title: A Youth Suicide Prevention Plan for Canada: A Systematic Review of Reviews.
abstract: OBJECTIVE
  We conducted an expedited knowledge synthesis (EKS) to facilitate evidence-informed decision making concerning youth suicide prevention, specifically school-based strategies and nonschool-based interventions designed to prevent repeat attempts.
  
  
  METHODS
  Systematic review of review methods were applied. Inclusion criteria were as follows: systematic review or meta-analysis; prevention in youth 0 to 24 years; peer-reviewed English literature. Review quality was determined with AMSTAR (a measurement tool to assess systematic reviews). Nominal group methods quantified consensus on recommendations derived from the findings.
  
  
  RESULTS
  No included review addressing school-based prevention (n = 7) reported decreased suicide death rates based on randomized controlled trials (RCTs) or controlled cohort studies (CCSs), but reduced suicide attempts, suicidal ideation, and proxy measures of suicide risk were reported (based on RCTs and CCSs). Included reviews addressing prevention of repeat suicide attempts (n = 14) found the following: emergency department transition programs may reduce suicide deaths, hospitalizations, and treatment nonadherence (based on RCTs and CCSs); training primary care providers in depression treatment may reduce repeated attempts (based on one RCT); antidepressants may increase short-term suicide risk in some patients (based on RCTs and meta-analyses); this increase is offset by overall population-based reductions in suicide associated with antidepressant treatment of youth depression (based on observational studies); and prevention with psychosocial interventions requires further evaluation. No review addressed sex or gender differences systematically, Aboriginal youth as a special population, harm, or cost-effectiveness. Consensus on 6 recommendations ranged from 73% to 100%.
  
  
  CONCLUSIONS
  Our EKS facilitates decision maker access to what is known about effective youth suicide prevention interventions. A national research-to-practice network that links researchers and decision makers is recommended to implement and evaluate promising interventions; to eliminate the use of ineffective or harmful interventions; and to clarify prevention intervention effects on death by suicide, suicide attempts, and suicidal ideation. Such a network could position Canada as a leader in youth suicide prevention.
authors.affiliation: Professor, McMaster University, Hamilton, Ontario.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Bennett
authors.affiliation: Research Scientist, St Michael's Hospital, Toronto, Ontario; Associate Professor, University of Toronto, Toronto, Ontario.
authors.forename: Anne E
authors.initials: AE
authors.lastname: Rhodes
authors.affiliation: Research Coordinator, McMaster University, Hamilton, Ontario.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Duda
authors.affiliation: Psychiatrist, Sunnybrook Health Sciences Centre, Toronto, Ontario; Associate Professor, University of Toronto, Toronto, Ontario.
authors.forename: Amy H
authors.initials: AH
authors.lastname: Cheung
authors.affiliation: Psychiatrist and Director, Anxiety Disorders, Hospital for Sick Children, Toronto, Ontario; Professor, University of Toronto, Toronto, Ontario.
authors.forename: Katharina
authors.initials: K
authors.lastname: Manassis
authors.affiliation: Chief of Psychiatry, London Health Sciences Centre, London, Ontario; Professor and Chair, Department of Psychiatry, The University of Western Ontario, London, Ontario.
authors.forename: Paul
authors.initials: P
authors.lastname: Links
authors.affiliation: Assistant Professor, Lakehead University and Northern Ontario School of Medicine, Thunder Bay, Ontario.
authors.forename: Christopher
authors.initials: C
authors.lastname: Mushquash
authors.affiliation: Psychiatrist, St Joseph's Care Group, Thunder Bay, Ontario; Assistant Professor, Northern Ontario School of Medicine, Thunder Bay, Ontario.
authors.forename: Peter
authors.initials: P
authors.lastname: Braunberger
authors.affiliation: Assistant Professor, University of Alberta, Edmonton, Alberta.
authors.forename: Amanda S
authors.initials: AS
authors.lastname: Newton
authors.affiliation: Professor, Dalhousie University, Halifax, Nova Scotia; Psychiatrist, IWK Health Centre, Halifax, Nova Scotia.
authors.forename: Stanley
authors.initials: S
authors.lastname: Kutcher
authors.affiliation: Investigator, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio; Associate Professor, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Bridge
authors.affiliation: Executive Director of Science and Policy, Healthy Child Manitoba Office, Government of Manitoba, Winnipeg, Manitoba; Assistant Professor, University of Manitoba, Winnipeg, Manitoba.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Santos
authors.affiliation: Clinical Psychologist, Researcher, and Executive Director, Provincial Centre of Excellence for Child and Youth Mental Health, Children's Hospital of Eastern Ontario, Ottawa, Ontario; Clinical Professor, University of Ottawa, Ottawa, Ontario.
authors.forename: Ian G
authors.initials: IG
authors.lastname: Manion
authors.affiliation: Assistant Professor, University of Calgary, Calgary, Alberta; Child Psychiatry Consultant, Alberta Health Services, Edmonton, Alberta.
authors.forename: John D
authors.initials: JD
authors.lastname: Mclennan
authors.affiliation: Psychiatrist, IWK Health Centre, Halifax, Nova Scotia; Associate Professor, Dalhousie University, Halifax, Nova Scotia.
authors.forename: Alexa
authors.initials: A
authors.lastname: Bagnell
authors.affiliation: Psychiatrist, McMaster Children's Hospital, Hamilton, Ontario; Professor, McMaster University, Hamilton, Ontario.
authors.forename: Ellen
authors.initials: E
authors.lastname: Lipman
authors.affiliation: Librarian and Research Coordinator, McMaster University, Hamilton, Ontario.
authors.forename: Maureen
authors.initials: M
authors.lastname: Rice
authors.affiliation: Chief, Child and Youth Mental Health Collaborative, Centre for Addiction and Mental Health, Hospital for Sick Children, and University of Toronto, Toronto, Ontario.
authors.forename: Peter
authors.initials: P
authors.lastname: Szatmari
mesh_terms: D000293:Adolescent; D002170:Canada; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration* / Q000592:standards; D012572:School Health Services / Q000458:organization & administration* / Q000592:standards; D013405:Suicide / Q000706:statistics & numerical data*; D000092864:Suicide Prevention