Supporting educational and youth organisations to deliver self-harm and suicide prevention and postvention: a mixed methods study and co-produced guidance (the 4S study)
Research Team: Judi Kidger, Lucy Biddle, Abby Russell, Emily Widnall, Rowan Davis, Liam Spencer and Hannah Robinson
Who's involved: University of Bristol, University of Exeter, PHRESH
March 2023 – January 2026
This project will investigate how well self-harm and suicide prevention and postvention for young people is working in practice. The findings will be used to create principles of practice, which will be useful for public health professionals seeking to support schools, colleges and other youth organisations in the prevention of self-harm and suicide, or following a death by suicide.
We will listen to young people with lived experience of self-harm and/or suicide, adults who work with young people, and adults who support education and other youth organisations. We will ask how well self-harm and suicide prevention for young people is working and how it could be improved. We will use what they tell us to create guidance for schools and other youth settings, to improve the support that young people receive.
In 2022 in the UK, 197 young people aged 10–19 in England and Wales died by suicide. The suicide of one young person is a tragic event that affects the entire community. When a number of people in a community take their own lives over a short time period, it is called ‘clustering’ or ‘contagion’. Policymakers, teachers and researchers have all called for more information on how to provide the best support to a community where a suicide has happened, to prevent clustering. We do not currently have good evidence about how to do this well and although some guidance exists, schools and other organisations do not always know where to find this.
The relationship between suicide and self-harm is complicated. Not all self-harm is an attempt to end one’s life, but people who self-harm are at higher risk of taking their own lives. Self-harm is a relatively common behaviour among young people. One study showed that one in five 17-year-olds have self-harmed at least once. It is important that schools and other organisations that work with young people know how to support those who are at risk of self-harm and suicide.
In this research project, we will work in partnership with young people, parents, people from organisations that work with young people such as schools and sports clubs, and people who support those organisations. We want to find out what support is available for organisations following a death by suicide. This sort of support is called ‘postvention’. We also want to find out how best to talk with young people about self-harm and suicide to try to stop it happening (‘prevention’).
Phase 1 (March 2023 – Present)
Aims:
• review the guidance that exists already about prevention and postvention;
• survey schools and other organisations to ask them what they currently do to prevent self-harm and suicide;
• look for data that already exists from other studies about how young people talk about self-harm;
• work with our public and practice partners to plan a second phase of the work.
Phase 2 (June 2024 – January 2026)
Aim: To strengthen the support provided to education and other youth organisations regarding the management of self-harm and suicide risk in young people and response to a death by suicide.
In this second phase, we will ask young people and adults from relevant organisations about the support that exists and to discuss existing guidance. We will focus on four geographical locations to recruit our participants. These areas have been chosen because they reflect inequalities in self-harm/suicide risk or in access to support. After this, we will work with professionals and public partners to create principles of practice for schools, other youth organisations, and organisations that provide support, such as those who work within local authorities’ suicide prevention teams. The principles will cover how to talk about self-harm with young people, how to identify and respond to self-harm and suicidal behaviour, and how to support organisations that have experienced a death by suicide.
The project benefits from the comments and guidance of academic, practice and public stakeholders. Additionally, two public advisory groups are involved in the project: young people with lived experience of self-harm and/or suicide and professionals who work with young people in self-harm and/or suicide prevention and postvention. These groups have contributed to the phase 1 review of guidance, the planning of phase 2, and the development of topic guides and recruitment material for the interviews and focus groups in phase 2.
We will share our findings with policymakers, public health and education professionals, other organisations working with young people, young people and their parents, and other researchers. We will work with our public partners and public advisory groups to ensure that our findings are presented in a way that is clear, appealing and useful to these different groups. This is anticipated to include infographics, blogs, podcasts, radio, and academic publications and presentations.
Widnall, E., Robinson, H., Wang, L. et al. Prevention and postvention guidance relating to self-harm and suicide for UK educational and youth organisations: a systematic review of grey literature. BMC Public Health (2026). https://doi.org/10.1186/s12889-026-27052-6
Background Many children in England are overweight. In 2022/23, about 23 out of 100 children aged 10–11 years were obese. Some children drink lots of sugary drinks, eat too much highly processed food and do not eat enough fruit and vegetables. It can be harder for families with less money…
Background Discrimination is a profound social injustice that fundamentally affects people’s physical and mental health. People often experience more than one form of discrimination at a time, based on race, age, gender, sexual orientation, etc, and this makes its impacts even more complex. We know that…
Background In our day-to-day lives, we are exposed to companies trying to sell us things through advertising and sponsorship. This is often for products that can be harmful to people and to the planet. Examples of this include unhealthy food and drink, vaping, gambling and cars and can often be…