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  • Case Study: The Evidence Behind SOS

    SOS Signs of Suicide has demonstrated a reduction in suicide attempts by 64%.

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Home >The Evidence Behind SOS Signs of Suicide

Overview

Since the program’s inception, researchers have assessed the effectiveness of SOS Signs of Suicide by conducting several randomized controlled trials – an evaluation known as the “gold standard” of research studies.

Additional research has also been done to evaluate SOS for School Staff, a one-hour online professional development course that teaches K-12 staff how to identify and help students at-risk.

SOS for Middle School

Acceptability and Feasibility of a Brief Online Suicide Prevention Training for School Staff (2024)

This research study explored school staff’s experiences with SOS for School Staff, a 1-hour online suicide prevention course for K-12 school personnel. The course builds on SOS Signs of Suicide, a suicide prevention program for students in grades 6-12.

Following the staff training, most participants reported knowledge of signs of suicide, confidence to have a caring conversation with a student, and the ability to safely connect a student with the appropriate school staff person. In the open-ended responses, 92.1% of school staff provided positive feedback, demonstrating high levels of acceptability. Factors central to learning included interactive training structure, videos modeling student interactions, and the inclusion of the voices of youth with lived experience with suicide. These findings support the use of this interactive virtual suicide prevention training model to educate school staff in suicide prevention.

 

Sources: Mirick, R. G. (2025). Acceptability and Feasibility of a Brief Online Suicide Prevention Training for School Staff. Journal of Technology in Human Services, 1–15. https://doi.org/10.1080/15228835.2024.2447692
Read the Complete 2024 Study

Virtual SOS Signs of Suicide: Student Perspectives and Acceptability (2022)

Researchers sought to evaluate SOS Signs of Suicide’s adaptation to an online format due to the COVID-19 pandemic.
Results showed that although some students were not sure what they thought about virtual SOS, of those with an opinion, 73.9% thought it was as good or better than in-person and 85.1% said it should continue to be offered.
Additionally, the benefits of virtual SOS included broader access to students, a more comfortable learning environment, and an easier experience.

 

Source: Mirick, R. G., & McCauley, J. (2022). Virtual SOS Signs of Suicide: Student Perspectives and Acceptability. School Psychology Review, 1–8.
Read the Complete 2022 Study

Evaluating the SOS Signs of Suicide Program: Middle School Students at Risk and Staff Acceptability (2021)

Researchers evaluated the implementation of SOS with over 2,500 students at two U.S. middle schools and through a treatment evaluation survey completed by school implementation staff.

Staff gave generally positive evaluations of the SOS program. Staff ’s responses to open-ended questions provided helpful information to guide future program implementations. Major themes regarding SOS strengths emerged from staff responses, including (a) the identification of at-risk students who were in need of mental health support, (b) exposure to valuable psychoeducation on suicide warning signs and action steps to be taken if these are observed, (c) using common language with students, and (d) efficient and effective implementation procedures.
These findings advance practical knowledge for effectively implementing school-based suicide prevention programs and may guide school psychologists in advocating for and implementing such interventions.

 

Source: Clark, K. N., Strissel, D., Malecki, C. K., Ogg, J., Demaray, M. K., & Eldridge, M. A. (2022). Evaluating the Signs of Suicide Program: Middle School Students at Risk and Staff Acceptability. School Psychology Review, 51(3), 354–369. 
Read the Complete 2021 Study

The SOS Signs of Suicide Prevention Program Pilot Study: High School Implementation Recommendations (2020)

A pilot study of the SOS prevention program was implemented over three years with data collection across grades 9-12.
Results showed that psychoeducation based on the SOS prevention program was effective in enhancing students’ knowledge and awareness of depression and suicide, including learning how to seek help for themselves and their peers.
It also demonstrated that the program modifications based on recommendations from the previous pilot study years (one and two) were effective in maintaining students’ gains in the following years (two and three).

 

Source: Volungis, Adam M. (2022) “The Signs of Suicide (SOS) Prevention Program Pilot Study: High School Implementation Recommendations.” North American Journal of Psychology 22(3): 455-468
Read the Complete 2020 Study

Further Evidence of SOS Efficacy & Effectiveness (2016)

Researchers sought to replicate prior SOS studies, using 1,000 9th grade students to further assess the program. Students completed a pre-test survey, then took a post-test survey three months later.

The results showed that students who received SOS training were approximately 64% less likely to report engaging in a suicide attempt than the control group.

 

Source: Schilling, Elizabeth A., Robert H. Aseltine Jr, and Amy James. (2016). “The SOS Suicide Prevention Program: Further Evidence of Efficacy and Effectiveness.” Prevention Science. 17(2): 157-166.
Read the Complete 2016 Paper

SOS Shows Promise as a Middle School Suicide Prevention Program (2014)

Researchers worked with 400 6th-8th grade students from diverse populations and backgrounds, with students completing a pre-test survey, then taking a post-test survey three months later.

Results showed that students who reported suicidal ideation in the pre-test before receiving SOS training were 96% less likely to report engaging in suicidal behaviors after participating in the program, versus their peers who reported previous suicidal ideation and did not receive SOS.

“This indicates that SOS may, for some students with suicidal ideation, interrupt the progression from suicidal ideation to more active stages of contemplation, planning, and attempt.”

 

Source: Schilling, Elizabeth A., PhD, Martha Lawless, BA, Laurel Buchanan, MA, and Robert H. Aseltine Jr, PhD. (2014). “‘Signs of Suicide’ Shows Promise as a Middle School Suicide Prevention Program.” Suicide and Life-Threatening Behavior. 44(6): 653-67.
Read the Complete 2014 Paper

Evaluating the SOS Suicide Prevention Program (2004 & 2007)

Researchers measured the short-term impact of SOS using 4,000 high school students. Three months after half the group received SOS training, both groups completed a short questionnaire.

The group who received SOS reported 40% fewer suicide attempts, greater knowledge of depression and suicide, and more adaptive attitudes towards these issues. These findings were consistent in subsequent studies.

 

Sources: 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. Aseltine, 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.
Read the Complete 2004 Paper Read the Complete 2007 Paper

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