Suicidal is one of the leading causes of young death, and most students who died by suicide on university campuses are not clients of student mental health services, highlighting the need for targeted on-campus suicide prevention programs. Three approaches to suicide intervention have been outlined: universal, selected, and indicated. Universal interventions focus on improving general awareness of suicide risk factors and available resources, selected interventions identified groups via by screening programs, health professionals, and peers, while indicated interventions are used for individuals at extremely high risk of suicidal behaviour. The World Health Organization recommends holistic approach involving a combination of all three to increase overall outreach and provide individualized supports (Breet et al., 2021).
Breet et al. used narrative synthesis to analyze and understand the types and outcomes of previously studied suicide prevention strategies. Interventions were classed as universal, selective, or indicated, based on the purpose of the intervention and the target population. Universal programs generally used psychoeducation to increase knowledge about suicide. Selected interventions involved “gatekeeper training”, a program educating students and teachers suicide crises response, and how to refer suicidal individuals to appropriate healthcare. Indicated interventions used psychotherapy approaches to decrease suicidal behaviour, and the most successful used evidence-based practices like cognitive and dialectical behavioural therapies.
Gatekeeper training was the most used common approach, though results were conflicting as to whether this training improved rates of crisis intervention. A shortcoming of the gatekeeper program is its requirement for an accessible mental health framework. In lower income or rural areas, the “identify and refer” model of gatekeeper training may not be applicable, as there are no more intensive mental health services available. Breet et al. also noted that no studies reported rates completed suicides following intervention, representing a need to re-examine the long term outcomes of all interventions.
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