School approaches to youth suicide prevention

Universal and indicated school-based suicide prevention programs are described, including conceptual bases, program components, ineffective approaches, and evaluation outcomes. Controlled evaluations of second-generation programs report positive outcomes, including positive changes in knowledge, attitudes toward suicide, intent to seek help, and reduction of suicidal feelings. Two comprehensive programs reported reduced suicide rates in targeted counties subsequent to program dissemination. Caution is raised concerning variations in program quality. Currently, some model universal and indicated programs show promise and are candidates for more research on mediating and moderating variables and program outcomes.