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The effects of educational interventions on suicide: A systematic review and meta-analysis

Journal article
Authors Isabella Pistone
Ulrika Beckman
Erik Eriksson
Helena Lagerlöf
Morten Sager
Published in International Journal of Social Psychiatry
Volume 65
Issue 5
Pages 399-412
ISSN 0020-7640
Publication year 2019
Published at Department of Philosophy, Linguistics and Theory of Science
Pages 399-412
Language en
Keywords Suicide prevention, systematic review, meta-analysis, educational intervention, school-based intervention, gatekeeper training
Subject categories Public health science, Community medicine, Psychiatry


Background: Suicide is a major public health problem. Educational interventions for preventing suicidal behaviour are widely used, although little is known regarding the collective effectiveness of these interventions. Aim: We evaluated the existing evidence for the effectiveness of education interventions in the prevention of suicidal behaviour. Methods: In this systematic review and meta-analysis, we searched multiple databases using terms related to suicide prevention. The articles were reviewed by two independent reviewers, and the quality of evidence was rated according to Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Data from individual studies were combined in meta-analyses. Results: We identified 41 studies evaluating two different types of interventions: school-based education interventions and gatekeeper training. Education interventions showed significant gains in terms of knowledge and attitudes, though the effects seem to vary depending on subjects’ personal characteristics. School-based education interventions significantly reduced suicidal ideation and suicide attempts in youths. Gatekeeper training showed no significant effect on suicide attempts or gatekeeper skills, though the quality of evidence for the estimate, according to GRADE criteria, was rated as very low. Conclusion: The results of this study indicate that school-based education interventions are effective in preventing suicidal ideation and suicide attempts. In clinical practice, as well as in research, the development and implementation of educational interventions should focus on participants’ individual characteristics.

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