Below you’ll find a wide variety of resources about preventing youth suicide. This document is accompanied by a public Google Drive folder that you can add to your own Drive to save these resources for future use. I have added to the folder any resources on this list that are publically available.

This document is searchable by hitting CONTROL + F on Windows and COMMAND + F on macOS. The Google Drive folder is also searchable.

This list is maintained by Erik Reinbergs, a PhD candidate in school psychology at the University of Massachusetts Amherst. This list is not a substitute for medical advice or consultation with a trained clinician. The information in this list is not a substitute for clinical training and supervision. This list is in no way comprehensive.

If you have any comments, questions, concerns, or additional resources to add, please use this form or contact me on twitter @ereinbergs. Please let me know if any links are broken. Individual studies are not added to the list due to the sheer number of important journal articles in this area. A handful of research summaries published in peer reviewed journals are included.  

This list is also accompanied by a Zotero folder of citations related to youth suicide begun by Jonathan Singer, PhD LCSW.

If you or a loved one needs support, please reach out to one of the resources below:

Quick Links to Sections

Reports, Policy Documents, & Toolkits

After a Suicide: A Toolkit for Schools - SPRC

“This toolkit reflects consensus recommendations developed in consultation with national experts, including school-based administrators and staff, clinicians, researchers, and crisis response professionals. It provides guidance and tools for postvention, a term used to describe activities that help people cope with the emotional distress resulting from a suicide and prevent additional trauma that could lead to further suicidal behavior and deaths, especially among people who are vulnerable. This resource was developed primarily for administrators and staff in middle and high schools, but it can also be useful for parents and communities.”

A Prioritized Research Agenda for Suicide Prevention - National Action Alliance

“Overall, U.S. rates of suicide deaths have not decreased appreciably in 50 years. In 2010 (the most recent data available at the time of this publication), there were more than 650,000 hospital visits related to suicide attempts, and more than 38,000 individuals died by suicide. The RPTF developed its agenda for research with the stated goal to reduce morbidity (attempts) and mortality (deaths), each by at least 20% in five years and 40% or greater in 10 years, if implemented fully and successfully. This approach is consistent with the Action Alliance goal to save 20,000 lives in five years. Asking Action Alliance members, and the RPTF stakeholders in suicide research, to consider these aspirational targets in their efforts has never been tried at a national level before. While such reductions in a relatively short amount of time may not be fully met, the intent of these targets is to inspire new ways of thinking of how the many suicide prevention efforts can all be a part of the solution. A research document alone cannot reduce suicide deaths or attempts; rather, its intent is to identify the research needed to guide practice and inform policy decisions across many areas—for example, health care, criminal justice, education, and social media-- which will cumulatively contribute to the 20% and 40% reduction goals.”

Confronting the Inevitability Myth: How Data-Driven Gun Policies Save Lives from Suicide - Giffords Law Center to Prevent Gun Violence

“Confronting the Inevitability Myth represents the culmination of a yearlong project by the attorneys at the Law Center to Prevent Gun Violence to study and analyze suicide in America. We took a hard look at the numbers and the harrowing stories behind them, and identified the smart gun laws and intervention programs that are most effective at saving lives from suicide.”

Guide to Developing and Revising Suicide Prevention Protocols for Youth in Contact with the Juvenile Justice System - Action Alliance

“The task force’s Suicide Prevention Programming and Training Workgroup was charged with developing a guide for implementing accepted suicide prevention guidelines at each point of contact. To do so, the group turned to Suicide Prevention in Juvenile Correction and Detention Facilities (Hayes, 1999), which was produced by the Council of Juvenile Correctional Administrators (CJCA) with support from the Office of Juvenile Justice and Delinquency Prevention. This report addresses performance-based standards for juvenile correction and detention facilities and describes a comprehensive suicide prevention program for juvenile facilities that involves the following components: • Training • Identification; Referral; Evaluation • Communication • Housing (Safe Environment) • Levels of Observation; Follow-Up; Treatment Planning • Intervention (Emergency Response) • Reporting and Notification • Mortality-Morbidity Review”

Model School District Policy on Suicide Prevention - Trevor Project, NASP, ASCA, AFSP

“This document outlines model policies and best practices for school districts to follow to protect the health and safety of all students. As suicide is the third leading cause of death among young people ages 10-19, it is critically important that school districts have policies and procedures in place to prevent, assess the risk of, intervene in, and respond to youth suicidal behavior.”

