Enhancing adolescent suicide prevention through the implementation of trauma-informed care models in school-based mental health programs

Adolescent suicide presents a critical public health crisis, exacerbated by cumulative trauma exposure and insufficiently trauma-responsive mental health systems in schools. This study investigates the efficacy of trauma-informed care (TIC) models integrated into school-based mental health programs for reducing suicide risk among adolescents aged 12–18. Utilizing a quasi-experimental mixed-methods design, the research deployed a multi-tiered TIC framework across 20 public schools, involving 600 participants stratified by gender and adverse childhood experiences (ACEs). Quantitative data were collected using the Columbia-Suicide Severity Rating Scale (C-SSRS) and ACE Questionnaire, while qualitative insights were gathered through semi-structured interviews analyzed using thematic analysis. Results demonstrated statistically significant reductions in suicidal ideation (mean difference = ?1.4, Cohen’s d = 0.85), psychological distress (mean difference = ?2.1, d = 0.78), and increased school engagement (mean difference = +1.5, d = 0.65) over a 16-week period. Subgroup analysis revealed greater responsiveness among female students and those with moderate ACE scores, while higher dropout and fidelity variability among certain cohorts exposed implementation limitations. The Generalized Linear Mixed Model (GLMM) confirmed the robustness of outcome predictions across clusters. The study concludes that TIC integration in educational settings yields multidimensional improvements in adolescent mental health and school functioning. Recommendations include gender-responsive program design, trauma-tiered intervention delivery, continuous fidelity monitoring, and policy-level integration through Multi-Tiered Systems of Support (MTSS). These findings support the systemic transformation of school environments into trauma-informed ecosystems that preemptively disrupt suicide trajectories and promote sustainable mental resilience. Keywords: Adolescent, Suicide Prevention, Trauma-Informed Care, School-Based, Mental Health Programs.