Abstract
Suicide, the second leading cause of death among adolescents, requires an integrative approach to maximize the effectiveness of prevention efforts. The current study draws on the social-ecological model and its relevance to the ecosystem at Vocational Education and Training (VET) high schools in the context of suicide prevention. The study examined the school-related factors of school connectedness, academic self-efficacy and school autonomy support in relation to suicidal thoughts and behavior. Participants included 5688 students (mean age 15.58) drawn from 62 vocational high schools across Israel. Structural equation modeling revealed that school connectedness and academic self-efficacy exhibit negative links to suicide ideation and behavior; moreover, these links were partly mediated by depressive symptoms. School autonomy support was found to be positively linked to suicide ideation and suicide attempts. The paper discusses the results with respect to suicide prevention efforts in the unique context of adolescents attending vocational schools.
Similar content being viewed by others
References
Anderman, E. M. (2002). School effects on psychological outcomes during adolescence. Journal of Educational Psychology, 94(4), 795.
Ang, R. P., & Huan, V. S. (2006). Relationship between academic stress and suicidal ideation: Testing for depression as a mediator using multiple regression. Child Psychiatry and Human Development, 37(2), 133.
Avraham, R., & Sarel-Mahleb, E. (2017). Choosing life: Talking directly with students. Suicide Prevention Unit.
Bauman, S., Toomey, R. B., & Walker, J. L. (2013). Associations among bullying, cyberbullying, and suicide in high school students. Journal of Adolescence, 36(2), 341–350.
Benatov, J., Chen-Gal, S., & Sapir, Z. (2020). Suicide prevention strategies in the vocational high-schools in Israel. Mifgash, Journal of Social Educational Work., 28(51–52), 33–40.
Benatov, J., Nakash, O., Chen, S. G., Abu, S. K., & Brunstein, A. K. (2016). Religious-ethnic differences in prevalence and correlates of suicidal ideation and attempts among Israeli vocational education students. Israel Journal of Psychiatry and Related Sciences, 53(3), 40–46.
Benatov, J., Nakash, O., Chen-Gal, S., & Brunstein Klomek, A. (2017). The association between gender, ethnicity, and suicidality among vocational students in Israel. Suicide and Life-Threatening Behavior, 47(6), 647–659.
Beyers, W., Goossens, L., Vansant, I., & Moors, E. (2003). A structural model of autonomy in middle and late adolescence: Connectedness, separation, detachment, and agency. Journal of Youth and Adolescence, 32(5), 351–365.
Birkett, M., Espelage, D. L., & Koenig, B. (2009). LGB and questioning students in schools: The moderating effects of homophobic bullying and school climate on negative outcomes. Journal of Youth and Adolescence, 38(7), 989–1000.
Blos, P. (1979). The adolescent passage. International University Press.
Bould, H., Mars, B., Moran, P., Biddle, L., & Gunnell, D. (2019). Rising suicide rates among adolescents in England and Wales. The Lancet, 394(10193), 116–117.
Brent, D. A., Kerr, M. M., Goldstein, C., Bozigar, J., Wartella, M., & Allan, M. J. (1989). An outbreak of suicide and suicidal behavior in a high school. Journal of the American Academy of Child & Adolescent Psychiatry, 28(6), 918–924.
Brent, D. A., Perper, J. A., Moritz, G., Allman, C., Friend, A. M. Y., Roth, C., Schweers, J., Balach, L., & Baugher, M. (1993). Psychiatric risk factors for adolescent suicide: A case-control study. Journal of the American Academy of Child & Adolescent Psychiatry, 32(3), 521–529.
Bronfenbrenner, U. (1979). The ecology of human development. Harvard University Press.
Brown, R. C., Straub, J., Bohnacker, I., & Plener, P. L. (2018). Increasing knowledge, skills, and confidence concerning students’ suicidality through a gatekeeper workshop for school staff. Frontiers in psychology, 9, 1233.
