University suicide prevention programs and initiatives – which way to choose?

Suicides among university students are quite common and typical for many countries of the world, including Russia. According to many sources, undergraduate and post-graduate students are characterized by a high risk of suicidal behavior, which is associated with a high stress load and difficulties in adapting to a new stage of life, new challenges, higher level of responsibility. In this respect, students may be seen as a specific group, although sometimes there are analogies with suicides in the school environment, especially in the first years of higher education. At the same time, prevention programs and strategies implemented in higher education institutions are not so detailed and are less represented in the scientific literature. Methodology. Scientific publications for this narrative review were searched using various Russian-language and international resources (Cyberleninka, eLibrary, PubMed). Results. While foreign sources discuss mainly the effectiveness of evidence-based programs and strategies (awareness raising, trainings for gatekeepers and decision-makers, psychotherapeutic techniques), while domestic literature mostly presents various internal university initiatives that can be considered as examples of a “good practice”. Foreign meta-analyses note that standardized programs demonstrate effectiveness regarding intermediate results (knowledge enhancement, awareness of suicide and mental health issues) as well in reducing depressive symptoms, anxiety, deviant behaviours and other psychological risk factors, but there is no convincing evidence that this leads to a decrease in the prevalence of suicides or suicide attempts among students. Existing programs and initiatives in the Russian universities reflect a general understanding of the different levels of prevention (primary, secondary, tertiary), but often with inconsistent “author’s interpretation” how to fill these prevention levels with specific actions. Russian universities also use practical technologies and programs that have been tested abroad, as well as independently developed organizational measures aimed at students themselves, psychological support services and university administration. Conclusions. Student suicides are much more numerous than adolescent suicides, but receive disproportionately little attention from researchers, practitioners and educational institutions administration. The implementation of various initiatives and practices within universities should take into account a need of balance between educational programs and information campaigns providing knowledge about the problem of suicide, and recommendations of positive actions aimed at improving the overall psychological well-being and adaptability of students. In our opinion, a comprehensive study of protective factors and antisuicidal barriers inherent to modern students is a promising area of research augmenting risk assessment, and potentially can lead to the development of more valid and comprehensive recommendations for university psychological services, as well as for university administrations.