Addressing Suicide Prevention through Universal Childhood Intervention: Results from the Seattle Social Development Project Intervention

Current youth suicide prevention programming tends to focus on identifying and treating individuals who are already suicidal or at high risk through selective or indicated intervention. However, the 2012 National Strategy for Suicide Prevention (NSSP) recommended an expansion of the suicide prevention paradigm by promoting the general health of broad populations to reduce the risk for suicidal behaviors and related problems such as substance abuse and depression. In a parallel body of evidence, recent studies provide examples of long-term effects of social-developmental childhood intervention 20+ years later into adulthood (Hawkins, et al., 2008; Kellam, et al. ,2008; Olds, et al., 2014; Patterson, et al. 2010; Sandler, et al., 2011).  The present study examines the question: Can universal childhood preventive intervention reduce suicide ideation, behaviors and related mental health risks in adulthood?  A nonrandomized controlled trial followed participants to age 39, 27 years after the intervention ended. Three intervention conditions are compared: a full-intervention group, assigned to intervention in grades 1 through 6; a late intervention group, assigned to intervention in grades 5 and 6 only; and a no-treatment control group. Eighteen public elementary schools serving diverse neighborhoods including high-crime neighborhoods of Seattle are the setting of the intervention. Six hundred eight participants in three intervention conditions were interviewed from age 10 through 39. Interventions included teacher training in classroom instruction and management, child social and emotional skill development, and parent workshops. Outcomes examined include DSM-IV symptoms of major depressive disorder, anxiety disorders, suicidal ideation and attempts.  Preliminary analyses at ages 24 and 27 show, compared to controls, the full intervention group had significantly lower generalized anxiety disorder symptoms and suicidal ideation, and marginally (p < .10) lower major depressive episode symptoms. Current analyses are underway to better understand how these effects unfold developmentally in longitudinal models, the role of possible mechanisms such as substance use, as well as to examine interactions of these intervention findings by gender and ethnicity. Findings are discussed in terms of the potential for including universal, developmentally-oriented childhood interventions within the range of approaches to youth suicide prevention.