Montana’s CAST-S: Crisis Action School Toolkit on Suicide

“The goal in the creation of CAST-S was to support each school district and their communities to have access to much needed resources in developing their own protocols and crisis plan for preventing and addressing youth suicides.  The CAST-S is a free resource for all Montana school leaders and staff.  The Risk Monitoring Tool in the CAST-S is from the book, Suicide in Schools, by Erbacher, Singer and Poland which is an excellent resource for schools.  Mental health and suicide prevention leaders from across Montana have been interviewed and have provided input in this suicide prevention toolkit, which is based on best practices in suicide prevention for schools.”

National Strategy for Suicide Prevention (2012) - US Surgeon General, NAAS

“The 2012 National Strategy for Suicide Prevention (the National Strategy) is the result of a joint effort by the Office of the U.S. Surgeon General and the National Action Alliance for Suicide Prevention (Action Alliance). The National Strategy is a call to action that is intended to guide suicide prevention actions in the United States over the next decade. It outlines four strategic directions with 13 goals and 60 objectives that are meant to work together in a synergistic way to prevent suicide in the nation.”

Preventing Juvenile Suicide through Improved Collaboration: Strategies for Mental Health and Juvenile Justice Agencies - Action Alliance

“This report, developed by the Youth in Contact with the Juvenile Justice System Task Force ( of the National Action Alliance for Suicide Prevention (Action Alliance) (http://www.actionallianceforsuicideprevention.

org), provides recommendations for achieving such collaboration. The task force’s Mental Health and Juvenile Justice Systems Collaboration Workgroup was charged with identifying priorities and strategies to help these agencies improve collaboration, ultimately resulting in more effective suicide prevention programming. The workgroup compiled recommendations, tailored for suicide prevention supports and services for youth involved in the juvenile justice system, in two categories: • Overarching Priorities: The workgroup recommends that state and local mental health and juvenile justice agencies pursue ten overarching collaborative priorities to inform joint policy and budgeting decisions associated with suicide prevention for youth involved in juvenile justice. 2 • Strategies: A set of twelve strategies was developed to facilitate achievement of the overarching priorities. Specific strategies that apply to each overarching priority are listed by number after the discussion of the respective overarching priority. As a visual organizer, a matrix graphically represents the alignment of the strategies and priorities.”

Preventing Suicide: A Global Imperative - WHO

“This report builds on previous work and contributes two key elements to moving forward: a global knowledge base on suicide and suicide attempts to guide governments, policy-makers and relevant stakeholders, and actionable steps for countries based on their current resources and contexts. In addition, it represents a significant resource for developing a comprehensive multisectoral strategy that can prevent suicide effectively.”;jsessionid=6BDDA57CAC513989A220E08DC8AA7017?sequence=1

Preventing Suicide: A Technical Package of Policy, Programs, & Practices - CDC

“This technical package represents a select group of strategies based on the best available evidence to help communities and states sharpen their focus on prevention activities with the greatest potential to prevent suicide. These strategies include: strengthening economic supports; strengthening access and delivery of suicide care; creating protective environments; promoting connectedness; teaching coping and problem-solving skills; identifying and supporting people at risk; and lessening harms and preventing future risk. The strategies represented in this package include those with a focus on preventing the risk of suicide in the first place as well as approaches to lessen the immediate and long-term harms of suicidal behavior for individuals, families, communities, and society. The strategies in the technical package support the goals and objectives of the National Strategy for Suicide Prevention and the National Action Alliance for Suicide Prevention’s priority to strengthen community-based prevention. Commitment, cooperation, and leadership from numerous sectors, including public health, education, justice, health care, social services, business, labor, and government can bring about the successful implementation of this package.”

