title: The impact of universal suicide-prevention programs on the help-seeking attitudes and behaviors of youths.
abstract: BACKGROUND
  While the ultimate goal of adolescent suicide-prevention efforts is to decrease the incidence of death by suicide, a critical intermediary goal is directing youths toward effective sources of assistance.
  
  
  OBJECTIVE
  To comprehensively review the universal prevention literature and examine the effects of universal prevention programs on student's attitudes and behaviors related to help-seeking.
  
  
  METHODS
  We systematically reviewed studies that assessed help-seeking outcomes including prevention efforts utilizing (1) psychoeducational curricula, (2) gatekeeper training, and (3) public service messaging directed at youths. Of the studies reviewed, 17 studies evaluated the help-seeking outcomes. These studies were identified through a range of sources (e.g., searching online databases, examining references of published articles on suicide prevention).
  
  
  RESULTS
  The results of this review suggest that suicide-prevention programming has a limited impact on help-seeking behavior. Although there was some evidence that suicide-prevention programs had a positive impact on students' help-seeking attitudes and behaviors, there was also evidence of no effects or iatrogenic effects. Sex and risk status were moderators of program effects on students help-seeking.
  
  
  CONCLUSIONS
  Caution is warranted when considering which suicidal prevention interventions best optimize the intended goals. The impact on adolescents' help-seeking behavior is a key concern for educators and mental-health professionals.
authors.affiliation: Department of Psychology and Psychiatry at the University of Minnesota, Minneapolis, MN 55455, USA. klimes@umn.edu
authors.forename: Bonnie
authors.initials: B
authors.lastname: Klimes-Dougan
authors.forename: David A
authors.initials: DA
authors.lastname: Klingbeil
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Meller
mesh_terms: D000293:Adolescent; D001293:Attitude to Death; D002423:Cause of Death; D003142:Communication; D003430:Cross-Sectional Studies; D006801:Humans; D010342:Patient Acceptance of Health Care; D010379:Peer Group; D012944:Social Support; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D000092864:Suicide Prevention