Evaluating Suicide Prevention Programs
July 12, 2013
A team of nationally recognized experts in suicide prevention reviewed research and evaluation studies on 16 youth suicide prevention programs. The team adapted a methodology described in the Guide to Community Preventive Services, “one of the most rigorous methods of systematic reviews,” to identify studies to include in their review; assess the effectiveness of the programs included in these studies; and understand the strengths and limitations of each study. The suicide prevention experts concluded that “student curriculum, combined curriculum and gatekeeper training, and competence programs have a positive effect on adolescents’ knowledge and attitudes about suicide, but only a negligible effect on suicidal behaviors.”
The authors identified some problems present in much of the suicide prevention research and evaluation literature. These problems included (1) untested assumptions that changing knowledge or attitudes would change behavior (and that changing the knowledge, attitudes, or skills of adults would change the behavior of young people with whom they interact); (2) evidence that pretests may raise knowledge and awareness and thus influence posttest results; and (3) a failure to describe either the evidence base of interventions or how fidelity was maintained during implementation.
The authors recommended that guidelines be developed to improve the design and implementation of research and evaluation studies of suicide prevention interventions. They suggested that studies of suicide prevention programs need to use randomized controlled trial designs, focus on understanding the effectiveness of individual program components, and examine the long-term effects and the cost-effectiveness of each program. They also recommended that research efforts need “to carefully consider issues of gender, dose, culture, fidelity, and training of those delivering interventions.” In addition, they suggested that centers and professional associations focusing on suicide prevention should “provide advanced training in methodologies related to the evaluation of school interventions.”
SPRC Commentary
The conclusions of the review articles summarized in this and the June 27 edition of the Weekly Spark came to similar conclusions about the continuing challenge of creating school-based suicide prevention programs that have a demonstrated impact on suicidal behaviors. Our ability to create effective programs is predicated on our ability to scientifically demonstrate whether programs have an impact. And our ability to continue to make progress requires that we understand why some interventions work – and others do not. For more information on this essential issue, read the full text of A Systematic Review Process to Evaluate Suicide Prevention.
York, J., Lamis, D., Friedman, L., Berman, A., Joiner, T., Mcintosh, J., … Pearson, J. (2012). A systematic review process to evaluate suicide prevention programs: A sample case of community-based programs. Journal of Community Psychology 41(1), 35-41.