Burton, L. (2007). Childhood adultification in economically disadvantaged families: A conceptual model. Family Relations, 56(4), 329–345.
Centers for Disease Control and Prevention. (2017). The social-ecological model: A framework for prevention. Retrieved January 2019 from https://www.cdc.gov/violenceprevention/overview/socialecologicalmodel.html
Centers for Disease Control and Prevention. (2018). Web‐based injury statistics query and reporting system (WISQARS) [Online database] https://www.cdc.gov/injury/wisqars/index.html
Chen, H., Cohen, P., & Chen, S. (2010). How big is a big odds ratio? Interpreting the magnitudes of odds ratios in epidemiological studies. Communications in Statistics Simulation and Computation, 39(4), 860–864.
Cramer, R. J., & Kapusta, N. D. (2017). A social-ecological framework of theory, assessment, and prevention of suicide. Frontiers in Psychology, 8, 1–10.
Dalen, J. D. (2012). The association between school class composition and suicidal ideation in late adolescence: Findings from the Young-HUNT 3 study. Child and Adolescent Psychiatry and Mental Health, 6(7), 37.
De Man, A. F., Labreche-Gauthier, L., & Leduc, C. P. (1993). Parent-child relationships and suicidal ideation in French-Canadian adolescents. The Journal of Genetic Psychology, 154(1), 17–23.
Dearden, K. A., De La Cruz, N. G., Crookston, B. T., Novilla, M. L. B., & Clark, M. (2005). Adolescents at risk: Depression, low academic performance, violence, and alcohol increase Bolivian teenagers’ risk of attempted suicide. International Electronic Journal of Health Education, 8, 104–119.
Deci, E. L., & Ryan, R. M. (2000). The ‘“what”’ and ‘“why”’ of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11(4), 227–268.
Deci, E. L., Schwartz, A., Sheinman, L., & Ryan, R. M. (1981). An instrument to assess adults’ orientations toward control versus autonomy in children: Reflections on intrinsic motivation and perceived competence. Journal of Educational Psychology, 73, 642–650.
Deci, E. L., Spiegel, N. H., Ryan, R. M., Koestner, R., & Kauffman, M. (1982). Effects of performance standards on teaching styles: Behavior of controlling teachers. Journal of Educational Psychology, 74, 852–859.
Derogatis, L. R. (2000). Brief Symptom Inventory 18. NCS Pearson.
Diamond, G. M., Didner, H., Waniel, A., Priel, B., Asherov, J., & Arbel, S. (2007). Perceived parental care and control among Israeli female adolescents presenting to emergency rooms after self-poisoning. Family Therapy, 34(3), 153.
Earley, L., & Cushway, D. (2002). The parentified child. Clinical Child Psychology and Psychiatry, 7(2), 163–178.
Elias, B., Mignone, J., Hall, M., Hong, S. P., Hart, L., & Sareen, J. (2012). Trauma and suicide behaviour histories among a Canadian indigenous population: An empirical exploration of the potential role of Canada’s residential school system. Social Science & Medicine, 74(10), 1560–1569.
Erhard, R. (2000). A kit for diagnosing characteristics of school violence. Israel Ministry of Education (Hebrew).
Erhard, R. (2001). An optimal educational climate: A kit for diagnosing and intervention. Israel Ministry of Education (Hebrew).
Evans, E., Hawton, K., & Rodham, K. (2004). Factors associated with suicidal phenomena in adolescents: A systematic review of population-based studies. Clinical Psychology Review, 24(8), 957–979.
Ewell Foster, C. J., Burnside, A. N., Smith, P. K., Kramer, A. C., Wills, A. A., & King, C. (2017). Identification, response, and referral of suicidal youth following applied suicide intervention skills training. Suicide and Life-Threatening Behavior, 47(3), 297–308.
Furlong, M. J., Morrison, G. M., & Boles, S. (2004). The California school climate and safety survey. California Association of School Psychologists.
