Evaluation of indicated suicide risk prevention approaches for potential high school dropouts

Am J Public Health. 2001 May;91(5):742-52. doi: 10.2105/ajph.91.5.742.


Objectives: This study evaluated the efficacy of 2 indicated preventive interventions, postintervention and at 9-month follow-up.

Methods: Drawn from a pool of potential high school dropouts, 460 youths were identified as being at risk for suicide and participated in 1 of 3 conditions randomly assigned by school: (1) Counselors CARE (C-CARE) (n = 150), a brief one-to-one assessment and crisis intervention; (2) Coping and Support Training (CAST) (n = 155), a small-group skills-building and social support intervention delivered with C-CARE; and (3) usual-care control (n = 155). Survey instruments were administered pre-intervention, following C-CARE (4 weeks), following CAST (10 weeks), and at a 9-month follow-up.

Results: Growth curve analyses showed significant rates of decline in attitude toward suicide and suicidal ideation associated with the experimental interventions. C-CARE and CAST, compared with usual care, also were effective in reducing depression and hopelessness. Among females, reductions in anxiety and anger were greater in response to the experimental programs. CAST was most effective in enhancing and sustaining personal control and problem-solving coping for males and females.

Conclusions: School-based, indicated prevention approaches are feasible and effective for reducing suicidal behaviors and related emotional distress and for enhancing protective factors.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Analysis of Variance
  • Anger
  • Anxiety / prevention & control
  • Depression / prevention & control
  • Female
  • Humans
  • Male
  • Northwestern United States
  • Pacific States
  • Program Evaluation
  • Regression Analysis
  • Risk
  • Risk-Taking
  • School Health Services*
  • Sex Factors
  • Social Support
  • Student Dropouts / psychology*
  • Suicide Prevention*