Abstract
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; Mage = 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.
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Data Availability
For ethical and legal reasons, we are unable to publicly share the database used for this study. However, individual requests will be considered with data sharing agreements and IRB approvals in place.
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This work was supported by the Substance Abuse and Mental Health Services Administration (SAMHSA; Grant Number U79 SM060427-01). This publication was made possible, in part, by Grant Number T32-GM081740 from National Institutes of Health – National Institute of General Medical Sciences (NIH-NIGMS). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of SAMHSA, the NIGMS or NIH.
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This work was supported by the Substance Abuse and Mental Health Services Administration [Grant Number U79 SM060427-01]. This publication was made possible in part by Grant Number T32-GM081740 from NIH-NIGMS.
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Gleason, L.L., Bender, A.M., Chen, J.I. et al. Under the Surface: The Role of Covert Cues in Peer Suicide Risk Referrals. School Mental Health 14, 125–135 (2022). https://doi.org/10.1007/s12310-021-09459-1
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DOI: https://doi.org/10.1007/s12310-021-09459-1