Preventing Suicide: A Toolkit for High Schools - SAMHSA 2012

“Preventing Suicide: A Toolkit for High Schools was funded by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) to help high schools, school districts, and their partners design and implement strategies to prevent suicide and promote behavioral health among their students. The information and tools in this toolkit will help schools and their partners: Assess their ability to prevent suicide among students and respond to suicides that may occur; Understand strategies that can help students who are at risk for suicide
Understand how to respond to the suicide of a student or other member of the school community; Identify suicide prevention programs and activities that are effective for individual schools and respond to the needs and cultures of each school’s students; Integrate suicide prevention into activities that fulfill other aspects of the school’s mission, such as preventing the abuse of alcohol and other drugs”

Screening and Assessment for Suicide Prevention: Tools and Procedures for Risk Identification among Juvenile Justice Youth - Action Alliance

“Identifying suicide risk among young people is a critical component of the comprehensive approach that the juvenile justice system must adopt to prevent suicide. Ideally, this identification is done with research-based screening and assessment instruments. To select effective instruments, it is necessary to be aware of the juvenile justice system’s responsibilities in preventing suicide, the contexts in which screening and assessment instruments are used, current standards for screening instruments and assessment tools used in mental health and juvenile justice settings, and specific instruments that are available to advance suicide prevention efforts. These facets of suicide prevention are explored in this paper, which was developed by the Youth in Contact with the Juvenile Justice System Task Force ( task-force/juvenilejustice) of the National Action Alliance for Suicide Prevention (Action Alliance) ( The paper was prepared by members of the task force’s Suicide Research Workgroup, which was charged with identifying gaps in literature and in research on suicide and its prevention among juvenile justice-involved youth.”

Self-Directed Violence Surveillance: Uniform Definitions & Uniform Data Structures - CDC

“Self-directed violence (SDV) is an important cause of mortality and morbidity in the United States and worldwide. Though numerous organizations collect information on fatal and non-fatal SDV, there is considerable confusion about how to define the phenomenon. To address the current lack of uniform definitions, the Centers for Disease Control and Prevention (CDC) proposes the following surveillance* definitions for SDV. Use of consistent terminology with standardized definitions will improve communication among researchers, clinicians, and others working in this important area.”

Youth Suicide Prevention Referral & Tracking Toolkit - Maine Youth Suicide Prevention Program

“This toolkit has been created to help school personnel involved in school-based suicide prevention and intervention to (1) track youth identified and referred for risk of suicide and (2) use that information to inform and evaluate suicide prevention practice. It is based on the lessons learned from the Maine Youth Suicide Prevention Program’s (MYSPP) implementation of a comprehensive approach to suicide prevention.”


Adolescent Suicide: Assessment and Intervention - Berman, Jobes, Silverman - 2006

“For the past decade, Adolescent Suicide: Assessment and Intervention has been recognized as the best and most authoritative text on this most tragic of subjects. This long-awaited second edition incorporates almost 15 years of new research and critical thinking about clinical assessment and intervention in addition to an expanded focus on prevention. Authored by three of the world’s leading experts on suicide, including among them a psychiatrist, this book is a must-have reference and text for those working with this at-risk population. This volume reflects on what is current and promising in working with the suicidal adolescent and provides information relevant to theory, research, practice, and intervention. It provides empirically based findings that can be easily integrated and translated for practical use by the clinician. In addition, the book includes discussion of malpractice risk management, over 40 case illustrations, and an extensive list of references—all of which help provide a thorough understanding of the at-risk-for-suicide patient.”

Dialectical Behavior Therapy with Suicidal Adolescents - Miller, Rathus, Linehan - 2007

“Filling a tremendous need, this highly practical book adapts the proven techniques of dialectical behavior therapy (DBT) to treatment of multiproblem adolescents at highest risk for suicidal behavior and self-injury. The authors are master clinicians who take the reader step by step through understanding and assessing severe emotional dysregulation in teens and implementing individual, family, and group-based interventions. Insightful guidance on everything from orientation to termination is enlivened by case illustrations and sample dialogues. Appendices feature 30 mindfulness exercises as well as lecture notes and 12 reproducible handouts for "Walking the Middle Path," a DBT skills training module for adolescents and their families. Purchasers get access to a Web page where they can download and print these handouts and several other tools from the book in a convenient 8½" x 11" size.”

