School‐based self‐harm prevention programs

A systematic review with implications for international implementation

Datos Bibliográficos

ID21391859
AutoresSophie Liljedahl (0000-0002-6505-9818, Department of Psychiatry for Affective Disorders, National Specialized Medical Care Unit for Severe Self‐Harm Behaviour Region Västra Götaland, Sahlgrenska University Hospital Gothenburg Sweden), Clara Hellner (0000-0002-8375-9447, Stockholm Health Care Services), Agneta Pettersson (0000-0002-5785-3069, Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) Stockholm Sweden), Ata Ghaderi (0000-0001-8483-7964, Division of Psychology, Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden)
Año2023
Volumen64
Número6
Páginas825-837
Fecha de publicación2023-12-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaScandinavian Journal of Psychology (JOURNAL)
Identificadores de la revistaISSN: 0036-5564 • E-ISSN: 1467-9450
EditorialWiley (PUBLISHER • GB)
DOI10.1111/sjop.12945
IdiomaEN
Referencias citadas48

Both self‐harm and suicidal behaviors have been targeted through school‐based prevention programs, many of which have been developed in the United States. The aims of this systematic review were to assess effects of school‐based prevention programs on suicide and self‐harm and to evaluate whether they are fit to the exporting culture. The review followed Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Our inclusion criteria, structured according to population/problem, intervention, control/comparison, outome, were: children and youth up to 19 years of age, school‐based programs at universal, selective or indicated levels compared with teaching as usual or with other programs, and outcomes of suicide or self‐harm measured at least 10 weeks after intervention. Studies without a control group or using non‐behavioral outcomes were excluded. A comprehensive and systematic literature search was conducted from the 1990s to March 2022. Risk for bias was assessed with checklists adapted from the Cochrane Risk of Bias (ROB) tool. A total of 1,801 abstracts were retrieved. Five studies fulfilled our inclusion criteria, but one had high risk for bias. Confidence in the evidence for effect was assessed with Grading of Recommendations Assessment, Development and Evaluation (GRADE). Studies included in this review were evaluated with respect to applicability in the context of international export. Only two school‐based programs demonstrated efficacy in preventing suicidal behaviors. Although implementation of evidence‐based interventions is a crucial next step, further replication with simultaneous attention to dissemination and implementation issues are called for. Funding and registration: conducted on assignment by the Swedish government. The protocol is available at the SBU website in Swedish