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Background Suicide is a worldwide public health problem. In response to this problem, Australia was one of the first countries to develop national suicide prevention policy. Guided by the National Suicide Prevention Office (NSPO), which was established in 2021, suicide prevention in Australia is in a period of reform. The NSPO is driving a nationally consistent and integrated approach to suicide prevention including leading the development of a new National Suicide Prevention Strategy. This article summarises findings from an environmental scan of government-led suicide prevention in Australia, conducted as an input for the development of the new Strategy. Methods The scan was conducted from August 2022 to January 2023. We searched relevant government websites and Google to identify policy documents and programs and services. We undertook a desktop review of documents and programs/services using coding templates developed to address the objectives of the scan. Qualitative information was extracted in a systematic manner using these templates. Results Australia’s suicide prevention efforts are significant as demonstrated by activities ranging from policy documents intended to guide and plan activity, the National Mental Health and Suicide Prevention Agreement committing the Federal Government and jurisdictions to work together, and the availability of national, state, local area based, and digital services and programs. Suicide prevention approaches in Australia are mostly selective or indicated. There is less emphasis on universal approaches, wellbeing promotion, strengthening protective factors and mitigating the impact of known drivers of distress. In addition, there is limited evidence to demonstrate a whole-of-government or whole-of-system approach is operating in Australia. Findings should be interpreted in the context that suicide prevention in Australia is currently in a period of transition. Conclusions Current government emphasis on and investment in suicide prevention activity, together with strong commitment to lived experience and cross sectorial collaboration, are substantial and appropriate. There are also many opportunities to further progress cross-portfolio and cross-jurisdiction suicide prevention and response efforts. This requires urgently adopting a shared understanding of suicide, which includes the diverse drivers of suicidal distress, and improving protective factors and social wellbeing.

Background Suicide and non-fatal suicidal behavior are significant public health issues worldwide requiring effective preventive interventions. Methods The aim of the present study was to analyze the effectiveness of national suicide prevention programs taking a statistical approach involving the segmented regression analysis of interrupted time series data. Results This study demonstrates that National Suicide Prevention Programs are effective, but this effect seems to correlate with age and sex. Our data have shown a statistical significant decline in suicide rates in the verum countries in males, with the strongest effects in groups aged 25-to-44 years and 45-to-64 years. Conclusion Our study implies that the implementation of a national strategy is an effective tool to reduce suicide rates.

Despite suicide ideation being one of the most frequently reported health issues impacting tertiary students, there is a paucity of research evaluating the efficacy of preventive interventions aimed at improving mental health outcomes for students studying at two tertiary institutes. The current study evaluated the efficacy of the “Talk-to-Me” Mass Open Online Course (MOOC) in improving tertiary students’ abilities to support the mental health of themselves and their peers via a randomised controlled trial design, comparing them to a waitlist control group. Overall, 129 tertiary students ( M  = 25.22 years, SD  = 7.43; 80% female) undertaking a health science or education course at two Western Australian universities were randomly allocated to either “Talk-to-Me” ( n  = 66) or waitlist control ( n  = 63) groups. The participants’ responses to suicidal statements (primary outcome), knowledge of mental health, generalised self-efficacy, coping skills, and overall utility of the program (secondary outcomes) were collected at three timepoints (baseline 10-weeks and 24-weeks from baseline). Assessment time and group interaction were explored using a random-effects regression model, examining changes in the primary and secondary outcomes. Intention-to-treat analysis ( N  = 129) at 10-weeks demonstrated a significant improvement in generalised self-efficacy for “Talk-to-Me” compared to the control group (ES = 0.36, p  = .04), with only the “Talk-to-Me” participants reporting increased knowledge in responding to suicidal ideation (primary outcome). This change was sustained for 24 weeks. Findings provide preliminary evidence suggesting that the “Talk-to-Me” MOOC can effectively improve tertiary students’ mental health and knowledge of how to support themselves and others in distress. ACTRN12619000630112, registered 18-03-2019, anzctr.org.au.

Vancouver Island Crisis Society has developed a unique approach to suicide prevention for youth and is encouraged to observe the positive impact these programs have had in the lives of students and on school communities as a result. This is the story of the evolution of two such school-based suicide prevention programs: (a) GRASP (Growth, Resilience, Acknowledgement, Suicide, Awareness, Personal Safe Planning); and (b) Speak Out, Reach Out, Help Out. While suicidal despair often thrives in isolation, what power might human connection have to combat it? And could that sense of connection be interwoven into youth suicide prevention programs, not to diminish what is already there but to enrich and enliven current best practices, and research-based information? Throughout this article, I will uncover the possibilities of what can emerge when practice is informed by the professional literature and a purposeful intent to create a sense of connection and relational engagement.

