Eleven studies (n=4,221) were included: 3 quasi-random controlled trials, 5 cohort studies, 1 retrospective matched cohort and 2 trials of Solomon Four Group Design.
Of the 3 studies examining changes in suicide risk, 2 showed a significantly greater reduction in suicide risk, specifically depression, anxiety and emotionality, than the control groups. There were no differences in suicide risk between counselled and control participants in the third study.
The reviewed studies demonstrated a relatively consistent, positive impact of programmes on knowledge related to suicide. Of the 8 studies that evaluated changes in knowledge, 6 found that knowledge increased.
Nine studies examined the effects of the suicide prevention programmes on students' attitudes relating towards disclosure of suicidal intention, seeking help from adults and professionals, and helping suicidal peers. Both beneficial and harmful effects of the programmes were found for these measures.
Four studies examined the effects of the suicide prevention programmes on self-rated measures of coping. Results were inconsistent, with 2 studies showing a significant positive change in coping skills, 1 showing no significant difference between intervention and control groups, and another showing a reduction in maladaptive coping in girls but an increase in boys.
Three studies included measures of hopelessness. Two studies showed no significant differences between intervention and control groups, the third study demonstrated a decrease in hopelessness for girls but an increase for boys.
One study evaluated empathy. An increase in empathy was demonstrated for girls undergoing a suicide prevention programme, but not for boys.