Suicidal thoughts and behaviors are highly prevalent among adolescents, and peers are often the first, and sometimes only, people to know about youth suicidality. Since many adolescents do not directly disclose suicidal thoughts, school-based suicide prevention programs aim to train youth to recognize warning signs of suicide in their peers that serve as “cues” to refer at-risk peers to an appropriate adult. However, peer-presented cues vary widely in presentation, and adolescents are more likely to recognize overt (i.e., obvious or explicit) as opposed to covert (i.e., hidden or implied) cues. The type of cue exhibited may, in turn, affect whether adolescents make a referral to an adult. The current study examined whether training suicide prevention influences referral intentions for overt and covert suicide cues. Participants included 244 high school students (54% female; M_age = 16.21) in the Southeastern United States who received suicide prevention training (SOS; signs of suicide) as part of their health curriculum. Prior to training, students endorsed higher referral intentions for peers exhibiting overt compared to covert cues. Training was associated with increased intentions to refer peers across cue type, but referral intentions for covert cues improved significantly from pre to post-training while those for overt cues remained high and stable. Findings suggest that suicide prevention training might differentially improve students’ ability to detect and respond appropriately to less obvious indicators of suicide risk. These findings may inform the adaptation and development of future, more nuanced school-based suicide prevention programming.

自杀念头和行为在青少年中非常普遍，而同龄人通常是第一个，有时甚至是唯一了解青少年自杀倾向的人。由于许多青少年不直接透露自杀念头，以学校为基础的自杀预防计划旨在训练青少年识别同龄人的自杀警告信号，这些信号可作为“提示”，将有风险的同龄人转介给合适的成年人。然而，同伴呈现的线索在表现上有很大差异，青少年更容易识别明显的（即明显的或明确的）而不是隐蔽的（即隐藏或暗示的）线索。所展示的提示类型可能反过来影响青少年是否会转介给成年人。当前的研究检查了自杀预防培训是否会影响公开和隐蔽的自杀线索的转介意向。M _age  = 16.21) 在美国东南部接受自杀预防培训（SOS；自杀迹象）作为健康课程的一部分。在培训之前，与隐蔽线索相比，学生对表现出明显暗示的同龄人表示赞同更高的推荐意向。培训与跨线索类型推荐同龄人的意图增加相关，但隐蔽线索的推荐意图从训练前到训练后显着改善，而公开线索的推荐意图保持高位且稳定。研究结果表明，自杀预防培训可能会不同程度地提高学生发现和应对不太明显的自杀风险指标的能力。这些发现可能会为未来更细致的以学校为基础的自杀预防计划的适应和发展提供信息。