Strong teens and resilient minds: Depression and Suicide Prevention in Higher Vocational Education

The current study examines the effectiveness of the multimodal prevention program for suicidality and depressive symptoms using a cluster randomized trial. This includes a combination of preventive interventions, such as (1) early detection and identification with subsequent clinical referral, (2) a safety net consisting of gatekeepers at school, (3) universal prevention focusing on stigma reduction, (4) screening to identify students that have elevated signs of the most important risk factor for suicidal behaviour, i.e. depression and subsequent indicated prevention for screen-positive students. The primary outcome will be suicidal behaviours, i.e. suicidal thoughts and plans, deliberate self-harm and suicide attempts as measured with the VOZZ. Secondary study outcomes are depressive feelings, self-esteem, self-efficacy, children’s quality adjusted life year (QALY) health gains, worry, mastery, stigma, school-related factors. Measurements of primary and secondary outcomes will be conducted in intervention and control condition at baseline and at 6-, 12- and 18-months after baseline.

It is expected that students receiving the multimodal school-based stepped approach towards preventing suicidality and depression, show a clinically significant reduction in severity of suicidality when compared to students receiving enhanced usual care.

Screening
T0; baseline
T1; 6-month follow-up
T2; 12 month follow-up
T3; 18-month follow-up

Screening
Gatekeepers training for school mentors
Universal preventive intervention focused on depression stigma in the form of a serious game
indicated preventive intervention focused on depressive symptoms in the form of a cbt-based skills training and an e-mental health mobile application.