International students are at risk of suicide and suicide prevention activities addressing their unique needs are required. However, no comprehensive review has been undertaken to identify effective suicide prevention approaches for international students. The current scoping review aimed to chart the extent, range, and nature of available evidence on the prevention strategies for international students. We systematically searched Medline, PsycInfo, ERIC, CINAHL, Proquest, and several gray literature databases to identify relevant peer-reviewed articles and gray literature. Eligible publications were those providing data or recommendations related to suicide prevention among international students; 15 peer-reviewed articles and 19 gray literature documents were included in the review. No studies of prevention programs or policies directly targeting suicidal ideation, suicide attempts, or suicide in international students were identified. A narrative synthesis of the suicide prevention recommendations for international students identified four categories: (1) cultural competency training on suicide and provision of culturally sensitive services; (2) improved and increased risk screening for suicide; (3) proactive intervention and engagement strategies; and (4) collaborative approaches to streamline service access and improve available support. These recommendations provide guidance on potential directions for international student suicide prevention. Research assessing the effectiveness of such recommendations will enable the development of novel evidence-based policies and interventions that reduce rates of suicide in international students.

Background: Suicide is the leading cause of death among young Australians, accounting for one-third of all deaths in those under 25. Schools are a logical setting for youth suicide prevention activities, with universal, selective and indicated approaches all demonstrating efficacy. Given that international best practice recommends suicide prevention programmes combine these approaches, and that to date this has not been done in school settings, this study aims to evaluate a suicide prevention programme incorporating universal, selective and indicated components in schools. Methods: This study is a trial of a multimodal suicide prevention programme for young people. The programme involves delivering universal psychoeducation (safeTALK) to all students, screening them for suicide risk, and delivering internet-based Cognitive Behavioural Therapy (Reframe IT) to those students identified as being at high risk for suicide. The programme will be trialled in secondary schools in Melbourne, Australia, and target year 10 students (15 and 16 year-olds). safeTALK and screening will be evaluated using a single group pre-test/post-test case series, and Reframe IT will be evaluated in a Randomised Controlled Trial. The primary outcome is change in suicidal ideation; other outcomes include help-seeking behaviour and intentions, and suicide knowledge and stigma. The programme’s cost-effectiveness will also be evaluated. Discussion: This study is the first to evaluate a suicide prevention programme comprising universal, selective and indicated components in Australian schools. If the programme is found to be efficacious and cost-effective, it could be more widely disseminated in schools and may ultimately lead to reduced rates of suicide and suicidal behaviour in school students across the region.

The rising incidence of suicide-related thoughts and behaviors among international students presents a significant public health challenge and growing concern among college campuses. Current intervention strategies often rely on Western-centric and colonized approaches developed and tested with primarily Western, Educated, Industrialized, Rich and Democratic (WEIRD) samples. Exclusion and historical underrepresentation of ethnoracially minoritized groups in suicide prevention treatment trials create gaps in advancing our science because they often miss the cultural contextualization crucial for effective prevention and intervention in diverse groups from different countries of origin. To address the limitations of these Western-centric strategies, we explored existing prevention recommendations and approaches through the lens of an expanded version of the newly developed Protective Factors Framework, tailored for non-Western cultural perspectives. We propose significant opportunities for enhancing current practices and point to promising future directions. The primary areas for development include: (1) bolstering community empowerment and ownership, (2) refining mechanisms of change to encompass multicultural viewpoints, and (3) focusing on effective implementation and thorough evaluation for ongoing refinement. This methodology not only shows promise for enhancing international student suicide prevention but also offers insights for broader application in suicide prevention among other culturally diverse populations.

Objective: The Brief Resilience Scale (BRS) is a relatively new and increasingly used measure of resilience. Despite its popularity, evidence regarding its unitary factor structure has been equivocal. The aim of this study was to examine whether the BRS should be operationalised as a single or dual factor model and further test the validity of the scale. Method: A sample of 288 adults (mean age = 34 years) completed an online survey measuring resilience, the Big-Five personality traits, positive and negative affect, perceived stress, and life satisfaction. Results: Confirmatory factor analysis demonstrated that a single-factor model that accounted for method effects within the negatively worded items had the best fit to the data. Additionally, no evidence of a dual factor structure was found using discriminant, construct and criterion validity markers of the Big-Five, life satisfaction, perceived stress or positive and negative affect. Results also demonstrated moderate to strong positive relationships between the BRS and measures of psychological wellbeing. Finally, the BRS was positively related to all Big-Five personality factors with the exception of a strong negative relationship with neuroticism. Discussion: The current findings support the conceptualisation of the BRS as a unidimensional measure of resilience. Moreover, the study lends further support to validity of the BRS as a brief measure of resilience through demonstrating expected relationships with markers of wellbeing and the Big-Five personality factors.

The gatekeeper training of parents is a promising approach for suicide prevention in young people, but little research has addressed the effectiveness of such training, especially using online delivery. This study aimed to evaluate the efficacy and acceptability of the delivery of an online suicide prevention training program, LivingWorks Start, to improve the capacity of parents to support young people at risk of suicide. The participants were 127 parents of young people aged 12–25 who completed the LivingWorks Start training and consented to participate in the evaluation. The participants completed online surveys before, after, and 3 months after training. The participants showed increases in perceived self-efficacy and formal help-seeking intentions but no change in suicide stigma. Suicide literacy also increased, but only at the three-month follow-up. Most parents found the training acceptable, and did not find it upsetting. Prior mental health, suicide-related experiences, and pre-participation vulnerability were not predictive of finding the training distressing. Overall, the findings show that online gatekeeper training for parents can be beneficial, and is rarely associated with distress.

Background: Current suicide prevention approaches are not adapted to international student needs, and participatory design is a method that may facilitate the development or adaptation of appropriate programmes for this group.Methods: This qualitative study investigated the experiences of international university students studying in Australia who participated in a co‐consultation process to adapt the LivingWorks safeTALK suicide prevention programme. Eight international students from the co‐consultation workshop completed semi‐structured interviews about their workshop experience. The data were analysed using reflexive thematic analysis.Results: The findings showed that participants found the co‐consultation process empowering and engaging. They also reported that the experience promoted mutual learning and challenged simplistic views of suicide. No students reported experiencing distress. Suggestions for improving participatory design for international students focussed on enhancing participant interaction, supporting quiet voices to be heard and ensuring understanding of mental health and suicide through shared language.Conclusions: This study underscores the value of participatory design in suicide prevention, emphasising its potential to empower international students and facilitate culturally sensitive programme adaptations.Patient or Public Contribution: International students were involved in the co‐consultation process to redevelop the training content and provided a series of recommendations for improving such processes for international students in the future. The two researchers who conducted the interviews and data analysis were former international students.