Guns and Suicide: An American Epidemic - Anestis 2018

“In Guns and Suicide, Michael Anestis reframes our perspective on gun violence by shifting the focus to suicide. Guns play a uniquely profound role in American suicide, and Anestis explains how they have this effect-not by making otherwise non-suicidal people want to die, but by facilitating suicide attempts among suicidal individuals. He reviews the evidence - in suicide and other public health concerns - that focusing on specific means for contracting an unwanted outcome (e.g., HIV) can successfully reduce the frequency of that outcome. With suicide, this could mean the passage of legislation related to firearm ownership and storage, non-legislative encouragement of safe storage of private firearms, voluntary and temporary removal of firearms from the home during times of distress, or a combination of these factors. Importantly, this is not a book about gun control. Anestis does not argue in favor of tighter restrictions on ownership, assault weapon bans, or longer waiting periods for purchase because these will not substantially reduce the staggering gun suicide rate. Rather, Anestis aims for a cultural shift towards suicide-specific safe gun ownership and puts forth unemotional suggestions in hopes of leveraging common ground in the pursuit of a lower suicide rate.”

International Handbook of Suicide Prevention - O’Conner & Pirkis - 2016

“The International Handbook of Suicide Prevention, 2nd Edition, presents a series of readings that consider the individual and societal factors that lead to suicide, it addresses ways these factors may be mitigated, and presents the most up-to-date evidence for effective suicide prevention approaches. An updated reference that shows why effective suicide prevention can only be achieved by understanding the many reasons why people choose to end their lives.

Gathers together contributions from more than 100 of the world’s leading authorities on suicidal behavior—many of them new to this edition; Considers suicide from epidemiological, psychological, clinical, sociological, and neurobiological perspectives, providing a holistic understanding of the subject; Describes the most up-to-date, evidence-based research and practice from across the globe, and explores its implications across countries, cultures, and the lifespan.”

Suicide in Schools: A Practitioner's Guide to Multi-level Prevention, Assessment, Intervention, and Postvention - Erbacher, Singer, Poland - 2014

“Suicide in Schools provides school-based professionals with practical, easy-to-use guidance on developing and implementing effective suicide prevention, assessment, intervention and postvention strategies. The authors include detailed case examples, innovative approaches for professional practice, usable handouts, and internet resources on the best practice approaches to effectively work with youth who are experiencing a suicidal crisis as well as those students, families, school staff, and community members who have suffered the loss of a loved one to suicide.”

The Oxford Handbook of Suicide and Self-Injury - Nock - 2014

“The Oxford Handbook of Suicide and Self-Injury provides a comprehensive summary of the most important and exciting advances in our understanding of suicide and self-injury and our ability to predict and prevent it. Comprised of a formidable who's who in the field, this volume covers the full spectrum of topics in suicide and self-injury across the lifespan, including the classification of different self-injurious behaviors, epidemiology, assessment techniques, and intervention. Chapters probe relevant issues in our society surrounding suicide, including assisted suicide and euthanasia, suicide terrorism, overlap between suicidal behavior and interpersonal violence, ethical considerations for suicide researchers, and current knowledge on survivors of suicide. The most comprehensive handbook on suicide and self-injury to date, this volume is a must-read for anyone interested in the most current thinking and research on these devastating behaviors.”

Why People Die by Suicide - Joiner - 2007

“In the wake of a suicide, the most troubling questions are invariably the most difficult to answer: How could we have known? What could we have done? And always, unremittingly: Why? Written by a clinical psychologist whose own life has been touched by suicide, this book offers the clearest account ever given of why some people choose to die. Drawing on extensive clinical and epidemiological evidence, as well as personal experience, Thomas Joiner brings a comprehensive understanding to seemingly incomprehensible behavior. Among the many people who have considered, attempted, or died by suicide, he finds three factors that mark those most at risk of death: the feeling of being a burden on loved ones; the sense of isolation; and, chillingly, the learned ability to hurt oneself. Joiner tests his theory against diverse facts taken from clinical anecdotes, history, literature, popular culture, anthropology, epidemiology, genetics, and neurobiology--facts about suicide rates among men and women; white and African-American men; anorexics, athletes, prostitutes, and physicians; members of cults, sports fans, and citizens of nations in crisis. The result is the most coherent and persuasive explanation ever given of why and how people overcome life's strongest instinct, self-preservation. Joiner's is a work that makes sense of the bewildering array of statistics and stories surrounding suicidal behavior; at the same time, it offers insight, guidance, and essential information to clinicians, scientists, and health practitioners, and to anyone whose life has been affected by suicide.”