Gunnell, D., Kidger, J., & Elvidge, H. (2018). Adolescent mental health in crisis. BMJ, 361, k2608. https://doi.org/10.1136/bmj.k2608
Harel-Fish, Y., Walsh, S. Shtainmaz. N., Lubel, S., Raizz, I., Tezler, R., & Haviv, J. (2016). Adolescents in Israel: Health, psychological and social well-being and risk behavior patterns. World Health Organization, HBSC report.
Hatzenbuehler, M. L. (2014). Structural stigma and the health of lesbian, gay, and bisexual populations. Current Directions in Psychological Science, 23(2), 127–132.
Hatzenbuehler, M. L., Birkett, M., Van Wagenen, A., & Meyer, I. H. (2014). Protective school climates and reduced risk for suicide ideation in sexual minority youths. American Journal of Public Health, 104(2), 279–286.
Hatzenbuehler, M. L., & Link, B. G. (2014). Introduction to the special issue on structural stigma and health. Social Science & Medicine, 103, 1–6.
Hewitt, P. L., Caelian, C. F., Chen, C., & Flett, G. L. (2014). Perfectionism, stress, daily hassles, hopelessness, and suicide potential in depressed psychiatric adolescents. Journal of Psychopathology and Behavioral Assessment, 36(4), 663–674.
Hill, R. M., & Pettit, J. W. (2013). The role of autonomy needs in suicidal ideation: Integrating the interpersonal-psychological theory of suicide and self-determination theory. Archives of Suicide Research, 17(3), 288–301.
Irons, C., & Gilbert, P. (2005). Evolved mechanisms in adolescent anxiety and depression symptoms: The role of the attachment and social rank systems. Journal of Adolescence, 28(3), 325–341.
Joiner, T. (2007). Why people die by suicide. Harvard University Press.
Joshi, H. L. (2013). Academic anxiety, depression and self-efficacy as predictors of suicide ideation among adolescents. Indian Journal of Health and Wellbeing, 4(7), 1438.
KatzBoltonKatzIsaakTilston-JonesSareen, C. S. L. L. Y. C. T. J., & Swampy Cree Suicide Prevention Team. (2013). A systematic review of school-based suicide prevention programs. Depression and Anxiety, 30(10), 1030–1045.
Khoury-Kassabri, M., Benbenishty, R., & Astor, R. A. (2005). The effects of school climate, socioeconomics, and cultural factors on student victimization in Israel. Social Work Research, 29(3), 165–180.
Kidd, S., Henrich, C. C., Brookmeyer, K. A., Davidson, L., King, R. A., & Shahar, G. (2006). The social context of adolescent suicide attempts: Interactive effects of parent, peer, and school social relations. Suicide and Life-Threatening Behavior, 36(4), 386–395.
King, K. A. (2001). Developing a comprehensive school suicide prevention program. Journal of School Health, 71(4), 132–137.
KingGrupp-PhelanBrentDeanWebbBridgeSpiritoChernickMahabee-GittensMistry ReaKellerRogersShenoiCwikBusbyCasper, C. A. J. D. J. M. M. J. A. A. L. S. E. M. R. D. M. A. A. R. M. D. R. T. C., & Pediatric Emergency Care Applied Research Network. (2019). Predicting 3-month risk for adolescent suicide attempts among pediatric emergency department patients. Journal of Child Psychology and Psychiatry, 60(10), 1055–1064.
Klomek, A. B., Sourander, A., & Gould, M. (2010). The association of suicide and bullying in childhood to young adulthood: A review of cross-sectional and longitudinal research findings. The Canadian Journal of Psychiatry, 55(5), 282–288.
Kuczera, M., Bastianica, T., & Field, S. (2018). Apprenticeship and vocational education and training in Israel. OECD Publishing.
Lareau, A. (2011). Unequal childhoods: Class, race, and family life. University of California Press.
