Friday, January 14, 2005

Campus Suicide Prevention in the News

The Washington Post has an article about the problem of student suicides on college campuses.  The article focuses on campuses in the Washington D.C. area, but it seems applicable to pretty much any college.  It article mentions a resource that I had forgotten about: the US Air Force Suicide Prevention Program.  (links: summary, full (2Mb) PDF file)  This is one of the very few programs that has some evidence that it actually works.  Interestingly, they looked -- not only at factors that increase risk -- but also at factors that decrease risk:
— Social support and interconnectedness
— Individual coping skills
— Cultural norms that promote and protect responsible help-seeking behavior
The summary of the document poses the question:  Is the Air Force Program Transferable to Civilian Communities?  They speculate that it can; although what is not known, is whether the program could be demonstrated to be effective in other settings.  That is, the essential elements of the program could be adapted to a nonmilitary setting, such as a college campus.  But would it be possible to prove that it works?  This raises a number of interesting methodological questions, which I won't go into now.  Perhaps more important is the policy question:  If it cannot be proved effective, is it worth funding? 

Currently, the trend in government agencies is to demand proof in order for funding to continue.  At first glance, it seems hard to argue with that.  After all, funding is scarce, competing demands are great, and fiscal responsibility generally is a good thing.  But in life-or-death situations, is it wise to demand proof?  And what if a statistically analysis shows that, not only is there no proof, but that such proof will not be possible?  What if the methodological problems are too great to overcome.  Given the the number of variables, the low incidence of suicide on any given campus, and the variation from one campus to another, it is possible that there is no study design that would provide adequate statistical power to resolve the question. 

My suggestion, then, is this: if anyone plans to try to study this, do not set a reduction of the rate of suicide as the only goal of the program.  If you can demonstrate that the program has related benefits, that might be sufficient to ensure continued funding.  For example, if you can show that the program increases campus-community involvement, enhances individual coping skills, etc., those outcomes might be deemed worthy of continued funding.