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Help-seeking behaviour following school-based screening for current suicidality among European adolescents

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Abstract

Purpose

To screen and clinically interview European adolescents reporting current suicidality (suicidal ideation and suicide attempt) and investigate attendance at the clinical interview.

Methods

The Saving and Empowering Young Lives in Europe (SEYLE) Project was carried out in 11 European countries. A baseline questionnaire was completed in school by 12,395 adolescents (mean age 14.9; SD 0.9). Those who screened positive for suicidality (attempting suicide and/or serious suicidal ideation or plans) in the past 2 weeks were invited to a clinical interview with a mental health professional.

Results

Of the 12,395 adolescents, 4.2 % (n = 516) screened positive for current suicidality. The prevalence ranged from 1.1 % in Hungary to 7.7 % in Israel (p < 0.001). 37.6 % (n = 194) of those who screened positive subsequently attended the clinical interview. Female students were more likely to attend for interview (42.0 % versus 30.6 %, p = 0.010). The attendance rate varied considerably across countries, from 5.7 % in Italy to 96.7 % in France (p < 0.001). Improved attendance was associated with using school as the only interview setting (Mean attendance rate, MAR = 88 vs. 31 %, p = 0.006) and arranging the interview within 1 week of contacting the student (MAR = 64 vs. 23 %, p = 0.013). The greater the travel time to interview, the lower the attendance rate (Pearson’s r = −0.64, p = 0.034). Independent of the variation by country, at the individual level, adolescents with more depressive symptoms and a recent suicide attempt more often attended for interview.

Conclusion

A high rate of current suicidality was found amongst European adolescents. However, the majority of these displayed limited help-seeking behaviour. Future studies should investigate ways of making screening programmes and other interventions more acceptable and accessible to young people, especially young males.

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Acknowledgments

The SEYLE project is supported through Coordination Theme 1 (Health) of the European Union Seventh Framework Program (FP7), Grant agreement number HEALTH-F2-2009-223091. The authors were independent of the funders in all aspects of study design, data analysis and writing of this manuscript. The Project Leader and Coordinator of the SEYLE project is Professor in Psychiatry and Suicidology Danuta Wasserman, Karolinska Institutet (KI), Head of the National Centre for Suicide Research and Prevention of Mental Ill-Health and Suicide (NASP), at KI, Stockholm, Sweden. Other members of the Executive Committee are Professor Marco Sarchiapone, Department of Health Sciences, University of Molise, Campobasso, Italy; Vladimir Carli, National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden; Professorv Christina Hoven and Anthropologist Camilla Wasserman, Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA. The SEYLE Consortium comprises centres in 12 European countries. Site leaders for each respective centre and country are: Danuta Wasserman (NASP, Karolinska Institutet, Sweden, Coordinating Centre), Christian Haring (University for Medical Information Technology, Austria), Airi Varnik (Estonian-Swedish Mental Health & Suicidology Institute, Estonia), Jean-Pierre Kahn (University of Nancy, France), Romuald Brunner (University of Heidelberg, Germany), Judit Balazs (Vadaskert Child and Adolescent Psychiatric Hospital, Hungary), Paul Corcoran (National Suicide Research Foundation, Ireland), Alan Apter (Schneider Children’s Medical Centre of Israel, Tel-Aviv University, Tel Aviv, Israel), Marco Sarchiapone (University of Molise, Italy), Doina Cosman (Iuliu Hatieganu University of Medicine and Pharmacy, Romania), Vita Postuvan (University of Primorska, Slovenia) and Julio Bobes (University of Oviedo, Spain).

Conflict of interest

On behalf of all the authors, the corresponding author states that there is no conflict of interest.

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Author notes

    Authors and Affiliations

    1. National Suicide Research Foundation, University College Cork, Western Gateway Building, Room 4.28, Cork, Ireland

      Pádraig Cotter, Paul Corcoran & Helen Keeley

    2. Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany

      Michael Kaess, Peter Parzer, Romuald Brunner & Franz Resch

    3. Department of Public Health Sciences, National Swedish Prevention of Mental Ill-Health and Suicide (NASP)/WHO Collaborating Centre for Research, Methods Development and Training in Suicide Prevention, Karolinska Institute, Stockholm, Sweden

      Vladimir Carli & Danuta Wasserman

    4. Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA

      Camilla Wasserman & Christina Hoven

    5. Department of Health Sciences, University of Molise, Campobasso, Italy

      Marco Sarchiapone

    6. Feinberg Child Study Center, Schneider Children’s Medical Center, Tel Aviv University, Tel Aviv, Israel

      Alan Apter

    7. Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary

      Judit Balazs

    8. Institute of Psychology, Eotvos Lorand University, Budapest, Hungary

      Judit Balazs

    9. Department of Psychiatry, School of Medicine, Centro de Investigación Biomédica en Red área de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain

      Julio Bobes

    10. Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania

      Doina Cosman

    11. Research Division for Mental Health, University for Medical Information Technology (UMIT), Hall in Tirol, Austria

      Christian Haring

    12. Department of Psychiatry, Centre Hospitalo-Universitaire CHU) de NANCY, Université de Lorraine, Nancy, France

      Jean-Pierre Kahn

    13. Slovene Center for Suicide Research, Andrej Marušič Institute, University of Primorska, Koper, Slovenia

      Vita Postuvan

    14. Estonian-Swedish Mental Health and Suicidology Institute, Est Ctr Behav and Hlth Sci, Tallinn University, Tallinn, Estonia

      Airi Värnik

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    1. Pádraig Cotter
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    2. Michael Kaess
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    3. Paul Corcoran
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    7. Vladimir Carli
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    Corresponding author

    Correspondence to Pádraig Cotter.

    Additional information

    P. Cotter and M. Kaess contributed equally to this paper and should, therefore, both be considered as first authors.

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    Cotter, P., Kaess, M., Corcoran, P. et al. Help-seeking behaviour following school-based screening for current suicidality among European adolescents. Soc Psychiatry Psychiatr Epidemiol 50, 973–982 (2015). https://doi.org/10.1007/s00127-015-1016-3

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