Signs of Suicide

How to access the program/practice?

Visit the Mind Wise Innovations website to learn more about pricing for licenses, trainings, and materials.

What is the practice? 

Signs of Suicide (SOS) is an evidence-based youth suicide prevention program that is designed to teach youth how to identify the signs of depression and suicide in themselves and their peers. It also provides materials that train school professionals, parents, and communities to recognize students who may be at risk and take appropriate action. The program has been recently enhanced and now offers practical advice on coping skills, spotlights the role of social media, and includes stories of hope and recovery. 

Who is the practice for? 

The program is intended for middle and high school students in grades 6 through 12. 

What outcomes does the practice produce? 

• Increased knowledge and adaptive attitudes about depression and suicide 
• Improvement in students seeking help for themselves or a friend 
• Decreased suicidal ideation in middle school students and suicide attempts in high school students 
• Decreased behavioral health stigma among students 

What is the evidence? 

Schilling, Elizabeth A., Robert H. Asteline Jr, and Amy James. (2016). “The SOS Suicide Prevention Program: Further Evidence of Efficacy and Effectiveness.” Prevention Science. 17(2): 157-166. https://pubmed.ncbi.nlm.nih.gov/26314868/  

The study sought to replicate results of prior studies on SOS and to further assess the program’s efficacy and effectiveness. More than 1,000 ninth-grade students were randomly divided into a treatment group who received the SOS student training and a control group who did not participate in suicide prevention education. Both groups of students completed a pre- and post-test survey 3 months after the treatment group participated in SOS. The results showed that students who received SOS were approximately 64% less likely to report a suicide attempt in the three months after the training compared with students who hadn’t been through the SOS program. 

Asteline, Robert H. Jr, Amy James, Elizabeth A. Schilling, and Jaime Glanovsky. (2007) “Evaluating the SOS suicide prevention program: a replication and extension.” BMC Public Health. 7:161. https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-7-161  

This study was an extension of the 2004 study and includes data from the second year of the trial in order to assess the short-term impact of the SOS program. The study demonstrated that youth who had received the SOS program were approximately 40% less likely to report a suicide attempt in the three months after the training compared to the control group. Exposure to the program’s curriculum resulted in great knowledge of depression and suicide and more adaptive attitudes toward these problems. 

Aseltine, Robert H. Jr, PhD and Robert DeMartino, MD. (2004). “An Outcome Evaluation of the SOS Suicide Prevention Program.” American Journal of Public Health. Vol 94, No 3, 446-51. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448274/  

This report examined the effectiveness of the Signs of Suicide (SOS) prevention program in reducing suicidal behavior. Students in 5 high schools in Columbus, GA, and Hartford, CN, were randomly assigned to intervention and control groups and self-administered questionnaires were completed by both groups approximately 3 months after program implementation. Results showed that the intervention group had significantly lower rates of suicide attempts, greater knowledge and more adaptive attitudes about depression and suicide. 

How is the practice implemented? 

There is no training or certification required to start using SOS in a school; however, there are virtual and in-person training workshops available for schools or organizations who seek additional support. Student training consists of a 20-minute educational video which shows how to identify signs and symptoms of depression and suicide and encouraging help-seeking behavior through the ACT™ techniques; Acknowledge signs of suicide in a friend, show your friend that you Care, Tell a trusted adult. After the video, students complete the Brief Screen for Adolescent Depression (BSAD) which can be completed anonymously as a tool to educate students and encourage help-seeking or with students identifying themselves, which helps staff in recognizing students who may require follow-up. All students complete a response slip at the end of the program indicating whether they would like to speak with someone about themselves or a friend. 

Who can implement the practice? 

SOS facilitators include school counselors, social workers, psychologists, and classroom teachers. 

What are the costs and commitments associated with becoming trained in this practice? 

Please contact the program for the most recent costs and commitments, as these may change. 

Both the high school and middle school programs, which each consists of 1 license per building, are each $300.00 – $495.00. The virtual training, 360 Guide to SOS is $199.00. The MindWise Mental Health Screening Platform behavioral health subscription is between $1,500.00 to $2,000.00. 

What resources are useful for understanding or implementing the practice? 

• Website: https://www.mindwise.org/suicide-prevention/  

Rating: Promising 

Secondary components: Positive Youth Development, Grief and Trauma Informed Practices