A school-based collaboration model to detect and prevent suicidal thoughts among adolescents
| ISRCTN | ISRCTN22260242 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN22260242 |
| ClinicalTrials.gov (NCT) | Nil known |
| Clinical Trials Information System (CTIS) | Nil known |
| Protocol serial number | Nil known |
| Sponsor | Region Västra Götaland |
| Funder | Forskningsrådet för hälsa, arbetsliv och välfärd |
- Submission date
- 10/11/2025
- Registration date
- 18/12/2025
- Last edited
- 18/12/2025
- Recruitment status
- Not yet recruiting
- Overall study status
- Ongoing
- Condition category
- Mental and Behavioural Disorders
Plain English summary of protocol
Background and study aims
Suicide is one of the leading causes of death among young people, both in Sweden and internationally. Many teenagers struggle with mental health problems, but schools often do not have structured ways to identify those who may be at risk. Different parts of the support system, schools, student health services, primary care and specialist mental health services, tend to work separately. This means that some young people who need help are never noticed in time.
This study aims to test whether a more systematic approach can help identify young people with suicidal thoughts earlier and offer them appropriate support sooner. The study examines whether mental health screening in schools, combined with clear routines for collaboration between schools, student health services and primary healthcare, can improve the detection of suicide risk and lead to timelier and more effective help.
The goal is to develop a model that is practical for everyday school settings and can be scaled nationally if shown to be effective.
Who can participate?
The study involves pupils in participating schools. All pupils in selected classes will be invited to complete a mental health questionnaire. The screening includes questions about mood, wellbeing and suicidal thoughts.
Young people who show signs of higher suicide risk based on the questionnaire will be invited to take part in a follow-up conversation with a psychologist. Participation is voluntary, and pupils can choose to take part in the screening, the follow-up, or neither. There are no restrictions related to sex, ethnicity or health status.
What does the study involve?
The study compares two types of school environments:
1. Schools that use a systematic mental health screening, followed by structured routines for collaboration between student health services, and primary care when adolescents show signs of suicide risk.
2. Schools that continue with their usual routines, where student health service identify and support pupils based on the methods they normally use.
Students in both types of schools complete a digital questionnaire called the Children’s Depression Inventory (CDI), which assesses mood and thoughts related to depression and suicide. Adolescents who show signs of increased suicide risk will be contacted by student health staff and offered a follow-up conversation with a psychologist as part of the study procedures.
The researchers will:
1. Compare how many adolescents with suicidal thoughts are identified in intervention compared to control schools.
2. Follow changes in mental health over time at 6, 12 and 18 months.
3. Talk with students, parents, teachers and school staff about their experiences and how well the approach works in practice.
4. Assess whether this model of screening and collaboration is feasible, helpful and potentially cost-effective.
What are the possible benefits and risks of participating?
Young people with suicidal thoughts or other signs of mental health problems may be identified earlier. Pupils who need support may receive timely access to psychological help. Schools may gain a clearer structure for how to respond when a student is in distress. By taking part, pupils contribute to research that could improve suicide prevention in schools across Sweden.
Answering questions about mood and suicidal thoughts may be emotionally uncomfortable for some pupils. Talking about these issues can temporarily increase worry or sadness for some individuals. To reduce risks, a psychologist or the student health service will follow up promptly with any student who shows signs of suicide risk. All conversations are voluntary, confidential and designed to ensure safety and support.
Where is the study run from?
The study is run by Västra Götalandsregionen in collaboration with participating schools. It is led from Regionhälsan, FoUUI primär och nära vård and includes collaboration with researchers at the University of Gothenburg and international experts in suicide prevention.
When is the study starting and how long will it run?
January 2026 to June 2029
Who is funding the study?
The study is funded by Forte through the call “Psykisk ohälsa och suicidprevention 2025”. The funding covers costs related to screening, staff training, follow-up conversations, data collection, analysis and communication of results.