LoCoco, A., Ingoglia, S., Zappulla, C., & Pace, U. (2001). Parental stress, emotional autonomy and psychological adjustment during adolescence. Età Evolutiva, 69, 88–94.
Madjar, N., Walsh, S. D., & Harel-Fisch, Y. (2018). Suicidal ideation and behaviors within the school context: Perceived teacher, peer and parental support. Psychiatry Research, 269, 185–190.
Marsh, H. W., & Craven, R. G. (2006). Reciprocal effects of self-concept and performance from a multidimensional perspective: Beyond seductive pleasure and unidimensional perspectives. Perspectives on Psychological Science, 1, 133–163.
Martin, G., Richardson, A. S., Bergen, H. A., Roeger, L., & Allison, S. (2005). Perceived academic performance, self-esteem and locus of control as indicators of need for assessment of adolescent suicide risk: Implications for teachers. Journal of Adolescence, 28(1), 75–87.
McNeely, C., & Falci, C. (2004). School connectedness and the transition into and out of health-risk behavior among adolescents: A comparison of social belonging and teacher support. Journal of School Health, 74(7), 284–293.
McNeely, C. L. E. A., Whitlock, J., & Libbey, H. (2010). School connectedness and adolescent well-being. Handbook of School-Family Partnerships, pp.266–286.
Milburn, N. G., Ayala, G., Rice, E., Batterham, P., & Rotheram-Borus, M. J. (2006). Discrimination and exiting homelessness among homeless adolescents. Cultural Diversity and Ethnic Minority Psychology, 12(4), 658.
Ministry of Health. (2019). Suicide in Israel. June 2019 update (Hebrew).
Mishara, B. L., & Côté, L. P. (2013). Suicide prevention and new technologies: Towards evidence based practice. In B. L. Mishara & A. J. F. M. Kerkhof (Eds.), Suicide prevention and new technologies. Palgrave Macmillan.
Moore, H., Benbenishty, R., Astor, R. A., & Rice, E. (2018). The positive role of school climate on school victimization, depression, and suicidal ideation among school-attending homeless youth. Journal of School Violence, 17(3), 298–310.
Muthén, L. K., & Muthén, B. O. (1998–2017). Mplus user’s guide (8th ed.). Muthén & Muthén.
Osterman, K. F. (2000). Students’ need for belonging in the school community. Review of Educational Research, 70(3), 323–367.
Pace, U., & Zappulla, C. (2009). Identity processes and quality of emotional autonomy: The contribution of two developmental tasks on middle-adolescents’ subjective well-being. Identity, 9(4), 323–340.
Pace, U., & Zappulla, C. (2010). Relations between suicidal ideation, depression, and emotional autonomy from parents in adolescence. Journal of Child and Family Studies, 19(6), 747–756.
Padmanathan, P., Bould, H., Winstone, L., Moran, P., & Gunnell, D. (2020). Social media use, economic recession and income inequality in relation to trends in youth suicide in high-income countries: A time trends analysis. Journal of Affective Disorders, 275, 58–65.
Paykel, E., Myers, J., Lindenthal, J., & Tanner, J. (1974). Suicidal feelings in the general population: A prevalence study. British Journal of Psychiatry, 124(582), 460–469.
Pickering, T. A., Wyman, P. A., Schmeelk-Cone, K., Hartley, C., Valente, T. W., Pisani, A. R., Rulison, K. L., Hendricks Brown, C., & LoMurray, M. (2018). Diffusion of a peer-led suicide preventive intervention through school-based student peer and adult networks. Frontiers in Psychiatry, 9, 598.
Pisani, A. R., Schmeelk-Cone, K., Gunzler, D., Petrova, M., Goldston, D. B., Tu, X., & Wyman, P. A. (2012). Associations between suicidal high school students’ help-seeking and their attitudes and perceptions of social environment. Journal of youth and adolescence, 41(10), 1312–1324.