Background Suicidal management and prevention in communities, especially in its first stages, is an effective intervention for the health systems. However, in numerous societies most cases go undetected. Primary Health Care (PHC) is an effective place for the management of Suicide Prevention Programs (SPP). In Malekan County, a health community assessment found suicide as the most important health problem. A regional SPP was performed for suicide prevention during 2014–2017. Methods This study was carried out in six steps: (1) Establishing a research team, (2) Improving a registry for suicidal behaviors (SBs), (3) Identifying local determinants of SBs, (4) Training healthcare providers, (5) Follow-up and monitoring of SBs, and (6) Public awareness campaigns. Our ultimate goal was to lower the rates of suicide, and suicide attempt (SA) by 15 and 20 %, respectively. Multiple logistic regression was used to estimate the adjusted odds ratios and the 95% confidence intervals. Results A total of 821 SAs and 32 suicides were identified. The gender distribution for suicides was 70% males whereas SAs were 64% among females. The majority of suicides occurred in spring 18 (56.25%) while summer was the most common season among SAs 288 (35.8%). Almost 62 and 75% of suicides and SAs have used hanging and poisoning methods, respectively. Hanging increased suicide risk significantly (OR: 8.5, 95% CI 2.9–76.99). During the study, 93 life-skill and parenting education sessions were held. The incidence rates of suicide and SA decreased from 11.22, and 203 per 100,000 in 2013 to 2.63, and 157 in 2017, respectively. Similarly, the re-attempt to SAs ratio decreased from 12% to 2013 to 6.7% in 2017. Moreover, more than 8% of SBs were collected from adjacent Counties. Conclusions At the study end, suicide, SA, and re-attempt were lowered by 75%, 22%, and 42%, respectively. The practical framework that achieved in this study could be used as a basis for developing future SPPs and suicide researches in the Iranian context. Furthermore, the various socio-economic and socio-cultural challenges highlight the need to consider a wide range of contextual factors when developing an SPP.

Introduction: Every year, over 700,000 individuals lose their life by suicide and many individuals attempt suicide. Suicide occurs in all age groups and is the fourth major cause of death among 15-29-year-olds globally in 2019. A suicide prevention program (SPP) is a capacity-building program that helps gatekeepers to identify the risk of suicide. The objective of the review is to determine the effectiveness of SPP on the improvement of knowledge, attitude, and gatekeeper behaviour among gatekeepers in South Asian countries so that the number of suicide cases will be reduced among college students in South Asia countries. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) will be followed in this review. This review will include all interventional studies (controlled and uncontrolled) that provided a suicide prevention program to the gatekeepers as an intervention. The full-text articles will be included from the following databases, Scopus, PubMed (MEDLINE), Cochrane, PsycINFO, Web of Science, and CINAHL, published in peer-reviewed, and indexed journals from the date of inception to 2022. A grey literature search and hand-search of reference lists of the included studies will also be done. A search strategy will be developed using keywords and MeSH terms for each database. Cochrane ROB-2 tool, JBI Critical Appraisal Checklist will be used to evaluate the quality of individual studies. Analysis of the data will be done using narrative synthesis. Conclusions: This review will provide information on knowledge, attitude, and gatekeeper behaviour toward suicide prevention in college students and will be helpful for the prevention of suicide. Therefore, the authors plan to publish the review outcome through a peer-reviewed journal. Registration : The review is registered in PROSPERO (CRD42023387020).

Background To ensure the effectiveness of school-based anxiety, depression and suicide prevention programmes, implementation fidelity, defined as the degree to which interventions are implemented as intended, is crucial. A comprehensive overview of fidelity measurements in these programmes is currently lacking, limiting the ability to compare and improve implementation efforts. This is particularly challenging in the context of scaling up prevention programmes, where ensuring both high-quality implementation and widespread adoption often proves insufficiently successful. With this review we aimed to (1) examine the extent to which fidelity measures were used and reported in existing studies of school-based anxiety, depression and suicide prevention programmes; (2) identify which fidelity components were measured; and (3) evaluate the quality of the fidelity measurements. Methods A systematic search was conducted across PubMed, PsycINFO, Medline, and ERIC using an AND-combination of search terms related to schools, adolescents, depression and interventions. Two researchers screened the selected articles, with discrepancies resolved by a third. Pre-defined inclusion criteria were used based on school-based prevention programmes, controlled trials, and psychological intervention techniques. For data extraction, fidelity components were extracted together with the methods for fidelity measurement. The quality of the measurements was assessed using criteria used in earlier fidelity research. Results Of 13,131 identified articles, 190 met our inclusion criteria. Of these, 72 (38%) measured at least one fidelity component, most commonly adherence (57, 79%), followed by responsiveness (24, 33%), dosage (19, 26%), and quality of delivery (9, 13%). Programme differentiation was not measured. The quality of fidelity measurements was most frequently moderate for adherence (65%), dosage (53%), and quality of delivery (56%), but low for responsiveness (79%). Conclusion Most school-based anxiety, depression, and suicide prevention programmes lack fidelity measurements, and existing assessments are often of moderate to low quality. To improve fidelity measurement, future research should prioritise the development of standardised methods with clear definitions and practical tools for assessing fidelity components. Embedding fidelity as a central element in study designs is essential to better link implementation efforts to intervention outcomes and to fully understand and optimise programme effectiveness, while ensuring that fidelity can be feasibly monitored in real-world settings.

Background/Objectives: This study assessed the effectiveness of a school-based suicide prevention program in Hong Kong. Methods: 105 secondary school students aged 14–16, identified as having high levels of depression and suicidal ideation. Participants were divided into three intervention groups: one for adolescents only, another for adolescents with peers, and a third for adolescents with parental involvement. All groups engaged in weekly online exercises. Repeated measures ANOVA was used to analyze the within-group and between-group differences in the levels of adolescents’ suicidal ideation, depression and anxiety. Results: The results indicated a statistically significant reduction in suicidal ideation, depression and anxiety levels after participation in all three groups. No statistically significant between-group differences were identified, meaning the effects of the three interventions on the measured outcomes were similar. Conclusions: This study demonstrates the promise of implementing school-based suicide prevention programs in the Hong Kong context.

This chapter contains sections titled: Abstract Introduction Screening for At‐Risk Youth Gatekeeper Training Skills Training Ecological and Comprehensive Approaches Conclusion References

Opens with a brief discussion of the epidemiology of suicide among American Indians and Alaska natives. Next comes a critical review of selective suicide preventive intervention programs identified in the literature and considers methods used to evaluate each program. Discussion then shifts to practices and policies. Concludes with recommendations for future program efforts. (BF)