An Open Access article published in the Health Behavior and Policy Review Journal.
The full article is available as a PDF download.


Nancy Eigel-Miller, MS
Lisa M. Vaughn, PhD
Michael Topmiller, PhD
Olga Semanova, MS
Jonelle Prideaux, BA
Kamali Bouvay, MD
Cheryl Hilvert, MA, LPCC
Erica Page, PhD


In this study, we examined characteristics and school contexts to identify profiles of schools at highest risk for suicide in Cincinnati, Ohio and the surrounding geographic area.


We conducted a retrospective cohort study supplemented by context analysis. Adolescent data included total psychiatric-related pediatric emergency department encounters, psychiatric-related inpatient admissions, and suicide encounters/admissions aggregated to school level. School factors included type, size, geographic location, academic rigor, existence of a mental health partner, and culture of suicide prevention efforts at the school.


Using a k-means cluster analysis, 173 schools were sorted into 4 distinct clusters based on based on patient data linked to schools. A context analysis of the 25 highest risk schools revealed general patterns of low academic achievement measures, limited mental health partnership, and poor suicide prevention ratings.


These findings suggest that schools which already reflect limited access to resources are the same ones disparately at higher risk for suicide in our geographic area. The variation of at- risk suicidality factors across schools suggests the need for tailored suicide prevention interventions specific to school characteristics and context.

Source: Health Behavior and Policy Review, Volume 9, Number 2, March 2022, pp. 738-750(13)
Publisher: Paris Scholar Publishing Ltd.