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Article 12 -School Approaches to Youth Suicide Prevention.docx

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PSYC 3690
Benjamin Gottlieb

1 Article 12 –School Approaches to Youth Suicide Prevention (Kalafat, 2003) Abstract -Talks about 2 broad types of prevention programs: -Universal and indicated school based suicide prevention programs are described, inc. conceptual bases, prndram components, ineffective approaches and evaluation outcomes -Controlled evaluations of 2 gen. Programs report positive outcomes inc. positive changes in knowledge attitudes toward suicide, internet to seek help, and reduction of suicidal feelings -2 comprehensive programs reported to reduce suicide rates in targeted counties subsequent to program dissemination -Caution is raised concerning variations in program quality -Currently some model universal and indicated programs show promise and are candidates for more research on mediating and moderating variables and program outcomes Other Notes -Suicide consistently ranks 2 or 3 as a leading cause of adolescent death -Ominous increase in rates for younger adolescents (10-14 yrs) appear to follow trends in substance abuse -Around 10% self-report suicide attempts -School is the community institution that is primarily responsible for the education and socialization of youth, so the school context has the potential to moderate the occurrence of risk behaviours and to identify and secure help for at-risk individuals -But now the responsibility to protect and socialize now carries the burden of dealing with youth from disadvantaged environments (family disintegration, substance abuse, interpersonal violence, and risky sexual behaviour) -Increasing demands on school dictate that suicide prevention programs must be consistent with school mandates and culture, and make effective use of school resources -Must also have: 1. Clear conceptual and empirical base 2. Use proven implementation and instructional strategies 3. Ecological or systematic by inc. relevant components of the school and community -Strategies that DO NOT work (based on research and field work): -One time presentations/assemblies -Insufficient program dosage, cannot monitor reactions to material -Media depictions or presentations by youth that have attempted suicide -May have modeling effects on vulnerable youth -Outsourcing programs (vs. in school) -Fails to enhance available local resources -Poorly implemented programs, regardless of content or intent -Also no basis for supporting a single approach –need to emphasize complementary roles of different empirically and conceptually grounded apraoches UNIVERSAL Conceptual and Empirical Bases of Universal Programs: -Most suicidal youth confide in peers more often than adults -Disrupted youth prefer peer supports more than non-disrupted -Some adolescents, esp. males, do not respond to troubled peers in empathetic or helpful ways -As few as 25% of peer confidants tell an adult about troubled/suicidal peers 2 -Inaccessability of and reluctance of adolescents to seek out helpful adults is considered to be a risk factor that contributes to destructive outcomes associated with a variety of troubled youth -There is also evidence that provision of help of youth may be beneficial to them -Participation in helping interactions can shape prosocial behaviours and reduce problematic behaviour, and is related to indices of social competencies that can carry over to other challenging situations Examples of Universal Programs: -Adolescent Suicide Awareness Program (ASAP) -Lifelines -Both evaluated and widely disseminated -Washington program -Features substantial involvement of students in the development of local peer support messages and provision of classroom lessons General Model Strategy Mediator Outcome -Administrative consultation -Social competence, decision -Increases in suicide -School gatekeeper training for all making, family connections, school knowledge and intent to faculty and staff on the ID of, initiabonding moderate the appearance seek to help on behalf of response to, and effective referral of risk factors inc. substance abuse, troubled students and of troubled/at-risk youth delinquency, violence, and decreases in ideation -Parent training problem sexual behaviour and -Community gatekeeper training pregnancy (coordination with schools and families) -Classes in health curriculum Goals of Intervention -To create competent school communities in which all members accept responsibility for the safety of each other and can provide an appropriate initial response to those at risk, designed to increase the likelihood that school gatekeepers and peers who come into contact with at-risk youth can more readily identify them, provide appropriate initial response to them and will know how to obtain help for them, and are consistently inclined to take such action Who Benefits? -Youth in the schools, esp. those at risk of suicide Classification Universal: school wide program Primary: want to prevent suicide/attempts before they occur Measures -Suicide rates, suicide knowledge, self-reported suicidal ideation Program Content -Administrative consultation to ensure policies are in place to ensure community linkages exi
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