Effectiveness of suicide prevention programmes among adolescents and sociocultural adaptation of programmes: a systematic review

Suicide is a leading cause of adolescent death and is preventable through school-based programs. This review aimed to identify available suicide prevention programmes for adolescents, their contextualisation, and effects on suicidal behaviours, help-seeking, knowledge, attitude and coping. This review was conducted by searching four databases following PRISMA guidelines. Articles published till September 2023 were searched, and the search was re-run in June 2024. All types of studies conducted among adolescents, outside healthcare facilities and published in English were included. Studies that included adolescents with pre-existing mental health conditions, gender and sexual minority groups were excluded. Quality was assessed using Joanna Briggs Institute tools. The review protocol was registered in PROSPERO (CRD42023469637). A total of 53 of 3663 identified articles were included. There were 41 different suicide prevention programmes used across the 53 studies. Data extraction focused on author, published year, country, study aims, population, interventions, comparison groups, contextualisation and the outcomes of interventions. Most of the studies (64.2%) were conducted in the United States of America. Three studies mentioned the contextualisation of the programme without details. Of the studies measuring suicidal behaviours (82.1%), help-seeking (66.7%), knowledge (93.8%), attitude (81.8%) and coping (50%), all reported on the effectiveness of programmes. Studies from low- and middle-income countries could not be identified, and very few studies mentioned the contextualisation of programmes. The heterogeneity of the studies and diversity of the programmes, tools, standards of delivery and follow-up times across the studies made it difficult to draw conclusions about the overall effectiveness of programmes.