Research Reviews & Summaries

Annual Research Review: Suicide among youth – epidemiology, (potential) etiology, and treatment - Cha, Franz, Guzman, Glenn, Kleiman, & Nock - 2018 (OPEN ACCESS)

“Background: Suicide is a leading cause of death and a complex clinical outcome. Here, we summarize the current state of research pertaining to suicidal thoughts and behaviors in youth. We review their definitions/measurement and phenomenology, epidemiology, potential etiological mechanisms, and psychological treatment and prevention efforts. Results: We identify key patterns and gaps in knowledge that should guide future work. Regarding epidemiology, the prevalence of suicidal thoughts and behaviors among youth varies across countries and sociodemographic populations. Despite this, studies are rarely conducted cross-nationally and do not uniformly account for high-risk populations. Regarding etiology, the majority of risk factors have been identified within the realm of environmental and psychological factors (notably negative affect-related processes), and most frequently using self-report measures. Little research has spanned across additional units of analyses including behavior, physiology, molecules, cells, and genes. Finally, there has been growing evidence in support of select psychotherapeutic treatment and prevention strategies, and preliminary evidence for technology-based interventions. Conclusions: There is much work to be done to better understand suicidal thoughts and behaviors among youth. We strongly encourage future research to: (1) continue improving the conceptualization and operationalization of suicidal thoughts and behaviors; (2) improve etiological understanding by focusing on individual (preferably malleable) mechanisms; (3) improve etiological understanding also by integrating findings across multiple units of analyses and developing short-term prediction models; (4) demonstrate greater developmental sensitivity overall; and (5) account for diverse high-risk populations via sampling and reporting of sample characteristics. These serve as initial steps to improve the scientific approach, knowledge base, and ultimately prevention of suicidal thoughts and behaviors among youth. Keywords: Suicide; risk factors; correlates; treatment; prevention.”

Assessment and Management of Suicide Risk in Children and Adolescents - Pettit & Boitron - 2018

“This article presents a pragmatic approach to assessing and managing suicide risk in children and adolescents. We first present general recommendations for conducting risk assessments with children and adolescents, followed by an algorithm for designating risk. Risk assessment and designation should be based on both distal (i.e., a prior history of self-harm behaviors) and proximal (i.e., suicide ideation, plans, intent, and preparations) predictors of suicide attempt. We then discuss safety planning as an easy-to-implement approach for intervening and managing suicide risk when working with children and adolescents. We end with a case example illustrating the implementation of risk assessment, risk designation, and safety planning with an adolescent client and her mother.”

A systematic review of psychosocial suicide prevention interventions for youth - Calear et. al. - 2016

“Youth suicide is a significant public health problem. A systematic review was conducted to examine the effectiveness of school, community and healthcare-based interventions in reducing and preventing suicidal ideation, suicide attempts and deliberate self-harm in young people aged 12–25 years. PsycInfo, PubMed and Cochrane databases were searched to the end of December 2014 to identify randomised controlled trials evaluating the effectiveness of psychosocial interventions for youth suicide. In total, 13,747 abstracts were identified and screened for inclusion in a larger database. Of these, 29 papers describing 28 trials fulfilled the inclusion criteria for the current review. The results of the review indicated that just over half of the programs identified had a significant effect on suicidal ideation (Cohen’s d = 0.16–3.01), suicide attempts (phi = 0.04–0.38) or deliberate self-harm (phi = 0.29–0.33; d = 0.42). The current review provides preliminary support for the implementation of universal and targeted interventions in all settings, using a diverse range of psychosocial approaches. Further quality research is needed to strengthen the evidence-base for suicide prevention programs in this population. In particular, the development of universal school-based interventions is promising given the potential reach of such an approach.”

School-Based Suicide Prevention: A Framework for Evidence-Based Practice - Singer, Erbacher, Rosen - 2018

