SEYLE - Saving and Empowering Young Lives in Europe

The Saving and Empowering Young Lives in Europe (SEYLE) is a mental health promoting programme for adolescents in European schools. The programme involved adolescents recruited from randomized schools in 11 European countries: Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain, with Sweden serving as the coordinating centre. The project was finalized in 2015.

SEYLEs main objectives are to lead adolescents to better mental health through decreased risk-taking and suicidal behaviours. Outcomes of different preventive programmes are evaluated and culturally-adjusted models are established for promoting adolescent mental health in different European countries.

Each participating country performs three active interventions and one minimal intervention in a control group. The active interventions include gatekeeper training (QPR), awareness training on mental health promotion for adolescents (Awareness), and screening for at-risk adolescents by health professionals (ProfScreen). Structured questionnaires were developed and administered to different target groups (pupils, teachers, school staff, professionals) at baseline, with 3-month and 12-month follow-ups to examine and compare the effects of the interventions.

Consistent with timeframe of the interventions, evaluation instruments were developed for administration at baseline, 3-month follow-up and 12-month follow-up for pupils, teachers, school staff and professionals to assess their respective responses to the different interventions of the SEYLE project.

Assessment instruments

Supplemental assessment instruments were also designed to evaluate intervention quality control, participant satisfaction, public health system referrals, and the intervention itself. Pupil questionnaires were constructed with validated scales could be administered in at each assessment to determine over time the impact of the different interventions on changing adolescent behaviours and improving their mental health. Upon their completion and prior to the start of the interventions, the evaluation instruments were distributed to all SEYLE centres for review. Each centre provided detailed comments on how to improve the accuracy and utility of the questionnaires, and these suggestions were then integrated into the instruments to formulate a final version.

The final version of instruments were pilot tested in several EU partner countries to establish a timeline for completion of the self-administered questionnaires and to receive input from the target groups. The results and comments were incorporated into the final version of the SEYLE questionnaire. This was then made available for evaluation by the local ethics committees

Independent ethics advisor

An independent ethics advisor supervised the implementation of the SEYLE project overall in order to ensure maximum protection of vulnerable individuals such as adolescents and to identify any sensitive issues. Each participating centre submitted an application to their local ethics committee before performing any type of SEYLE intervention in their respective country. A protocol comprising timelines, milestones and outcomes for the ethics committee application process was distributed to all the centres. Templates for consent forms for pupils and parents and data protection forms were disseminated to all SEYLE centres. Procedures for coding pupil data anonymously were included as part of the data collection procedures. All evaluation instruments and prevention kits were translated into the appropriate languages and culturally adapted, and then submitted for local ethics review. Support was provided to all SEYLE centres by the Hungarian and Spanish centres, as well as the coordinating centre in Sweden. Eight out of eleven countries received ethics approval on the first submission, with minor comments and/or requests for clarifications. The SEYLE centres in France, Austria and Slovenia were required to submit supplemental information before approval was granted. The main concerns raised by the local ethics committees were about the potentially sensitive items in the questionnaire on topics such as religion, sexuality and discrimination. However, after the supplemental information and explanation was submitted, the remaining three countries obtained ethics approval. The coordinating centre worked with each individual centre to provide official documents, address specific ethical concerns, and to maintain high ethical standards throughout the entire programme. It was therefore possible to use the same questionnaire in all countries participating in SEYLE.

SEYLE materials

SEYLE materials (evaluation instruments & prevention kits) were originally developed in English and later translated into the following languages: German, Gaelic (Irish), Estonian, French, Hungarian, Hebrew, Italian, Romanian, Slovenian and Spanish. Translation coordinators were elected in each participating country by the respective site leader. All site leaders were requested to implement the cultural adaptation protocol during the translation process and pilot testing. Focus groups were developed in each participating country to facilitate open discussions and feedback of cultural adaptability of SEYLE materials. A systematic assessment of the content for cultural appropriateness was performed. If discrepancies were detected, consultation with a cultural linguistic advisor was sought. Based on those results, items were incorporated into the final versions accordingly.

Baseline evaluation

A comprehensive epidemiological database regarding mental health, suicidal behaviour and at risk-behaviours of European adolescents has been collected within the framework of the SEYLE project. The database contains information regarding 12395 subject with age comprised between 14 and 17. 

