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Suicide claims some 800 000 lives a year and is the second leading cause of death among 15- to 29-year-olds. Suicidal tendencies in teenagers – often influenced by stigma, developmental changes and peer pressure – are especially hard to target and require specifically tailored, evidence-based prevention strategies.
The EU-funded SEYLE project addressed this issue and created an interactive, school-based intervention programme aimed at 14- to 16-year-olds. Known as Youth Aware of Mental Health (YAM), it seeks to empower adolescents and combines role play, discussions and a hands-on take on sensitive topics.
The five-hour programme, spread over four weeks, has since been commercialised and is being used in schools in several countries, including the United Kingdom, Austria, Sweden, the United States and Australia.
“In YAM, youth are considered the experts of their own mental health and their voices and experiences take centre stage,” says SEYLE principal investigator Danuta Wasserman, professor of psychiatry and suicidology at the Karolinska Institute in Sweden.
Integrating role play, reflection and dialogue helps youth reflect on complex mental health problems such as stress, crises, bullying, discrimination, depression and suicide, says YAM creator Camilla Wasserman, an anthropologist and researcher in public mental health at Columbia University in the USA.
“YAM is designed to change students’ perceptions about mental health and improve their coping skills and management of adverse life events,” she adds.
Suicide attempts halved
YAM was evaluated during an extensive SEYLE study on the effectiveness of school-based suicide prevention programmes that involved more than 11 000 teenagers from 168 schools in 10 EU countries.
The cluster-randomised controlled trial – which also tested two other interventions that targeted teachers and additional school personnel, as well as professional screening to identify at-risk students – showed that YAM had substantial success.
“The results of SEYLE show that the YAM intervention programme was significantly effective in preventing new cases of depression, severe suicidal ideation and suicide attempts,” Danuta Wasserman says. “In fact, the programme was successful in reducing incident suicide attempts by more than half compared to the control group.”
Window into young minds
The SEYLE sample of more than 11 000 teenagers also led to the development of an extensive database that provides key insight into the behaviours and psychological well-being of European teenagers.
For example, studies done using the data reveal that around 29 % of such adolescents had slight symptoms of depression, more than one in four showed self-harming behaviour and about one in five slept less than six hours a night – a practice linked to emotional and behavioural difficulties, anxiety and suicidal thoughts, according to Danuta Wasserman.
Knowing more about what causes teenage suicidal tendencies and countering any signs early on helps reduce substantial social burdens later. “Young suicide attempters have significantly more persistent mental health problems like depression, substance dependence and physical health problems, such as metabolic syndrome and inflammatory diseases, when they reach adulthood,” Danuta Wasserman adds. “They are also more likely to be engaged in violent crime, intimate partner abuse, to be unemployed and in need of long-term healthcare.”
The YAM programme has been commercialised by R&D SME Mental Health in Mind International AB, which is co-owned by Karolinska Institutet Holding AB and supported by Karolinska Institutet Innovations AB. An implementation project involving 140 schools is currently under way in the greater Stockholm area and may result in a Sweden-wide roll-out in 2020.
The SEYLE project resonated well with researchers and has led to the publication of more than 40 scientific articles.