Suicide is the second leading cause of death among youth aged 10–25 years, and approximately one in six adolescents reported serious suicidal ideation in the past year (Centers for Disease Control and Prevention [CDC] in Web-based Injury Statistics Query and Reporting System (WISQARS)., 2017). Schools are a unique environment in which to identify and respond to youth suicide risk, yet the research base for school-based suicide prevention programs is limited due to challenges with implementation and evaluation. The purpose of this article is to review best practice approaches and existing empirical support for school-based suicide prevention and to present a framework for how these efforts can be embedded within multi-tiered systems of support (MTSS). In line with the Substance Abuse and Mental Health Services Administration [SAMHSA] (Preventing suicide: a toolkit for high schools., 2012) framework for suicide prevention in schools, the article overviews existing programs for student education, staff training, and screening, noting where these programs may be situated across tiers of intervention. This is followed by a review of school-related outcomes of existing suicide prevention programs, which highlights the limitations of existing research. Because there are only two school-based prevention programs with evidence for reducing suicide risk in students, the authors encourage school staff to implement best practice recommendations in collaboration with school mental health professionals who can provide ongoing evaluation of program effectiveness, as well as with researchers who are able to design and conduct outcome studies addressing the limitations of current research. Findings also underscore the need for greater integration of suicide prevention programming with existing school initiatives such as MTSS, which aligns with a growing focus in the field of suicide prevention on “upstream approaches.”

Suicidal Ideation and Behavior Among Youth in the Juvenile Justice System: A Review of the Literature - Action Alliance

Despite significant concern over suicidal ideation and behavior among youth involved with the juvenile justice system, no systematic review of the literature on suicidal ideation and behavior among this population exists. In response, this paper was developed by the Youth in Contact with the Juvenile Justice System Task Force (

task-force/juvenilejustice) of the National Action Alliance for Suicide Prevention (Action Alliance) ( to: a) provide a comprehensive review of the available research, b) assess what we know and identify existing gaps, and c) offer a series of recommendations for future research. This review explores the prevalence of recent and past suicidal ideation and suicide attempts among justice-involved youth; gender and ethnic differences; and variables associated with suicidal ideation and attempt.”

Suicide Prevention Media Campaigns: A Systematic Literature Review - Pirkis, Rossetto, Nicholas, Ftanou, Robinson & Reavley - 2017

“Suicide prevention media campaigns are gaining traction as a means of combating suicide. The current review set out to synthesize information about the effectiveness of these campaigns. We searched four electronic databases for studies that provided evidence on the effectiveness of media campaigns. We focused on studies that described an evaluation of the effectiveness of an entire campaign or a public service announcement explicitly aimed at suicide prevention. We identified 20 studies of varying quality. Studies that looked at whether campaign exposure leads to improved knowledge and awareness of suicide found support for this. Most studies that considered whether campaign materials can achieve improvements in attitudes toward suicide also found this to be the case, although there were some exceptions. Some studies found that media campaigns could boost help-seeking, whereas others suggested that they made no difference or only had an impact when particular sources of help or particular types of help-seeking were considered. Relatively few studies had sufficient statistical power to examine whether media campaigns had an impact on the ultimate behavioral outcome of suicides, but those that did demonstrated significant reductions. Our review indicates that media campaigns should be considered in the suite of interventions that might be used to prevent suicide. Evidence for their effectiveness is still amassing, but there are strong suggestions that they can achieve positive results in terms of certain suicide-related outcomes. Care should be taken to ensure that campaign developers get the messaging of campaigns right, and further work is needed to determine which messages work and which ones do not, and how effective messages should be disseminated. There is an onus on those developing and delivering campaigns to evaluate them carefully and to share the findings with others. There is a need for evaluations that employ rigorous designs assessing the most pertinent outcomes. These evaluations should explore the nature of given campaigns in detail – in particular the messaging contained within them – in order to tease out which messages work well and which do not. They should also take into account the reach of the campaign, in order to determine whether it would be reasonable to expect that they might have their desired effect.”

Suicide prevention strategies revisited: 10-year systematic review - Zalsman et al - 2016

Background Many countries are developing suicide prevention strategies for which up-to-date, high-quality evidence is required. We present updated evidence for the effectiveness of suicide prevention interventions since 2005. Methods We searched PubMed and the Cochrane Library using multiple terms related to suicide prevention for studies published between Jan 1, 2005, and Dec 31, 2014. We assessed seven interventions: public and physician education, media strategies, screening, restricting access to suicide means, treatments, and internet or hotline support. Data were extracted on primary outcomes of interest, namely suicidal behaviour (suicide, attempt, or ideation), and intermediate or secondary outcomes (treatment-seeking, identification of at-risk individuals, antidepressant prescription or use rates, or referrals). 18 suicide prevention experts from 13 European countries reviewed all articles and rated the strength of evidence using the Oxford criteria. Because the heterogeneity of populations and methodology did not permit formal meta-analysis, we present a narrative analysis.

