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Suicide prevention

Interventions to prevent suicide - Higher education

Read Overview

Higher education includes colleges and universities. It used to be thought that suicide rates among college students, at least in the United States, were high. However, careful study showed that the rate was generally lower than that in the general population matched for age, but that there was wide variation between colleges, so that any conclusions may not be generalisable to the sector as a whole.

We found 34 systematic reviews and seven RCTs. Of these, only one systematic review included material relevant to the higher education setting. 1



In this section:

Key Messages

  • It used to be thought that suicide rates among college students, at least in the United States, were high
  • Careful study shows that the rate was lower than that in the general population matched for age, but the wide variation between colleges means the conclusions may not be able to be generalised to the sector as a whole 1
  • Increasing access to higher education for students with previous mental health problems may be altering the observed rates 1
  • If suicides among students who have dropped out of higher education are included, the picture may be very different 1
  • Institutes of higher education (at least in the United States) may be reluctant to identify suicidal students for fear of liability should the student subsequently take their own life 1
  • There is no unequivocal evidence for the effectiveness of interventions based in higher education. 1

Population Interventions

Population interventions that work

We have not found any randomised controlled trials of interventions based in higher education that demonstrate a significant reduction in completed suicides. However, this may be because suicide itself is a fairly rare event, and very large-scale studies would be needed to demonstrate the effectiveness of an intervention that did actually work.

Population interventions that may work

Online screening for suicide risk

One study examined the use of online screening questionnaires and categorised students into three risk groups, and invited those in the two highest risk groups to attend face-to-face clinical evaluation and discussion. Feedback from students in focus groups has been positive about the project’s intent and provided suggestions for improving wording and streamlining some procedures. The project also appeared to increase awareness of depression, suicide and related problems, and decreased stigma by bringing mental health issues into the open.

There is as yet no evidence as to the impact on suicide rate, and given the low base rate, large numbers would be needed to demonstrate whether or not such screening is effective; evaluation will focus on suicide attempts rather than completed suicides. 1

Population interventions that do not work

We have not identified any evidence of interventions proven to be ineffective or harmful.

What we don't know

We do not have any firm evidence as to the rate of suicide among students in higher education. This rate compared with that in the general population of similar age and sex may alter as the proportion of people accessing higher education, including those with pre-existing special needs, changes in line with government policy.

There is no comprehensive system in the UK for identifying student suicides, and exhaustive discussions with the higher education sector show there is little scope for capturing this data. An expert seminar concluded that the greatest potential lay in enhancing the information collected by coroners. 2

We do not know of any interventions in higher education that definitely work, though a recent study of twenty student suicides highlights suggestions for positive practice. 2

Even if online screening is able successfully to identify students at high risk, the outcome will be dependent upon engaging them in effective interventions thereafter, and there is much that we don’t yet know about how to do this.

References

  1. Haas AP, Hendin H, Mann JJ. Suicide in College Students. Am Behav Sci 2003;46:1224-1240. External Link
  2. Stanley N, Mallon S, Bell J, Hilton S, Manthorpe J. Responses and prevention in student suicide. Department of Social Work, University of Central Lancashire;2007. External Link accessed April 15 2007
  3. van der Sande R, Buskens E, Allart E, van der Graaf Y, van Engeland H. Psychosocial intervention following suicide attempt: a systematic review of treatment interventions. Acta Psychiatr Scand 1997;96:43-50. External Link
  4. National Institute for Mental Health in England (NIMHE). National Suicide Prevention Strategy for England Annual Report on Progress 2006. NIMHE. Department of Health; 2007. . External Link

Contributors

Dr Jenny Bywaters

Suicide Prevention

Dr Jenny Bywaters is Senior Public Mental Health Advisor for the National Institute for Mental Health in England (NIMHE) where she directs the national programmes for suicide prevention and mental health promotion/public mental health. She has been seconded to North East Public Health Observatory (NEPHO) two days a week since April 2005 as part of the Public Mental Health Observatory team. She previously worked in the mental health policy branch at the Department of Health, and before that as Senior Commissioning Manager for Mental Health and Learning Disability Services at Birmingham Health Authority. She chairs the joint Faculty of Public Health/NIMHE Working Group on Mental Health.