Reddy, R., Rhodes, J. E., & Mulhall, P. (2003). The influence of teacher support on student adjustment in the middle school years: A latent growth curve study. Development and Psychopathology, 15(1), 119–138.
Richardson, A. S., Bergen, H. A., Martin, G., Roeger, L., & Allison, S. (2005). Perceived academic performance as an indicator of risk of attempted suicide in young adolescents. Archives of Suicide Research, 9(2), 163–176.
Robinson, J., Cox, G., Malone, A., Williamson, M., Baldwin, G., Fletcher, K., & O’Brien, M. (2013). A systematic review of school-based interventions aimed at preventing, treating, and responding to suicide-related behavior in young people. Crisis, 34, 164–182.
Robinson, J., Hetrick, S., Cox, G., Bendall, S., Yuen, H. P., Yung, A., & Pirkis, J. (2016). Can an internet-based intervention reduce suicidal ideation, depression and hopelessness among secondary school students: Results from a pilot study. Early intervention in psychiatry, 10(1), 28–35.
Robinson, J., Hetrick, S. E., & Martin, C. (2011). Preventing suicide in young people: Systematic review. Australian & New Zealand Journal of Psychiatry, 45(1), 3–26.
Rosenblatt, J. A., & Furlong, M. J. (1997). Assessing the reliability and validity of student self-reports of campus violence. Journal of Youth and Adolescence, 26(2), 187–202.
Ryan, R. M., & Lynch, J. H. (1989). Emotional autonomy versus detachment: Revisiting the vicissitudes of adolescence and young adulthood. Child Development, 60(2), 340–356.
Schilling, E. A., Aseltine, R. H., & James, A. (2016). The SOS suicide prevention program: Further evidence of efficacy and effectiveness. Prevention Science, 17(2), 157–166.
Silviken, A., & Kvernamo, S. (2007). Suicide attempts among indigenous Sami adolescents and majority peers in Arctic Norway: Prevalence and associated risk factors. Journal of Adolescence, 30, 613–626.
Soenens, B., Vansteenkiste, M., Lens, W., Luyckx, K., Goossens, L., Beyers, W., & Ryan, R. M. (2007). Conceptualizing parental autonomy support: Adolescent perceptions of promotion of independence versus promotion of volitional functioning. Developmental Psychology, 43, 633–646. https://doi.org/10.1037/0012-1649.43.3.633
Spruyt, B., Van Droogenbroeck, F., & Kavadias, D. (2015). Educational tracking and sense of futility: A matter of stigma consciousness? Oxford Review of Education, 41(6), 747–765.
Stanley, N., Mallon, S., Bell, J., & Manthorpe, J. (2009). Trapped in transition: Findings from a UK study of student suicide. British Journal of Guidance & Counselling, 37(4), 419–433.
Stice, E., Ragan, J., & Randall, P. (2004). Prospective relations between social support and depression: Differential direction of effects for parent and peer support? Journal of Abnormal Psychology, 113(1), 155.
Suldo, S. M., Riley, K. N., & Shaffer, E. J. (2006). Academic correlates of children and adolescents’ life satisfaction. School Psychology International, 27(5), 567–582.
Tandon, S. D., Marshall, B., Templeman, A. J., & Sonenstein, F. L. (2008). Health access and status of adolescents and young adults using youth employment and training programs in an urban environment. Journal of Adolescent Health, 43(1), 30–37.
Tanney, B. L., Ramsay, R. F., Lang, W. A., & Kinzel, T. A. (2006). Safetalk: Development of brief skills training in suicide intervention. Psychiatria Danubina, 18(Suppl 1), 94–95.
Tsai, M. H., Chen, Y. H., Chen, C. D., Hsiao, C. Y., & Chien, C. H. (2011). Deliberate self-harm by Taiwanese adolescents. Acta Paediatrica, 100(11), e223–e226.
Twenge, J. M. (2020). Why increases in adolescent depression may be linked to the technological environment. Current Opinion in Psychology, 32, 89–94.