Findings We identified 1797 studies, including 23 systematic reviews, 12 meta-analyses, 40 randomised controlled trials (RCTs), 67 cohort trials, and 22 ecological or population-based investigations. Evidence for restricting access to lethal means in prevention of suicide has strengthened since 2005, especially with regard to control of analgesics (overall decrease of 43% since 2005) and hot-spots for suicide by jumping (reduction of 86% since 2005, 79% to 91%). School- based awareness programmes have been shown to reduce suicide attempts (odds ratio [OR] 0·45, 95% CI 0·24–0·85; p=0·014) and suicidal ideation (0·5, 0·27–0·92; p=0·025). The anti-suicidal effects of clozapine and lithium have been substantiated, but might be less specific than previously thought. Effective pharmacological and psychological treatments of depression are important in prevention. Insufficient evidence exists to assess the possible benefits for suicide prevention of screening in primary care, in general public education and media guidelines. Other approaches that need further investigation include gatekeeper training, education of physicians, and internet and helpline support. The paucity of RCTs is a major limitation in the evaluation of preventive interventions. Interpretation In the quest for effective suicide prevention initiatives, no single strategy clearly stands above the others. Combinations of evidence-based strategies at the individual level and the population level should be assessed with robust research designs.”

Data Sources

Web-based Injury Statistics Query and Reporting System WISQARS - CDC

“CDC’s WISQARS™ (Web-based Injury Statistics Query and Reporting System) is an interactive, online database that provides fatal and nonfatal injury, violent death, and cost of injury data from a variety of trusted sources. Researchers, the media, public health professionals, and the public can use WISQARS™ data to learn more about the public health and economic burden associated with unintentional and violence-related injury in the United States.”

Youth Risk Behavior Surveillance System - CDC

The Youth Risk Behavior Surveillance System (YRBSS) monitors six types of health-risk behaviors that contribute to the leading causes of death and disability among youth and adults, including • Behaviors that contribute to unintentional injuries and violence • Sexual behaviors related to unintended pregnancy and sexually transmitted diseases, including HIV infection • Alcohol and other drug use • Tobacco use • Unhealthy dietary behaviors • Inadequate physical activity. YRBSS also measures the prevalence of obesity and asthma and other priority health-related behaviors plus sexual identity and sex of sexual contacts. YRBSS includes a national school-based survey conducted by CDC and state, territorial, tribal, and local surveys conducted by state, territorial, and local education and health agencies and tribal governments.

Free Clinical Tools & Trainings

Ask Suicide-Screening Questions (ASQ) Toolkit - NIMH

“The Ask Suicide-Screening Questions (ASQ) Toolkit is a free resource for medical settings (emergency department, inpatient medical/surgical units, outpatient clinics/primary care) that can help nurses or physicians successfully identify youth at risk for suicide. The ASQ is a set of four screening questions that takes 20 seconds to administer. In an NIMH study, a “yes” response to one or more of the four questions identified 97% of youth (aged 10 to 21 years) at risk for suicide. By enabling early identification and assessment of young patients at high risk for suicide, the ASQ toolkit can play a key role in suicide prevention.”

Assessment Instruments - University of Washington, Center for Behavioral Technology, Behavior Research and Therapy Clinics

This website has links to free PDFs of lots of assessment tools: .

Columbia-Suicide Severity Rating Scale (C-SSRS)

The C-SSRS, based on more than 20 years of scientific study, filled an urgent need for suicide research and prevention: a better way to uniformly and reliably identify people who are at risk. The C-SSRS achieved accurate and comparable results by using consistent, well-defined, and science-based terminology. Just as important as its ability to identify who might attempt suicide, it was the first scale to assess the full range of a person’s suicidal ideation and behavior, including intensity, frequency, and changes over time. In 2011, the Centers for Disease Control and Prevention adopted the scale’s definitions for suicidal behavior and recommended the use of the C-SSRS for data collection. In 2012, the Food and Drug Administration declared the C-SSRS the standard for measuring suicidal ideation and behavior in clinical trials. Today, the C-SSRS is used in clinical trials, public settings, and everyday situations, such as in schools, faith communities, hospitals, and the military, to identify who needs help — saving lives in 45 nations on six continents.

