CHICAGO, DEC. 25 -- Teenage suicide prevention programs in schools may actually stir up depressed feelings rather than help youths who have tried to kill themselves, according to a new study.
Although there was little evidence that the programs reduced suicides and suicide attempts, "there was some evidence of unwanted effects," researchers wrote in the study, published in Wednesday's Journal of the American Medical Association.
"There is a clear need to evaluate such programs to determine their efficacy and safety," the researchers wrote.
David Shaffer, director of the division of child and adolescent psychiatry at Columbia University College of Physicians and Surgeons in New York, and colleagues studied the impact of prevention programs on the attitudes of pupils in the ninth and 10th grades who said they had tried to commit suicide.
They found that those teenagers continued to believe suicide was a possible solution to their problems and that they would be less likely to seek help or discuss their feelings with peers who have not tried to kill themselves.
Suicide is the third leading cause of death among people 15 to 24 years old.
A psychiatrist not connected with the study said the results are not surprising and add support to theories that teenagers have a romantic view of suicide.
The study evaluated the impact of school-based suicide prevention programs on 973 teenagers, 63 of whom said on two occasions that they had tried to kill themselves.
The students were divided into two groups, with 524 participating in prevention programs, including 35 suicide attempters. The 449 others -- 28 of whom had tried to take their lives -- did not participate in the programs.
The programs, some lasting as long as three hours, were intended to raise awareness of teenage suicides by describing the warning signs of young people at risk and recommending counseling.
Participants were surveyed about their attitudes toward suicide before and after the programs.
"Attempters exposed to programs were significantly less likely to recommend that the programs be presented to other students and significantly more likely to indicate that talking about suicide makes some kids more likely to try to kill themselves," the study said.
Of the teenagers who had tried to kill themselves, 26.7 percent thought the programs increase the chances that youths will attempt suicide.
Only 11.5 percent of those who hadn't attempted suicide thought the programs might increase suicide attempts.
Researchers also concluded that the attitudes of suicide attempters who did not participate in the programs were not significantly more negative than those who did.
"I'm not surprised by these results," said Jan Fawcett, chairman of the Department of Psychiatry at Rush Presbyterian-St. Luke's Hospital in Chicago and an authority on suicides.
"You can't just get kids not to commit suicide by just educating them about the problem and telling them where to get help," Fawcett said. "It's not an intellectual exercise. There's more to it than that."
Fawcett said prevention programs should treat suicide like an illness, such as depression or stress, which can be cured with the help of friends and family.
The programs must be careful not to focus too heavily on suicide and instead concentrate on the factors that often lead to it, he said.
"The problem is de-romanticizing suicide," Fawcett said. "Kids are very suggestible. They see reports about suicide on television and may begin to see suicide as a way to end their troubles or make their parents feel bad. They may not have a concept of death as a final consequence."