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Influence of coping strategies on the efficacy of YAM (Youth Aware of Mental Health): a universal school-based suicide preventive program

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Abstract

The school-based mental health promotion and suicide prevention universal program Youth Aware of Mental Health (YAM) significantly reduces incident suicide attempts and severe suicidal ideation. This paper aims at elucidating psychological mechanisms underlying YAM’s efficacy. Our hypothesis is that YAM operates through interactions with coping strategies (CS) on the reduction of suicidal ideation (SI). In the Saving and Empowering Young Lives in Europe (SEYLE) study, five coping strategies were assessed at baseline (T0) and 12-month follow-up (T12): “learning”, “help-seeking”, “arts”, “sports” and “fight”. We analyzed interactions between the YAM intervention, coping strategies and SI in the YAM group (N = 1693) and the minimal intervention group (N = 1909), after excluding prevalent cases with SI and previous suicide attempts from our total sample (N = 5654). General Linear Mixed Model regressions were performed. The present study confirms that coping strategies play an influential role on suicidal ideation. Our results showed that YAM acts whatever the prevailing coping strategies used. It is particularly efficient for pupils insufficiently using adaptive coping strategies such as LEARN and HELP-SEEKING or using maladaptive coping strategies, such as ARTS and FIGHT. The socialization induced by the YAM intervention seems to be a strong component of its efficiency.

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Acknowledgements

The SEYLE project is supported through Coordination Theme 1 (Health) of the European Union Seventh Framework Program (FP7), Grant agreement HEALTH-F2-2009-22309. 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 Institute (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; Deputy Director Vladimir Carli, National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden; Professor Christina W. 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 Institute, Sweden, Coordinating Centre), Christian Haring (University for Medical Information Technology, Austria), Airi Varnik (Estonian Swedish Mental Health & Suicidology Institute, Estonia), Jean-Pierre Kahn (Université de Lorraine, 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). Support for “Ethical Issues in Research with Minors and other Vulnerable Groups” was obtained by a grant from the Botnar Foundation, Basel, for Professor of Ethics, Dr. Stella Reiter-Theil, Psychiatric Clinic at Basel University, who served as the independent ethical consultant to the SEYLE project.

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Authors and Affiliations

  1. Université de Lorraine, Nancy, France

    Jean-Pierre Kahn, Renaud F. Cohen & Francis Guillemin

  2. Centre Hospitalier Régional Universitaire de Nancy, Nancy, France

    Jean-Pierre Kahn & Francis Guillemin

  3. Department of Psychiatry and Clinical Psychology, Pôle de Psychiatrie Et Psychologie Clinique, Unité 6, Centre Psychothérapique de Nancy, 1, rue du Dr Archambault, 54520, Nancy, Laxou, France

    Jean-Pierre Kahn, Renaud F. Cohen & Alexandra Tubiana

  4. Fondation Santé Des Etudiants de France, Paris, France

    Jean-Pierre Kahn

  5. Inserm, CIC-1433 Epidémiologie Clinique, CHRU de Nancy, Nancy, France

    Karine Legrand & Francis Guillemin

  6. Université de Lorraine, Université Paris Descartes, EA 4360 APEMAC, Vandoeuvre-lès-Nancy, France

    Karine Legrand & Francis Guillemin

  7. National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden

    Camilla Wasserman, Vladimir Carli & Danuta Wasserman

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

    Camilla Wasserman & Christina W. Hoven

  9. Feinberg Child Study Centre, Schneider Children’s Medical Centre, Tel Aviv University, Tel Aviv, Israel

    Alan Apter & Shira Barzilai

  10. Institute of Psychology, Eötvös Loránd University, Budapest, Hungary

    Judit Balazs & Gergley Mészàros

  11. Bjørknes University College, Oslo, Norway

    Judit Balazs

  12. Department for Psychiatry and Psychotherapy B, Tirol Kliniken, State Hospital Hall in Tyrol, Innsbrück, Austria

    Raphaele Banzer & Christian Haring

  13. Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy

    Francesca Baralla & Marco Sarchiapone

  14. Department of Psychiatry, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain

    Julio Bobes & Pilar Saiz

  15. Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany

    Romuald Brunner & Michael Kaess

  16. National Suicide Research Foundation, Cork, Ireland

    Paul Corcoran & Elaine McMahon

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

    Doina Cosman

  18. University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland

    Michael Kaess

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

    Urša Mars Bitenc & Vita Postuvan

  20. Doctoral School of Semmelweis University, Budapest, Hungary

    Gergley Mészàros

  21. Estonian-Swedish Mental Health and Suicidology Institute, Tallinn, Estonia

    Airi Varnik & Peeter Varnik

  22. Ctr. Behav. and Hlth. Sci, Tallinn University, Tallinn, Estonia

    Airi Varnik & Peeter Varnik

  23. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA

    Christina W. Hoven

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Kahn, JP., Cohen, R.F., Tubiana, A. et al. Influence of coping strategies on the efficacy of YAM (Youth Aware of Mental Health): a universal school-based suicide preventive program. Eur Child Adolesc Psychiatry 29, 1671–1681 (2020). https://doi.org/10.1007/s00787-020-01476-w

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