Effectiveness of Suicide Prevention Programmes Among Adolescents and Sociocultural Adaptation of Programmes: A Systematic Review.

No statistical integration was possible because study designs, programmes, outcome measures and follow-up periods were heterogeneous. No single study measured suicidal behaviour, help-seeking, knowledge, attitude and coping together, so the review cannot show that any programme works across all outcomes. Most studies were from high-income countries, and none from low- or middle-income countries or South Asia were retrieved, limiting generalisability to culturally diverse settings. Almost half of programmes (20) were developed and used in the same country, and very few reported cultural adaptation details, so transferring programmes to other contexts is not well supported. Sample sizes varied from 8 to 11 110, retention varied from 44% to 100%, and follow-up ranged from immediately to 18 months, so some positive findings may be unstable. The review excluded hospital or healthcare settings, adolescents with psychiatric problems and gender and sexual minority groups, so it does not address higher-risk clinical groups. No adverse effects were reported, but that is absence of evidence from included studies, not evidence that the programmes are safe. Only English-language studies were included, so relevant studies in other languages may be missing.

Do not read the many positive study findings as proof that a school-based suicide prevention programme reliably reduces suicide attempts or works across all outcomes. The review found inconsistent effects, no single study measured all outcomes, and no programme was identified as the gold standard.