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Vladimir Carli

Senior Lecturer/Senior Physician


Risk and protective factors for psychotic experiences in adolescence: a population-based study.
McMahon EM, Corcoran P, Keeley H, Clarke M, Coughlan H, Wasserman D, et al
Psychol Med 2020 Feb;():1-9

Influence of coping strategies on the efficacy of YAM (Youth Aware of Mental Health): a universal school-based suicide preventive program.
Kahn JP, Cohen RF, Tubiana A, Legrand K, Wasserman C, Carli V, et al
Eur Child Adolesc Psychiatry 2020 Feb;():

Life Events Predicting the First Onset of Adolescent Direct Self-Injurious Behavior-A Prospective Multicenter Study.
Kaess M, Eppelmann L, Brunner R, Parzer P, Resch F, Carli V, et al
J Adolesc Health 2020 Feb;66(2):195-201

A longitudinal examination of the interpersonal theory of suicide and effects of school-based suicide prevention interventions in a multinational study of adolescents.
Barzilay S, Apter A, Snir A, Carli V, Hoven CW, Sarchiapone M, et al
J Child Psychol Psychiatry 2019 Oct;60(10):1104-1111

Longitudinal development of risk-taking and self-injurious behavior in association with late adolescent borderline personality disorder symptoms.
Ghinea D, Koenig J, Parzer P, Brunner R, Carli V, Hoven CW, et al
Psychiatry Res 2019 03;273():127-133

Psychopathology is associated with reproductive health risk in European adolescents.
Gambadauro P, Carli V, Wasserman C, Hadlaczky G, Sarchiapone M, Apter A, et al
Reprod Health 2018 Nov;15(1):186

Comorbidity of Physical and Anxiety Symptoms in Adolescent: Functional Impairment, Self-Rated Health and Subjective Well-Being.
Balázs J, Miklósi M, Keresztény A, Hoven CW, Carli V, Wasserman C, et al
Int J Environ Res Public Health 2018 08;15(8):

Predictive factors of alcohol consumption in adolescents: data from 1-year follow-up prospective study.
Bousoño Serrano M, Al-Halabí S, Burón P, Garrido M, Díaz-Mesa EM, Galván G, et al
Adicciones 2019 Jan;31(1):52-63

Bi-directional longitudinal associations between different types of bullying victimization, suicide ideation/attempts, and depression among a large sample of European adolescents.
Brunstein Klomek A, Barzilay S, Apter A, Carli V, Hoven CW, Sarchiapone M, et al
J Child Psychol Psychiatry 2019 02;60(2):209-215

Direct Self-Injurious Behavior (D-SIB) and Life Events among Vocational School and High School Students.
Horváth LO, Balint M, Ferenczi-Dallos G, Farkas L, Gadoros J, Gyori D, et al
Int J Environ Res Public Health 2018 05;15(6):

A cost-effectiveness analysis of school-based suicide prevention programmes.
Ahern S, Burke LA, McElroy B, Corcoran P, McMahon EM, Keeley H, et al
Eur Child Adolesc Psychiatry 2018 Oct;27(10):1295-1304

Mental health difficulties and suicidal behaviours among young migrants: multicentre study of European adolescents.
McMahon EM, Corcoran P, Keeley H, Cannon M, Carli V, Wasserman C, et al
BJPsych Open 2017 Nov;3(6):291-299

Explicit Motives, Antecedents, and Consequences of Direct Self-Injurious Behaviors.
Snir A, Apter A, Barzilay S, Feldman D, Rafaeli E, Carli V, et al
Crisis 2018 Jul;39(4):255-266

Bullying Victimization and Suicide Ideation and Behavior Among Adolescents in Europe: A 10-Country Study.
Barzilay S, Brunstein Klomek A, Apter A, Carli V, Wasserman C, Hadlaczky G, et al
J Adolesc Health 2017 Aug;61(2):179-186

Factors associated with different smoking status in European adolescents: results of the SEYLE study.
Banzer R, Haring C, Buchheim A, Oehler S, Carli V, Wasserman C, et al
Eur Child Adolesc Psychiatry 2017 Nov;26(11):1319-1329

Review of health and risk-behaviours, mental health problems and suicidal behaviours in young Europeans on the basis of the results from the EU-funded Saving and Empowering Young Lives in Europe (SEYLE) study.
Wasserman D
Psychiatr. Pol. 2016 Dec;50(6):1093-1107

Substance use or abuse, internet use, psychopathology and suicidal ideation in adolescents.
Bousoño Serrano M, Al-Halabí S, Burón P, Garrido M, Díaz-Mesa EM, Galván G, et al
Adicciones 2017 Jan;29(2):97-104

Association between victimization by bullying and direct self injurious behavior among adolescence in Europe: a ten-country study.
Brunstein Klomek A, Snir A, Apter A, Carli V, Wasserman C, Hadlaczky G, et al
Eur Child Adolesc Psychiatry 2016 Nov;25(11):1183-1193

Prospective risk for suicidal thoughts and behaviour in adolescents with onset, maintenance or cessation of direct self-injurious behaviour.
Koenig J, Brunner R, Fischer-Waldschmidt G, Parzer P, Plener PL, Park J, et al
Eur Child Adolesc Psychiatry 2017 Mar;26(3):345-354

Physical activity in European adolescents and associations with anxiety, depression and well-being.
McMahon EM, Corcoran P, O'Regan G, Keeley H, Cannon M, Carli V, et al
Eur Child Adolesc Psychiatry 2017 Jan;26(1):111-122

