Suicide Prevention Public Service Announcements (PSAs) Targeting Adolescents: A Randomized Controlled Trial

Adolescent suicide is a major problem in most Western countries. One of the strategies that has received increasing support to combat youth suicide are media campaigns, particularly in the form of TV public service announcements (PSAs). However, studies evaluating the impact of PSAs are scarce. The aims of this project are to assess positive and negative effects (in terms of suicidal ideation, attitudes towards suicide, emotional well-being, and likelihood of help-seeking). The project will be conducted in Vienna, Austria, over three phases. In Phase 1, we will run a school project for high school students to develop suicide prevention PSAs. In Phase 2, we will conduct focus groups with the participating students to analyze their experiences with the development of the PSAs. In Phase 3, we will conduct an experiment of the best PSA, as assessed by an international jury. 288 16-19 year olds will be recruited from schools and randomly allocated to view either (a) the suicide prevention PSA or (b) a control PSA on an unrelated health issue with similar stylistic features. Before the start of the experiment, participants will complete a socio-demographic questionnaire and a series of measures to assess various aspects of psychological and emotional well-being (e.g., suicidal ideation), including a scale to assess current suicide risk in order to identify individuals at risk for suicidal behavior, who will be offered help. Immediately post-viewing, participants will complete questionnaires about the PSA itself, and about identification with the protagonists. They will also complete the questionnaires from before the viewing in order to investigate immediate effects of the PSA. Four weeks later, the participants will complete the outcome measures again, in order to analyze the sustainability of effects. We will also investigate if the effects vary with regard to identification or vulnerability of the participants. The project is important and innovative in that it uses PSAs that are produced by young people and therefore more likely to resonate with young people. Without this research, it is quite possible that ineffective or harmful PSAs could be rolled out. The project will yield material for prevention campaigns targeting adolescents in Austria and elsewhere, and will allow health organizations to better balance the risks and benefits involved in these campaigns. Thereby, the results from this project can contribute to combatting suicide and help save young lives.

Adolescent suicide is a major problem in most Western countries. One strategy to combat youth suicide are media campaigns, particularly in the form of prevention videos featuring personal stories of hope. Prevention messages are commonly assumed to be especially useful when tailored toward a specific population and the inclusion of individuals from the target group has been recommended, but related evaluations are scarce particularly for messages targeting young people. The aims of this project were to develop and investigate effects of one suicide prevention video messages developed by and for adolescents regarding several mental health-related outcomes, including suicidal ideation, help-seeking intentions, attitudes to suicide, and suicide stigma. Further, we aimed at capturing qualitative information on the participants' experiences during the development process of the videos. The current project was conducted in Vienna, Austria, over three phases. In phase 1, we ran a school project for high school students to develop suicide prevention videos. In total, seven videos were produced that featured adolescents engaging in various sorts of help-seeking. In phase 2, we conducted focus groups with the participating students to analyze their experiences with the development of the videos. All participants perceived the process as positive and mentioned several benefits, and also participants with lived experience of suicidal ideation perceived the project as enjoyable. In phase 3, we conducted a randomized controlled trial to test the effects of the video that received the best ratings by an international jury including prevention experts. A total of 299 14-19-year-olds were recruited and randomly allocated to view either (a) the suicide prevention video or (b) a control video on an unrelated health issue. Participants completed questionnaires on different mental health related outcomes before and immediately after watching the video, and again at four-week follow-up. The video was effective in reducing suicidal ideation. Help-seeking intentions increased significantly after watching the intervention video and a sustained reduction of favourable attitudes to suicide was reported. Effects on suicidal ideation were mediated by identification with the character. The more young people identified with the persons featured in the video, the greater were their benefits. In this study, the inclusion of individuals from the target population in the development of suicide prevention messages turned out to be key to tailor such messages specifically to adolescents. Participating adolescents benefitted from the production process, and young people watching these videos reacted with a decrease in suicidal thoughts and an increase in help-seeking intentions. The findings may encourage school staff, educators, and policy makers to include adolescents in the development of suicide prevention videos in a school setting. These results provide important new insight into suicide prevention approaches for adolescents that can contribute to combatting suicide and help save young lives.