The purpose of this study was to investigate the impact of the SOS suicide prevention program on help-seeking, attitudes toward depression and suicide, and suicidal behavior among high school students. Current research protocol has extended this evaluation to the Middle School version of SOS.

Three cohorts have participated in outcome evaluations of the SOS suicide prevention program to assess its effects on help-seeking, attitudes toward depression and suicide, and suicidal behavior. The first two cohorts consisted of 25 public state high schools in Massachusetts, Georgia, and Connecticut. The third cohort consisted of 9 middle schools and 10 high schools from outside of Connecticut with high proportions of military dependants.

Hypotheses:

H1: Exposure to the SOS program will be significantly associated with lower rates of suicidal ideation and suicide attempts; greater levels of help-seeking; greater knowledge of and more adaptive attitudes toward depression and suicide; and increased communication with and perceived support from peers.

H2: The reduction in suicide attempts among youths exposed to the program can be explained by increases in knowledge about depression and suicide, more favorable attitudes regarding suicide, and improved communication with and support from peers.

Methods

1. The intervention: The SOS program was presented to students in 2 consecutive classes over a 2 day period, typically in health or social studies classes. The SOS program's teaching materials include a video and a discussion guide. The video includes dramatizations depicting the signs of suicidality and depression, recommended ways to react to someone who is depressed and suicidal, as well as interviews with real people whose lives have been touched by suicide. Students are also asked to complete the Brief Screen for Adolescent Depression (BSAD), a brief screening instrument for depression that is derived from the Diagnostic Interview Schedule for Children IV (Lucas et al., 2001).
2. The sample: The first cohort involved approximately 4000 students in 9 high schools in Columbus Georgia, Hartford Connecticut, and western Massachusetts over a two-year period. The second cohort consisted ove an additional 1100 students were recruited from 16 Technical High Schools in Connecticut. A third cohort consisted of over 600 students from 9 middle schools and 10 high schools from outside of Connecticut with high proportions of military dependants.
3. The research design: The experimental design for the evaluation was a randomized control group design with posttest only data collection. At the beginning of each school year approximately half of the classes of teachers presenting the program were randomly assigned to the treatment group, which received the SOS Prevention Program in the fall/winter of that year; the other half were assigned to the control group, which did not receive the program until the evaluation is completed.

To ascertain the effect of the program on participants' knowledge of and attitudes toward suicide and help seeking behavior, students in both the treatment and control groups were asked to complete a short questionnaire 3 months following implementation of the program. Questionnaires were anonymous. After the outcome evaluation was completed, the group of students who did not receive the program earlier in the school year received the complete SOS Program.

Inclusion Criteria:

1. Attendance at school participating in study
2. English speaking youth with parental consent.

Exclusion Criteria:

1.Youth who do not speak and read English