Open Access Study protocol

Saving and Empowering Young Lives in Europe (SEYLE): a randomized controlled trial

Danuta Wasserman1*, Vladimir Carli113, Camilla Wasserman15, Alan Apter2, Judit Balazs3, Julia Bobes4, Renata Bracale13, Romuald Brunner5, Cendrine Bursztein-Lipsicas2, Paul Corcoran6, Doina Cosman7, Tony Durkee1, Dana Feldman2, Julia Gadoros3, Francis Guillemin8, Christian Haring10, Jean-Pierre Kahn9, Michael Kaess5, Helen Keeley6, Dragan Marusic11, Bogdan Nemes7, Vita Postuvan11, Stella Reiter-Theil12, Franz Resch5, Pilar Sáiz4, Marco Sarchiapone13, Merike Sisask14, Airi Varnik14 and Christina W Hoven15

Author Affiliations

1 National Swedish Prevention of Mental Ill-Health and Suicide (NASP), Karolinska Institutet, Stockholm, Sweden

2 Feinberg Child Study Center, Schneider Children's Medical Center, Tel Aviv University, Tel Aviv, Israel

3 Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary

4 Department of Psychiatry, School of Medicine, University of Oviedo; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM. Oviedo, Spain

5 Clinic of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany

6 National Suicide Research Foundation, Cork, Ireland

7 Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania

8 Centre d'Epidémiologie Clinique -Inserm-EC CIE6, CHU de NANCY, hôpital Marin, Université H. Poincaré, Nancy, France

9 Department of Psychiatry, Centre Hospitalo-Universitaire CHU de NANCY, Université H. Poincaré, Nancy, France

10 Research Division for Mental Health, University for Medical Information Technology (UMIT), Innsbruck, Austria

11 Mental Health Department, PINT, University of Primorska, Primorska, Slovenia

12 Department of Medical and Health Ethics, Medical Faculty, University Hospital Basel, Basel, Switzerland

13 Department of Health Sciences, University of Molise, Campobasso, Italy

14 Estonian-Swedish Mental Health & Suicidology Institute, Tallinn, Estonia

15 Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA

For all author emails, please log on.

BMC Public Health 2010, 10:192  doi:10.1186/1471-2458-10-192

Published: 13 April 2010

Abstract

Background

There have been only a few reports illustrating the moderate effectiveness of suicide-preventive interventions in reducing suicidal behavior, and, in most of those studies, the target populations were primarily adults, whereas few focused on adolescents. Essentially, there have been no randomized controlled studies comparing the efficacy, cost-effectiveness and cultural adaptability of suicide-prevention strategies in schools. There is also a lack of information on whether suicide-preventive interventions can, in addition to preventing suicide, reduce risk behaviors and promote healthier ones as well as improve young people's mental health.

The aim of the SEYLE project, which is funded by the European Union under the Seventh Framework Health Program, is to address these issues by collecting baseline and follow-up data on health and well-being among European adolescents and compiling an epidemiological database; testing, in a randomized controlled trial, three different suicide-preventive interventions; evaluating the outcome of each intervention in comparison with a control group from a multidisciplinary perspective; as well as recommending culturally adjusted models for promoting mental health and preventing suicidal behaviors.

Methods and design

The study comprises 11,000 adolescents emitted from randomized schools in 11 European countries: Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain, with Sweden serving as the scientific coordinating center. Each country performs three active interventions and one minimal intervention as a control group. The active interventions include gatekeeper training (QPR), awareness training on mental health promotion for adolescents, and screening for at-risk adolescents by health professionals. Structured questionnaires are utilized at baseline, 3- and 12-month follow-ups in order to assess changes.

Discussion

Although it has been reported that suicide-preventive interventions can be effective in decreasing suicidal behavior, well-documented and randomized studies are lacking. The effects of such interventions in terms of combating unhealthy lifestyles in young people, which often characterize suicidal individuals, have never been reported. We know that unhealthy and risk-taking behaviors are detrimental to individuals' current and future health. It is, therefore, crucial to test well-designed, longitudinal mental health-promoting and suicide-preventive interventions by evaluating the implications of such activities for reducing unhealthy and risk behaviors while concurrently promoting healthy ones.

Trial registration

The German Clinical Trials Register, DRKS00000214.