Counseling on Access to Lethal Means - CALM New Hampshire

“This course explains why means restriction is an important part of a comprehensive approach to suicide prevention. It will teach you how to ask suicidal patients/clients about their access to lethal means, and work with them and their families to reduce their access.”

Educational Videos of Suicide Screening - NIMH

Lethal Means Counseling - Means Matter Harvard

“If you’re concerned that a patient or client is suicidal, in addition to using your standard clinical strategies to assess and manage suicidal risk, talk with them and their family members about whether there are firearms and other lethal means at home.”

Patient Health Questionnaire Screeners

Short depression screener that includes questions of suicidal ideation. (Adolescent) (General)

Resources & Programs Search - SPRC

Use the Resource and Program Type filter on the left to find: Resources (e.g., articles, tools, fact sheets, reports) developed by SPRC and other suicide prevention organizations and experts, Programs and Practices (e.g., education, screening, treatment, environmental change), including former BPR listings, Programs with evidence of effectiveness are indicated by the icon.

Safety Planning Intervention

“This site contains information about the Safety Planning Intervention that was developed by Barbara Stanley, Ph.D. and Gregory K. Brown, Ph.D. The Safety Plan is a written, prioritized list of coping strategies and resources for reducing suicide risk. It is a prevention tool that is designed to help those who struggle with their suicidal thoughts and urges to survive.”

Suicide Assessment Five-Step Evaluation & Triage (SAFE-T)

The Suicide Assessment Five-step Evaluation and Triage (SAFE-T) pocket card for mental health clinicians and health care professionals, provides protocols for conducting a comprehensive suicide assessment, estimating suicide risk, identifying protective factors, and developing treatment plans and interventions responsive to the risk level of patients. The pocket card includes triage and documentation guidelines for clinicians. It was developed through collaboration between Screening for Mental Health, Inc. (SMH) and the Suicide Prevention Resource Center (SPRC). Douglas Jacobs, CEO and Founder of SMH originally conceived the model of the SAFE-T pocket card. The protocols and guidelines featured on the card were developed based on the American Psychiatric Association Practice Guidelines for the Assessment and Treatment of Patients with Suicidal Behaviors (see A Resource Guide for Implementing the Joint Commission on Accreditation of Healthcare Organizations 2007 Patient Safety Goals on Suicide in Section II of the Best Practices Registry for more information about these guidelines).”

Suicide Safety - SAMHSA Suicide Prevention App

Suicide Safe, SAMHSA's new suicide prevention app for mobile devices and optimized for tablets, helps providers integrate suicide prevention strategies into their practice and address suicide risk among their patients. Suicide Safe is a free app based on SAMHSA's Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) card.

Fact Sheets & Brief Resources

About Suicide - AFSP

Coping After Suicide Loss - APA

Foster Care Providers: Helping Youth at Risk of Suicide - SPRC

Guidance on 13-Reasons Why Netflix Series - NASP

How to Talk to a Child About a Suicide Attempt in Your Family - VA RM MIRECC

Recommendations for Reporting on Suicide

Preventing Suicide: Guidelines for Administrators and Crisis Teams - NASP

Preventing Youth Suicide - NASP

Preventing Youth Suicide: Tips for Parents & Educators - NASP

Save a Friend: Tips for Teens to Prevent Suicide - NASP

State Fact Sheets - AFSP

State Laws: Suicide Prevention in Schools - AFSP

Suicide Among Youth - CDC

Suicide Prevention - NIMH

Suicide Statistics - NIMH

Talking to Teens: Suicide Prevention - APA

The Role of High School Teachers in Preventing Suicide - SPRC

The Role of High School Mental Health Providers in Preventing Suicide - SPRC

Warning Signs of Suicide - SPRC


American Association of Suicidology

American Foundation for Suicide Prevention

Centers for Disease Control

Crisis Text Line

National Action Alliance for Suicide Prevention

National Institutes of Mental Health

National Suicide Prevention Lifeline

Substance Abuse and Mental Health Services Administration

Suicide Awareness Voices of Education

Suicide Prevention Resource Center

The Jed Foundation

Trans Lifeline

Trevor Project

World Health Organization

Zero Suicide


ASFP Research Grants