Who is the main contact?
Dr Carl Wikberg, carl.wikberg@allmed.gu.se
Contact information
Public, Scientific, Principal investigator
Guldhedsgatan 5 a
413 20
Göteborg
Göteborg
413 20
Sweden
 ORCID ID |
0000-0002-6494-5922 |
|---|---|
| Phone | +46 (0)703821660 |
| carl.wikberg@allmed.gu.se |
Study information
| Primary study design | Interventional |
|---|---|
| Study design | Multicenter interventional - longitudinal case-control study |
| Secondary study design | Non randomised study |
| Scientific title | Systematic screening to detect and prevent suicide in adolescents in school settings - the SPARK study (Suicidal Prevention And Resilience in Kids) |
| Study acronym | SPARK |
| Study objectives | This study aims to develop and evaluate a sustainable, collaborative model for suicide prevention among adolescents in Swedish schools. |
| Ethics approval(s) |
Not yet submitted |
| Health condition(s) or problem(s) studied | Prevention of suicidal ideation and suicide in adolescents |
| Intervention | A collaboration model between student health service at each participating school, and a primary care centre in close proximity. The model includes a screening part with Children Depression Inventory (CDI) were adolescents who score 1 or 2 on item 9 (suicidal thoughts) will be contacted by a primary care psychologist the same day (if 2 on CDI item 9) or in close proximity to the screening (if 1 on CDI item 9). The study compares two types of school environments: 1. Schools that use a systematic mental health screening, followed by structured routines for collaboration between student health services, and primary care when adolescents show signs of suicide risk. 2. Schools that continue with their usual routines, where student health service identify and support pupils based on the methods they normally use. Students in both types of schools complete a digital questionnaire called the Children’s Depression Inventory (CDI), which assesses mood and thoughts related to depression and suicide. Adolescents who show signs of increased suicide risk will be contacted by student health staff and offered a follow-up conversation with a psychologist as part of the study procedures. The researchers will: 1. Compare how many adolescents with suicidal thoughts are identified in intervention compared to control schools. 2. Follow changes in mental health over time at 6, 12 and 18 months. 3. Talk with students, parents, teachers and school staff about their experiences and how well the approach works in practice. 4. Assess whether this model of screening and collaboration is feasible, helpful and potentially cost-effective. |
| Intervention type | Other |
| Primary outcome measure(s) |
Number of adolescents identified with suicidal thoughts at schools who conduct the screening and assessment model measured using CDI and assessment records compared to control schools where no screening or assessment model is used between 2026-2029 |
| Key secondary outcome measure(s) |
Qualitative aspects of this collaboration model measured using interviews and focus group discussions with adolescents and their guardians (separately) after completion of follow ups |
| Completion date | 30/06/2030 |
Eligibility
| Participant type(s) | Population, Other |
|---|---|
| Age group | Child |
| Lower age limit | 13 Years |
| Upper age limit | 16 Years |
| Sex | All |
| Target sample size at registration | 90 |
| Key inclusion criteria | Adolescents and their guardians at participating schools who: 1. Score 1 or 2 on item 9 in the CDI screening or who has been identified with: 1. Suicidal ideations through the collaboration model with the psychological assessment in primary care. 2. Been identified through the student health service 3. Said YES to participate in the study, after oral and written consent |
| Key exclusion criteria | 1. Want to withdraw from the study |
| Date of first enrolment | 01/01/2026 |
| Date of final enrolment | 31/12/2029 |
Locations
Countries of recruitment
- Sweden
Study participating centres
Tjörn
471 50
Sweden
Tjörn
471 70
Sweden
Results and Publications
| Individual participant data (IPD) Intention to share | No |
|---|---|
| IPD sharing plan summary | Not expected to be made available |
| IPD sharing plan |
Editorial Notes
11/11/2025: Study's existence confirmed by the Swedish Research Council for Health, Working Life and Welfare.
