Wei Yifeng, Kutcher Stan, LeBlanc John C
IWK Health Centre, Halifax, Nova Scotia.
Department of Psychiatry and Sun Life Financial Chair in Adolescent Mental Health, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia.
J Can Acad Child Adolesc Psychiatry. 2015 Winter;24(1):5-16. Epub 2015 Mar 4.
Youth suicide is highly related to mental disorders. While communities and schools are marketed to with a plethora of suicide prevention programs, they often lack the capacity to choose evidence-based programs.
We conducted a systematic review of two youth suicide prevention programs to help determine if the quality of evidence available justifies their wide spread dissemination. We searched Medline, PsycINFO, EMBASE, CINAHL, the Cochrane Library, Campbell Collaboration SPECTR database, SocIndex, Sociological Abstracts, Social Services Abstracts, ERIC, Social Work Abstracts, Research Library, and Web of Science, for relevant studies. We included studies/systematic reviews/meta-analysis that evaluated the effectiveness, cost-effectiveness, and/or safety of Signs of Suicide (SOS) and Yellow Ribbon (YR) suicide prevention programs that target adolescents. We applied the Office of Justice Program What Works Repository (OJP-R) to evaluate the quality of the included studies as effective, effective with reservation, promising, inconclusive evidence, insufficient evidence, and ineffective. Two SOS studies were ranked as "inconclusive evidence" based on the OJP-R. One SOS study was ranked as having "insufficient evidence" on OJP-R. The YR study was ranked as "ineffective" using OJP-R. We only included studies in peer-reviewed journals in English and therefore may have missed reports in grey literature or non-English publications.
We cannot recommend that schools and communities implement either the SOS or YR suicide prevention programs. Purchasers of these programs should be aware that there is no evidence that their use prevents suicide.
Academics and organizations should not overstate the positive impacts of suicide prevention interventions when the evidence is lacking.
青少年自杀与精神障碍高度相关。尽管社区和学校被大量的自杀预防项目所营销,但它们往往缺乏选择基于证据的项目的能力。
我们对两个青少年自杀预防项目进行了系统评价,以帮助确定现有证据的质量是否足以证明它们广泛传播的合理性。我们检索了Medline、PsycINFO、EMBASE、CINAHL、Cochrane图书馆、坎贝尔协作SPECTR数据库、SocIndex、社会学文摘、社会服务文摘、教育资源信息中心、社会工作文摘、研究图书馆和科学引文索引,查找相关研究。我们纳入了评估针对青少年的自杀迹象(SOS)和黄丝带(YR)自杀预防项目的有效性、成本效益和/或安全性的研究/系统评价/荟萃分析。我们应用司法项目办公室有效实践知识库(OJP-R)将纳入研究的质量评估为有效、有保留的有效、有前景、证据不确凿、证据不足和无效。根据OJP-R,两项SOS研究被评为“证据不确凿”。一项SOS研究在OJP-R上被评为“证据不足”。YR研究使用OJP-R被评为“无效”。我们只纳入了英文同行评审期刊上的研究,因此可能遗漏了灰色文献或非英文出版物中的报告。
我们不能建议学校和社区实施SOS或YR自杀预防项目。这些项目的购买者应该意识到,没有证据表明使用它们能预防自杀。
在缺乏证据的情况下,学者和组织不应夸大自杀预防干预措施的积极影响。