A comprehensive approach to adolescent suicide prevention: insights from a narrative review perspective

KW is supported by a post-doctoral fellowship awarded by the American Foundation for Suicide Prevention. AM is supported by the Victorian Health and Medical Research Fellowship. SH is supported by an Auckland Medical Research Foundation Douglas Goodfellow Repatriation Fellowship. JR is supported by a NHMRC Career Development Fellowship. Funding SPRC Recover Together resources from the Future Global Generations Fund and the William Buckland Foundation supported several of the research assistants (including EB and NS). The following is the supplementary data related to this article.

Building Hope: 9 Essential Steps to Reducing Youth Suicide

We therefore cannot be certain that changes at follow-up are in fact the result of a true reduction in the treatment effect over time. A third limitation relates to the quality of the studies included in the meta-analysis, the results of which should be treated with caution. Although these steps are encouraged, they are not a requirement of compliance with the PRISMA statement and were not anticipated to impact the results; therefore due to time and resource constraints they were not a part of the present review. Other minor methodological limitations relate to our decisions not to prospectively register the review and not to contact key authors in the field.

2 Protective factors for adolescent mental health and suicide prevention

Researchers have begun to identify the signs of proximal risk for suicidal ideation and behavior in adolescents – those which are present during the 24-hours or less prior to the suicidal experience. While this section described pilot work seeking to inform an adaptive intervention for youth at risk for suicide , large-scale studies will be necessary to guide progress in this area. Second, as suicidal youth are not homogeneous with respect to risk profiles or time-varying changes in risk states , a related consideration is to test adaptive interventions that specify how, when, and for whom interventions should be delivered. As the field looks toward addressing gaps in treatment approaches for adolescents at risk for suicide, we pose four recommendations.

The Good Behavior Game (GBG) program that reduces aggressive–antisocial behavior leverages the influence of teacher practices and students across the classroom to promote behavioral control and classroom norms.11 The following considerations, drawn from epidemiologic and prevention science perspectives, guided selection of the most promising prevention targets and research pathways. Practitioners can address these research needs by contributing studies to the body of literature. As a practitioner, the provider may have clinical responsibilities with regard to either an individual patient, a broader community, or both. In 2019, NVDRS expanded data collection and now funds all 50 states, the District of Columbia, and Puerto Rico. If you have a question or an access need, please get in touch with us at

No significant differences were found across interventions in SI at 6–12-month follow-up.Goldston et al. developed an integrated CBT grounded in the relapse prevention model (CBT-RP) for treating adolescents with co-occurring suicidal behavior, depression, and substance use disorders. Searches were conducted in four electronic databases (PUBMED, PsycINFO, Web of Science, and Scopus), from 1 January 2016 to 31 December 2022, to identify updated research evaluating the efficacy of psychological interventions for adolescents with suicidal behaviors and specifically SA. Therefore, the main objective of this study is to provide an updated review of the existing psychological interventions for the treatment of suicide attempts (SA) in adolescents and to analyze the efficacy of such interventions. These preliminary findings supported the feasibility and acceptability of this intervention and pointed to its positive impact on parental engagement in suicide prevention activities and lowering post-ED suicide attempts among adolescents.

• This is likely to require developing and nurturing active working partnerships among researchers, healthcare professionals, healthcare and public policy changemakers, insurers, and leaders in pertinent youth-serving settings and institutions.
• Increased efforts to tackle suicide risk in settings where young people frequently engage, such as pediatric primary care and schools, are vital.99 This section will review specific strategies and interventions for youth suicide prevention, including selective and indicated strategies.
• As a narrative review, this article has several inherent limitations.
• One key protective factor of suicide is to restrict access to the methods for committing it.

What Are Teen Suicide Risk Factors?

The Florida Legislature originally created the Statewide Office for Suicide Prevention within the Office of the Governor as the state’s official lead agency for suicide prevention. Through the creation of OSP, CDPH was formally designated as the state entity responsible for coordinating and aligning statewide suicide prevention efforts and resources. Wisconsin appointed a public-private partnership, Prevent Suicide Wisconsin (PSW), to lead suicide prevention in the state. Oklahoma’s Suicide Prevention Act designated the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) as the lead agency for the state’s suicide prevention education and activities. Massachusetts has an $8 million annual budget line item that funds suicide prevention activities. In 2014, Washington’s House Bill 2315 authorized the development of a suicide prevention plan with requirements to involve a steering committee, base the plan on current research, make the plan accessible to the public, and update the plan as needed.

Because studies to guide continuation or maintenance treatment for young people at risk for suicide are not available, the length of treatment is determined by clinical judgment and the patient’s and family’s preferences. Other somatic treatments that have been applied to suicide risk in young people with little in the way of controlled trials include electroconvulsive therapy and transcranial magnetic stimulation treatments such as theta burst stimulation. Initial management of suicide risk in young people is typically multifaceted, including elements of safety planning, optimizing environmental safety via education on lethal means restriction, crisis stabilization, enhanced monitoring, and linkage with further treatment. At follow-up, parents who received the education reported taking more action to limit access (for example, locking up firearms and medication) than those who did not receive the education.102 Other examples of selective interventions include those developed for young people bereaved by suicide, those presenting to the emergency department with suicidal ideation or depression and substance use, and those reporting high levels of perceived burdensomeness.103 Selective suicide prevention programs are developed for groups of young people known to be at an increased risk for suicide. By comparison, the UK National Institute for Health and Care Excellence (NICE) recommends against stratification of suicide risk into low, medium, or high to determine who should be offered treatment or discharged from hospital or to predict future individual risk of suicide or self-harm.98 The NICE Guideline Committee determined that risk assessment measures cannot accurately predict risk of suicide or self-harm and that the potential harms of risk stratification outweigh any benefits, partly because of the dynamic nature of suicide risk but also because people who die by suicide often score low on these risk scores.