Multi-Tiered Suicide Prevention for Schools: A Framework with Evidence of Feasibility and Impact for Schools

Body of Abstract: CDC data has shown rising rates of school-aged youth hopelessness, suicide thoughts, and suicide attempts over the past decade. Historic school-based efforts to prevent suicide have centered on one-time trainings on the warning signs of suicide; yet have not shown strong evidence of impact. In 2021, the Education Development Center (EDC) developed an evidence-informed framework to help school systems implement a comprehensive approach to suicide prevention across grade levels: Multi-Tiered Suicide Prevention for Schools (MTSP). MTSP provides 6 key components for schools to implement across their multi-tiered systems of support (MTSS). The components include suicide prevention strategies that reach the entire school community such as student wellbeing and life skills development activities (tier 1 strategies in MTSS), the identification of students who are at increased risk of suicide (tier 2 strategies in MTSS), and the support of students who are exhibiting suicide warning signs or who are impacted by a suicide death (tier 3 strategies in MTSS). This workshop will seek to introduce participants to the MTSP framework and service; present pre-post environmental assessment data findings; and share qualitative data from school professionals on the feasibility of implementing MTSP across school districts. Additionally, this session will provide participants with information on how to learn more about the MTSP framework and access the freely available MTSP environmental assessment.

Research

Aims: EDC sought to create and evaluate a framework capable of supporting school districts across the United States in building sustainable, comprehensive approaches to suicide prevention. This session will introduce participants to the MTSP framework, the theory and evidence-base for the 6 key components of school suicide prevention, and insights from the MTSP pilot implemented over two school years (2022-2024) with 12 school districts in Northcentral Indiana. Evaluation findings will also be presented.

Method: EDC developed and launched an evidence-based MTSP environmental assessment guided by the Stages of Change Theory and wider school suicide prevention evidence-base, such as SAMHSA’s Suicide Prevention Toolkit. The 12 participating school districts participating in the MTSP pilot formed MTSP implementation teams made up of diverse school staff. The school teams collectively completed the assessment before and after implementation of the MTSP framework. This assessment measured school district readiness to implement 6 key components of school suicide prevention. Additionally, key informant interviews were conducted with school district representatives to assess their perspectives on the feasibility of implementing the MTSP framework within their school systems.

Results: Pre-post MTSP assessment data showed strong evidence of framework impact in creating the environmental change necessary for implementation and sustainment of comprehensive approaches to suicide prevention in participating school districts. Key informant interviews provided evidence of school district representative belief in the acceptability and feasibility of applying the MTSP framework within their systems.

Conclusions: MTSP provides a much-needed framework for school-based suicide prevention, enabling school districts across the US to invest in comprehensive, sustainable approaches to suicide prevention that incorporate suicide prevention efforts into their multi-tiered systems of support.

Through this workshop, session participants will learn about the MTSP framework, its initial impact, demonstrated feasibility, and ideas for strengthening school-based suicide prevention efforts. Participants will learn strategies for developing comprehensive, evidence-based suicide prevention within school systems and walk away with tools (the MTSP framework, environmental assessment, and associated resources) they can use to strengthen their existing suicide prevention efforts. Participants will receive guidance on how to access the full digital online assessment, along with additional MTSP resources and information, including 2 school district case studies from a large, urban school district and a small, rural school district who participated in the pilot implementation of MTSP.

Learning Objectives:

• List MTSP’s 6 evidence-based components of school suicide prevention
• Recite the demonstrated impact and feasibility of the MTSP framework in school suicide prevention
• Analyze their own school community readiness to implement one of MTSP’s 6 key components of school suicide prevention
• Identify at least 3 MTSP strategies or lessons learned that can strengthen their school suicide prevention efforts
• Describe how to access EDC’s MTSP assessment and resources