is known regarding effective interventions for managing and preventing suicide-related behavior.

AIMS:
To review the empirical literature pertaining to suicide postvention, prevention, and early intervention, specifically in school settings.

METHOD:
MEDLINE, PsycINFO, and the Cochrane Central Register of Controlled Trials (CCRCT) as well as citation lists of relevant articles using terms related to suicide and schools were searched in July 2011. School-based programs targeting suicide, attempted suicide, suicidal ideation, and self-harm where intent is not specified were included. No exclusion was placed on trial design. All studies had to include a suicide-related outcome.

RESULTS:
A total of 412 potentially relevant studies were identified, 43 of which met the inclusion criteria, as well as three secondary publications: 15 universal awareness programs, 23 selective interventions, 3 targeted interventions, and 2 postvention trials.

LIMITATIONS:
Overall, the evidence was limited and hampered by methodological concerns, particularly a lack of RCTs.

CONCLUSIONS:
The most promising interventions for schools appear to be gatekeeper training and screening programs. However, more research is needed.