Evidence on tap: youth suicide prevention

Article type
Authors
Bennett K1, n/a TYSEOTT2
1McMaster University, Canada
2n/a
Abstract
Objectives: We partnered with Government of Canada policy-makers through the Canadian Institutes of Health Research (CIHR) Evidence on Tap program to conduct an expedited knowledge synthesis (EKS) on youth suicide prevention. The goal was to inform a national suicide prevention strategy with respect to (i) school-based strategies; and (ii) interventions for high-risk youth who have attempted suicide.

Methods: Our EKS included two stages: (1) Overview of reviews: Review inclusion criteria were: (i) systematic review or meta-analysis; (ii) prevention in youth aged ≤ 24 years; (iii) peer-reviewed English language. Quality was assessed using AMSTAR. (2) Consideration of primary studies published after eligible reviews: Inclusion criteria were: (i) recommendation from advisory team member; (ii) peer-reviewed English language RCT or controlled cohort study. Quality was assessed using Cochrane risk of bias criteria.

Results: Six reviews of school-based interventions (e.g., awareness curriculums, gatekeeper training, screening) received moderate-high AMSTAR scores and reported positive impacts on risk and protective factors. Only one trial (suicide awareness and screening) showed reductions in suicide related behaviours (SRB; youth reported suicide attempts). Thirteen reviews relevant to youth with ≥ 1 suicide attempt received moderate—high AMSTAR scores. Emergency department transition programs and health-care provider training were promising strategies for reducing SRB. Eligible reviews did not address gender differences in intervention effects. Effective treatment of mental health problems, particularly depression, is recommended but has not yet been demonstrated to mediate reductions in SRB.

Conclusions: CIHR, the Public Health Agency of Canada (PHAC) and Health Canada knowledge-users rated our findings as highly useful following a 1-day knowledge exchange workshop, and will use them to implement Bill C-300 (An Act respecting a Federal Framework for Suicide Prevention). Uncertainties regarding the impact of these activities on youth SRB can be reduced by implementing promising interventions within a national collaborative youth suicide research network.