Key Determinants of School-Based Suicide Prevention: Barriers and Facilitators to Implementation

Abstract Research has focused on evaluating programs and practices used for school suicide prevention, yet the implementation and coordination processes for these programs and practices are relatively unexplored. Across school settings, activities included in suicide prevention initiatives are highly variable and evaluations of program effectiveness often produce mixed results. Furthermore, little is known regarding the barriers and facilitators to effective implementation faced by school staff and teams when coordinating school-wide suicide prevention. To address this gap, the current qualitative study presents findings from formative interviews conducted with school staff in charge of suicide prevention efforts from 10 high schools located in a western state of the U.S. Rapid assessment procedures (RAP) were used to identify barrier and facilitator themes by the five domains of Consolidated Framework for Implementation Research (CFIR). School teams reported suicide prevention successes occurring in the areas of staff and student programming, student self-regulation strategies, mental health provider and community organization collaboration, and student data collection. Results also indicated that school teams encountered frequent implementation barriers spanning across all five domains of the CFIR. The study findings highlight key suicide prevention implementation challenges while also providing scalable implementation facilitators for school staff conducting and coordinating suicide prevention activities.