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Preventing suicide among young people

Most young people are in good mental health, but a small but growing group are severely depressed.

There is currently no simple recipe for preventing suicide, and as a science, suicide prevention is fairly new and, because of the taboo surrounding it, relatively neglected. But despite this, scientists have good knowledge of what society and its members can do to improve the mental health of young people and prevent new suicides. Read more in our special issue.

Suicide prevention tested in the EU

How can suicide among young people best be prevented? For the first time, a pan-European study has been carried out to determine the best methods.

The earlier in the suicide process that action is taken, the more effective it can be. However, researchers are uncertain of the best method of preventing suicide among young people.

Earlier research carried out by the Swedish National Prevention of Suicide and Mental Ill-health (NASP), a department under KI's Department of Public Health Sciences, showed that it is possible to reduce the suicide rate amongst young girls by raising awareness of preventative measures in school pupils and informing them of whom they can turn to for help. The study included around 1,000 pupils from a number of schools in Stockholm. However, the effects on the boys' suicidal tendencies was not as distinct.

"The results prompted us to test other types of intervention with larger groups of pupils to obtain more reliable results," says Vladimir Carli, assistant project leader for the study and researcher at NASP. "We're now comparing for the first time several different preventative methods in the same scientific study at a European level."

Eleven thousand 15-year olds from eleven EU countries are to be included in the study. This gives 1,000 young people from each country, who will be divided up into four groups of 250. The aim of the project is to study three different methods of preventing suicide and mental ill-health among young people in order to find the best and most cost-effective way of reducing the suicide rate in this particular sector of the population.

Three suicide prevention methods are to be studied

Group 1. A method specially developed by researchers at NASP and Columbia University in New York to raise awareness of mental ill-health and suicidal behaviour in young people, so that they have better access to support and can seek help more quickly.

Group 2. Training teachers and other school personnel to recognise young people in the risk zone so that they can persuade them to seek help.

Group 3. Letting people working in psychiatry for children and young people use screening methods to identify pupils at risk in their schools so that they can be offered help.

Group 4. The control group will only be passively exposed to posters around the school, informing them about where to turn if they have suicidal thoughts or signs of depression.

Before, during and after the methods are tested, the subjects will be asked to complete a survey on mental health, suicidal behaviour, values and lifestyle, such as alcohol and tobacco consumption and internet use. This will allow the researchers to measure if, and if so, how their attitudes, habits, mental health, etc. have changed during the study. As suicide is relatively rare among young people, it is especially important for European countries to cooperate in order to obtain statistically significant results, says Vladimir Carli.

In another EU study, scientists will be examining the link between truancy and mental ill-health, including suicide. Vladimir Carli believes that pupils in the risk zone for suicide can be found amongst those who take unauthorised absence from school.

"The more we know about the risk factors, the easier it will be."

Can the internet be used to prevent suicide?

Bild på Gergö Hadlaczky

Four questions for Gergö Hadlaczky about suicide and the internet.

How do you think internet use has affected the mental health of young people?

"It's hard to study, but it probably has both positive and negative effects. On the one hand, the internet can make it easier to contact others and thus reduces the sense that someone's alone in their problems. On the other hand, there's a danger that healthy internet use becomes addictive use, and we know that there's a lot of bullying and persecution going on on the net too."

How can the internet be used to prevent suicide?

"To inform people about suicide prevention methods and help create a more open climate around questions of mental health. But few of the websites that deal with suicide prevention are made with young people in mind, something that the SUPREME project intends to change. The main purpose is to encourage healthy young people to take an active interest in suicide prevention and the promotion of mental health, and to give support to those who need it."

Is there a danger that internet can aggravate suicidal tendencies?

"Some internet sites contain detailed information about how to take your own life, and even urge people to do so. A survey carried out by Michael Westerlund, a doctoral student at Stockholm University and Professor Danuta Wasserman at Karolinska Institutet, shows that even though there are only a handful of such sites, they end up rather high up on search engine hit lists when you search under suicide. They therefore constitute a considerable risk."

Cant such sites be closed down?

"Swedish law prohibits the banning of such sites. The best way of dealing with them is to make sure that suicide prevention sites get higher priority on the hit lists. This can be done by making them as readable and engaging as possible so that the number of people visiting them increases."

Text: Cecilia Odlind. Published in Medical Science, issue no 4, 2009.