Evaluation of indicated suicide risk prevention approaches for potential high school dropouts

Objectives. This study evaluated the efficacy of 2 indicated preventive int erventions. postintervention and at 9-month follow-up. Methods. Drawn from a pool of potential high school dropouts, 460 youths we re identified as being at risk for suicide and participated in 1 of 3 condi tions randomly assigned by school: (1) Counselors CARE (C-CARE) (n = 150), a brief one-to-one assessment and crisis intervention; (2) Coping and Suppo rt Training (CAST) (n = 155), a small-group skills-building and social supp ort intervention delivered with C-CARE, and (3) usual-care control (n = 155 ). Survey instruments were administered preintervention, following C-CARE ( 4 weeks), following CAST (10 weeks), and at a 9-month follow-up. Results. Growth curve analyses showed significant rates of decline in attit ude toward suicide and suicidal ideation associated with the experimental i nterventions. C-CARE and CAST compared with usual care, also were effective in reducing depression and hopelessness. Among females, reductions in anxi ety and anger were greater in response to the experimental programs. CAST w as most effective in enhancing and sustaining personal control and problem- solving coping for males and females. Conclusions. School-based. indicated prevention approaches are feasible and effective for reducing suicidal behaviors and related emotional distress a nd for enhancing protective factors.