Evidence Hub

Increased belongingness as a mechanism of change of school-based programs mitigating suicidal ideation among adolescents

Barzilay S, Ekstein D, Cohen I, Stein N, Strauss KTV, Frenk ML

European child & adolescent psychiatry, 2026

436 participants · 1 citation

Abstract

Suicide is a leading cause of death among adolescents, highlighting the importance of early intervention in school settings. Universal mental health awareness programs, aimed at improving mental health literacy and help-seeking behaviors, are a key preventive approach. This study examined whether changes in thwarted belongingness and perceived burdensomeness-two constructs from the Interpersonal Theory of Suicide (IPTS)-mediate the effects of school-based mental health interventions on suicidal ideation (SI). A total of 436 adolescents from central Israel (154 boys, 279 girls; M = 14.6, SD = 1.1) were randomly assigned to either a mental health awareness intervention (N = 256) or a minimal-intervention control group with attendance monitoring (N = 180). Belongingness, burdensomeness, and SI were assessed at baseline, 1-month, and 1-year post-intervention. Regression analyses showed that lower belongingness (β = -0.25, p < .001) and higher burdensomeness (β = 0.21, p < .01) predicted higher SI at 1-month, while only belongingness remained significant at 1-year (β = -0.19, p < .01). The mental health awareness intervention increased school-specific belongingness (β = 0.22, p < .001), whereas attendance monitoring intervention increased general belongingness (β = 0.18, p < .01). Mediation analysis indicated that the effects of the intervention type on SI were not significantly mediated by general and school belongingness. These findings suggest that promoting broader social…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 436 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

Read the paper

Related studies

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free