School-based Comprehensive Suicide Intervention in Shanghai, China

Shanghai Pu Dong Institute of Education Development, Shanghai Sanling North Junior Middle School, Shanghai Shangnan East Junior Middle School, Shanghai Sanling Senior Middle School, Shanghai Yangsi Senior Middle School

The primary aim of this study is to examine whether a school-based suicide intervention is effective in reducing suicide related risk factors in a population of middle and high students. It hypothesized that receiving the intervention will reduce the severity of suicide related risk factors such as depression, hopelessness, suicidal behaviors and increasing protective factors such as social support, self esteem, suicide knowledge and attitude and so on, as compared to the control group.

A total of 3000 students from two junior schools (grade 7 and 8) and two senior schools (grade 10 and 11) in Shanghai Pu Dong district were recruited in our study. All students were randomly assigned into universal study group or universal control group by class level. In those two groups, high risk of suicidal students were identified by screening. A universal suicide intervention was conducted in the universal study group; an indicated suicide intervention was conducted in the indicated study group. All students in universal study group and universal control group completed the self-administered questionnaire before and 6 months after the end of universal intervention. High risk of suicidal students in the indicated study group and indicated control group completed another self-administered questionnaire before, 6 months and 18 months after the end of the indicated intervention.

1500 students are randomized to receive a universal suicide intervention apart from usual school psychology classes. Furthermore, high risk of suicidal students screened in study group will receive an indicated suicide intervention in addition to usual school psychology classes.

1500 students are randomized to receive usual school psychology classes. High risk of suicidal students screened in control group will receive usual psychology classes.

universal intervention:(1)students: 4 sections about cherishing life, coping strategies, suicide and depression disorder during 2 semesters, each session lasting 45 minutes.(2)gatekeeper: 4 sessions about teenagers psychological crisis intervention strategies during 2 semesters, 30minutes per session. indicated intervention: (1)student: 2 semesters, 20 sessions' group life skill and cognitive-behavioral psychological training lesson, including Youth rational emotive group tutoring(eight classroom sessions), Coping skill group tutoring(six classroom sessions)and Behavior group tutoring(six classroom sessions), once a week, each session lasting 1.5hours.(2)gatekeeper: a social support net.

"Change from baseline in suicide behavior at 6 months after the end of the intervention" and "Change from baseline in suicide behavior at 18 months after the end of intervention"

"Change from baseline in suicide knowledge at 6 months after the end of the intervention" and "Change from baseline in suicide knowledge at 18 months after the end of intervention"

Inclusion Criteria: students of grade 6,7,9,10 from four schools (2 middle schools, 2 high schools) Exclusion Criteria: students who are not attending school because of long term sickness or moving to other school,or going aboard, etc. students whose parents don't agree to participate the study