Twelve-month service use, suicidality and mental health problems of European adolescents after a school-based screening for current suicidality

Michael Kaess, N. Schnyder, C. Michel, R. Brunner, V. Carli, M. Sarchiapone, C. W. Hoven, C. Wasserman, A. Apter, J. Balazs, J. Bobes, D. Cosman, C. Haring, J. P. Kahn, H. Keeley, A. Kereszteny, T. Podlogar, V. Postuvan, A. Varnik, F. ReschD. Wasserman

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Suicide is one of the leading causes of death in adolescents and help-seeking behaviour for suicidal behaviour is low. School-based screenings can identify adolescents at risk for suicidal behaviour and might have the potential to facilitate service use and reduce suicidal behaviour. The aim of this study was to assess associations of a two-stage school-based screening with service use and suicidality in adolescents (aged 15 ± 0.9 years) from 11 European countries after one year. Students participating in the ‘Saving and Empowering Young Lives in Europe’ (SEYLE) study completed a self-report questionnaire including items on suicidal behaviour. Those screening positive for current suicidality (first screening stage) were invited to an interview with a mental health professional (second stage) who referred them for treatment, if necessary. At 12-month follow-up, students completed the same self-report questionnaire including questions on service use within the past year. Of the N = 12,395 SEYLE participants, 516 (4.2%) screened positive for current suicidality and were invited to the interview. Of these, 362 completed the 12-month follow-up with 136 (37.6%) self-selecting to attend the interview (screening completers). The majority of both screening completers (81.9%) and non-completers (91.6%) had not received professional treatment within one year, with completers being slightly more likely to receive it (χ2(1) = 8.948, V = 0.157, p ≤ 0.01). Screening completion was associated with higher service use (OR 2.695, se 1.017, p ≤ 0.01) and lower suicidality at follow-up (OR 0.505, se 0.114, p ≤ 0.01) after controlling for potential confounders. This school-based screening offered limited evidence for the improvement of service use for suicidality. Similar future programmes might improve interview attendance rate and address adolescents’ barriers to care.

Original languageEnglish
Pages (from-to)229-238
Number of pages10
JournalEuropean Child and Adolescent Psychiatry
Issue number2
StatePublished - Feb 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020, The Author(s).


SEYLE Project Leader and Principal Investigator is Professor in Psychiatry and Suicidology Danuta Wasserman, National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP) at Karolinska Institutet (KI), Stockholm, Sweden. The Executive Committee comprises Professor Danuta Wasserman and Senior Lecturer Vladimir Carli, both from NASP, KI, Sweden; Professor Marco Sarchiapone from the University of Molise, Italy; Professor Christina W. Hoven, and Anthropologist Camilla Wasserman, both from the Department of Child and Adolescent Psychiatry, Columbia University and New York State Psychiatric Institute, New York, US; the SEYLE Consortium comprises sites in twelve European countries. Site leaders are Danuta Wasserman (NASP, Coordinating Centre), Christian Haring (Austria), Airi Varnik (Estonia), Jean-Pierre Kahn (France), Romuald Brunner (Germany), Judit Balazs (Hungary), Paul Corcoran (Ireland), Alan Apter (Israel), Marco Sarchiapone (Italy), Doina Cosman (Romania), Vita Postuvan (Slovenia) and Julio Bobes (Spain). Special thanks regarding this manuscript go to Katja Klug, Gloria Fischer and Lisa Gobelbecker from the University of Heidelberg, Germany, for their extensive help in the development and evaluation of the screening procedure during the SEYLE study, and to Miriam Strohmenger for the preliminary work done for her master thesis. Open access funding provided by University of Bern. The SEYLE project is supported by the European Union through the Seventh Framework Program (FP7), Grant agreement number HEALTH-F2-2009-223091. At the time of submission, N. S. was funded by the Swiss National Science Foundation (SNSF) Early Postdoc Mobility fellowship (Grant number: P2BEP3_181901).

FundersFunder number
Alan Apter (Israel), Marco Sarchiapone
Christian Haring
Columbia University and New York State Psychiatric Institute
Doina Cosman
Judit Balazs
National Centre for Suicide Research and Prevention of Mental Ill-Health
National Association of School Psychologists
Seventh Framework Programme223091
European Commission
Universität Heidelberg
Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen ForschungP2BEP3_181901
Karolinska Institutet
Seventh Framework ProgrammeHEALTH-F2-2009-223091
Università degli Studi del Molise


    • Adolescents
    • Help-seeking
    • SEYLE
    • Screening
    • Suicidal behaviour
    • Suicide


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