Van Petegem, S., Beyers, W., Vansteenkiste, M., & Soenens, B. (2011). Psychological reactance as an explaining mechanism for adolescent rebellion: Associations with autonomy, parenting, and psychosocial functioning. Program Book, 15th European Conference on Developmental Psychology, Bergen, Norway. https://w2.uib.no/filearchive/ecdp_final_program_2.pdf
Van Petegem, S., Beyers, W., Vansteenkiste, M., & Soenens, B. (2012). On the association between adolescent autonomy and psychosocial functioning: Examining decisional independence from a self-determination theory perspective. Developmental Psychology, 48(1), 76.
Vlaardingerbroek, B., & Hachem El-Masri, Y. (2008). Student transition to upper secondary vocational and technical education (VTE) in Lebanon: From stigma to success. Journal of Vocational Education and Training, 60(1), 19–33.
Wasserman, D., Hoven, C. W., Wasserman, C., Wall, M., Eisenberg, R., Hadlaczky, G., Kelleher, I., Sarchiapone, M., Apter, A., Balazs, J., Bobes, J., Brunner, R., Corcoran, P., Cosman, D., Guillemin, F., Haring, C., Iosue, M., Kaess, M., Kahn, J. P., … Bobes, J. (2015). School-based suicide prevention programmes: The SEYLE cluster-randomised, controlled trial. The Lancet, 385(9977), 1536–1544.
Whitaker, K., Shapiro, V. B., & Shields, J. P. (2016). School-based protective factors related to suicide for lesbian, gay, and bisexual adolescents. The Journal of Adolescent Health, 58, 63–68.
Whitlock, J., Wyman, P. A., & Moore, S. R. (2014). Connectedness and suicide prevention in adolescents: Pathways and implications. Suicide and Life-Threatening Behavior, 44, 246–272.
Wilcox, H. C., Kellam, S. G., Brown, C. H., Poduska, J., Ialongo, N. S., Wang, W., et al. (2008). The impact of two universal randomized first- and second-grade classroom interventions on young adult suicide ideation and attempt. Drug and Alcohol Dependence, 95(Suppl 1), S60–S73.
Wollschlager, N., & Guggenheim, E. F. (2004). A history of vocational education and training in Europe: From divergence to convergence. European Journal: Vocational Training, 32, 1–3.
World Health Organization.(2019). World Mental Health Day 2019: Focus on suicide prevention. https://www.who.int/news-room/events/detail/2019/10/10/default-calendar/world-mental-health-day-2019-focus-on-suicide-prevention
Wyman, P. A. (2014). Developmental approach to prevent adolescent suicides: Research pathways to effective upstream preventive interventions. American Journal of Preventive Medicine, 47(3), S251–S256.
Wyman, P. A., Brown, C. H., Inman, J., Cross, W., Schmeelk-Cone, K., Guo, J., et al. (2008). Randomized trial of a gatekeeper program for suicide prevention: 1-year impact on secondary school staff. Journal of Consulting and Clinical Psychology, 76(1), 104–115.
Yu, C., Li, X., & Zhang, W. (2015). Predicting adolescent problematic online game use from teacher autonomy support, basic psychological needs satisfaction, and school engagement: A 2-year longitudinal study. Cyberpsychology, Behavior, and Social Networking, 18(4), 228–233.
Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., Höschl, C., Barzilay, R., Balazs, J., & Purebl, G. (2016). Suicide prevention strategies revisited: 10-year systematic review. The Lancet Psychiatry, 3(7), 646–659.
Acknowledgements
The first author received support from the Research Fund of the Research Authority of the College of Management Academic Studies, Rishon Lezion, Israel.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Benatov, J., Brunstein-Klomek, A. & Chen-Gal, S. Suicide Behavior Among Vocational High School Students: The Role of School-Related Factors. School Mental Health 13, 707–718 (2021). https://doi.org/10.1007/s12310-021-09435-9
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12310-021-09435-9