Risk Factors Addressed in Programs for the Prevention of Child and Adolescent Suicide in the School Setting: A Systematic Review

Abstract

Background: Suicide is increasing among adolescents and young adults worldwide, so its prevention is a topic of great educational interest. In this context, several prevention programs have been developed. However, this problem continues to increase among young people.

Methods: The objective of this study is to systematically analyze the concordance between the risk factors addressed in suicide prevention programs in school settings and the suicide risk factors (RFs) described in the literature (systematic and meta-analyses). Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol, this review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the code CRD42023431649. After launching the search algorithm in the various databases, Web of Science (WOS), SCOPUS, Education Resources Information Center (ERIC), ProQuest Psychology, and PubMed, duplicate references were removed using the bibliographic reference management software Zotero. Two independent researchers assessed their possible eligibility. A third judge resolved any disagreements on the inclusion/exclusion of the selected articles. For the quality assessment, the Joanna Briggs Institute (JBI) was employed. Finally, 24 articles published between January 1, 2000, and February 1, 2025, were selected. The data extraction and qualitative analysis were divided in three phases: (1) Scoping umbrella review of suicide risk factors; (2) Systematic review of suicide risk factors addressed in child and adolescent suicide prevention programs and their efficacy; (3) Systematic analysis of the concordance between suicide risk factors found in the literature of systematic reviews and meta-analyses and their inclusion in prevention programs.

Results: The risk factors more frequently addressed in the programs are anxiety, depression, peer support, and social relationships. Sexual orientation and bullying/cyberbullying are two risk factors whose role in adolescence is crucial and which are barely or not addressed in current prevention programs. Multi-modal interventions provide the best indicators of effectiveness. In addition, the inclusion of working with the family appears to be a component that affects the effectiveness of the programs. A relationship was found between a higher number of risk factors addressed in the programs and their effectiveness.

Conclusion: There is a need to update and create new programs for Generation Z and Alpha students.