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.
To review the empirical literature pertaining to suicide postvention, prevention, and early intervention, specifically in school settings.
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.
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.
Overall, the evidence was limited and hampered by methodological concerns, particularly a lack of RCTs.
The most promising interventions for schools appear to be gatekeeper training and screening programs. However, more research is needed.