Prevention Interventions for Suicidal Ideations and Attempts Among Adolescents: A Systematic Review of Experimental and Quasi-Experimental Studies, 2015-2025.

BACKGROUND

Suicidal ideation and suicide attempts among adolescents are major global public health concerns. Prevention approaches vary in target population, intensity, setting, and professional delivery, making cross-context interpretation difficult.

OBJECTIVE

To synthesize and critically appraise experimental and quasi-experimental evidence on interventions targeting suicidal ideation, suicide attempts, and related risk factors among adolescents.

METHODS

This PRISMA 2020 review searched PubMed, Scopus, CINAHL, PsycINFO, and Web of Science for peer-reviewed English-language studies published during 2015-2025. JBI tools assessed methodological quality; RoB 2.0 and ROBINS-I assessed risk of bias. The review was registered retrospectively in PROSPERO on January 8, 2026 (CRD420261281127), after the literature search was completed on October 31, 2025.

RESULTS

Twenty-three studies (19 randomized and 4 quasi-experimental; reported sample sizes totaling 2952 participants) were included. The most consistent beneficial patterns for direct suicide-related outcomes were observed in structured, multi-session CBT- and DBT-informed interventions for high-risk adolescents, while family-based interventions showed generally favorable but less extensive evidence. Findings for universal, selective, brief, digital, media-based, and culturally adapted approaches were more heterogeneous or preliminary. Improvements in secondary outcomes such as help-seeking, emotional symptoms, and service linkage were not interpreted as equivalent to reductions in suicidal ideation or attempts. Delivery involved school psychologists, psychiatric nurses, social workers, counselors, psychiatrists, psychologists, therapists, and interdisciplinary clinical teams across school, outpatient, emergency, and inpatient settings.

CONCLUSION

Adolescent suicide prevention should be interpreted according to prevention level, clinical risk, intervention intensity, setting, and service context. Coordinated school and healthcare pathways may support risk-matched care, but heterogeneity in interventions, outcomes, follow-up, and study quality limits firm comparative conclusions.