Identifying Ethical Issues in Mental Health Research with Minors Adolescents: Results of a Delphi Study.
Hiriscau EI, Stingelin-Giles N, Wasserman D, Reiter-Theil S
Int J Environ Res Public Health 2016 05;13(5):

Pathological Internet Use and Risk-Behaviors among European Adolescents.
Durkee T, Carli V, Floderus B, Wasserman C, Sarchiapone M, Apter A, et al
Int J Environ Res Public Health 2016 Mar;13(3):

Developmental trajectories of self-injurious behavior, suicidal behavior and substance misuse and their association with adolescent borderline personality pathology.
Nakar O, Brunner R, Schilling O, Chanen A, Fischer G, Parzer P, et al
J Affect Disord 2016 Jun;197():231-8

Reading Books and Watching Films as a Protective Factor against Suicidal Ideation.
Kasahara-Kiritani M, Hadlaczky G, Westerlund M, Carli V, Wasserman C, Apter A, et al
Int J Environ Res Public Health 2015 Dec;12(12):15937-42

A 2-year longitudinal study of prospective predictors of pathological Internet use in adolescents.
Strittmatter E, Parzer P, Brunner R, Fischer G, Durkee T, Carli V, et al
Eur Child Adolesc Psychiatry 2016 Jul;25(7):725-34

Important Variables When Screening for Students at Suicidal Risk: Findings from the French Cohort of the SEYLE Study.
Kahn JP, Tubiana A, Cohen RF, Carli V, Wasserman C, Hoven C, et al
Int J Environ Res Public Health 2015 Sep;12(10):12277-90

Help-seeking behaviour following school-based screening for current suicidality among European adolescents.
Cotter P, Kaess M, Corcoran P, Parzer P, Brunner R, Keeley H, et al
Soc Psychiatry Psychiatr Epidemiol 2015 Jun;50(6):973-82

School-based suicide prevention programmes: the SEYLE cluster-randomised, controlled trial.
Wasserman D, Hoven CW, Wasserman C, Wall M, Eisenberg R, Hadlaczky G, et al
Lancet 2015 Apr;385(9977):1536-44

Alcohol consumption patterns among adolescents are related to family structure and exposure to drunkenness within the family: results from the SEYLE project.
Rüütel E, Sisask M, Värnik A, Värnik P, Carli V, Wasserman C, et al
Int J Environ Res Public Health 2014 Dec;11(12):12700-15

Pathological Internet use among European adolescents: psychopathology and self-destructive behaviours.
Kaess M, Durkee T, Brunner R, Carli V, Parzer P, Wasserman C, et al
Eur Child Adolesc Psychiatry 2014 Nov;23(11):1093-102

Hours of sleep in adolescents and its association with anxiety, emotional concerns, and suicidal ideation.
Sarchiapone M, Mandelli L, Carli V, Iosue M, Wasserman C, Hadlaczky G, et al
Sleep Med. 2014 Feb;15(2):248-54

Risk-behaviour screening for identifying adolescents with mental health problems in Europe.
Kaess M, Brunner R, Parzer P, Carli V, Apter A, Balazs JA, et al
Eur Child Adolesc Psychiatry 2014 Jul;23(7):611-20

Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: a comparative study of findings in 11 European countries.
Brunner R, Kaess M, Parzer P, Fischer G, Carli V, Hoven CW, et al
J Child Psychol Psychiatry 2014 Apr;55(4):337-48

The saving and empowering young lives in Europe (SEYLE) randomized controlled trial (RCT): methodological issues and participant characteristics.
Carli V, Wasserman C, Wasserman D, Sarchiapone M, Apter A, Balazs J, et al
BMC Public Health 2013 May;13():479

Adolescent subthreshold-depression and anxiety: psychopathology, functional impairment and increased suicide risk.
Balázs J, Miklósi M, Keresztény A, Hoven CW, Carli V, Wasserman C, et al
J Child Psychol Psychiatry 2013 Jun;54(6):670-7

Suicide prevention for youth--a mental health awareness program: lessons learned from the Saving and Empowering Young Lives in Europe (SEYLE) intervention study.
Wasserman C, Hoven CW, Wasserman D, Carli V, Sarchiapone M, Al-Halabí S, et al
BMC Public Health 2012 Sep;12():776

Prevalence of pathological internet use among adolescents in Europe: demographic and social factors.
Durkee T, Kaess M, Carli V, Parzer P, Wasserman C, Floderus B, et al
Addiction 2012 Dec;107(12):2210-22

Saving and empowering young lives in Europe (SEYLE): a randomized controlled trial.
Wasserman D, Carli V, Wasserman C, Apter A, Balazs J, Bobes J, et al
BMC Public Health 2010 Apr;10():192

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