Signs of Suicide

Signs of Suicide (SOS) is a youth suicide prevention program that has demonstrated an improvement in students’ knowledge and adaptive attitudes about suicide risk and depression.

Designed for grades 6-12, SOS teaches students how to identify signs of depression and suicide in themselves and their peers, while providing materials that support school professionals, parents, and communities in recognizing at-risk students and taking appropriate action.

This program is approved for WV Expanded School Mental Health.

Last reviewed: 2023

Intended Outcomes:

  • Decrease suicide and suicide attempts by increasing student knowledge and adaptive attitudes about depression
  • Encourage personal help-seeking and/or help-seeking on behalf of a friend
  • Reduce the stigma of mental illness and acknowledge the importance of seeking help or treatment
  • Engage parents and school staff as partners in prevention through “gatekeeper” education
  • Encourage schools to develop community-based partnerships to support student mental health

Continuum of Care:
Universal Prevention

Topic Areas:
Behavioral Health/Mental Health, Depression, Suicide

Childhood (4-12), Teen/Adolescent (13-18)

Geographic Locations:
Rural, Urban

Delivery Settings:

Cultural Considerations:
A balanced amount of the research involved diverse populations

This program is for middle school students (ages 11-13), high school students (ages 13-17), teachers, and parents.

This program may be delivered by school counselors, social workers, psychologists, or classroom teachers.


Is Training Required?

Who can provide the required training?
While there is no training or certification required to start using SOS, there are virtual or in-person training workshops available nationally for schools or organizations seeking additional support. An annual license must be purchased. Please see the following link for more information:

Program Costs (materials, training, etc.):
Yes, refer to program website

Program/Practice Website:

Relevant Published, Peer-Reviewed Research:

Aseltine, R. H., James, A., Schilling, E., A., & Glanovsky, J. (2007). Evaluating the SOS suicide prevention program: A replication and extension. BMC Public Health, 7(161). DOI:10.1186/1471-2458-7-161

Aseltine, R. H., & DeMartino, R. (2004). An outcome evaluation of the SOS suicide prevention program. American Journal of Public Health, 94(3). 446-451.

Clark, K. N., Strissel, D., Malecki, C. K., Ogg, J., Demaray, M. K., & Eldridge, M. A. (2022). Evaluating the Signs of Suicide program: Middle school students at risk and staff acceptability. School Psychology Review, 51(3). 354-369.

Ogawa, S., Suzuki, H., Takahashi, T., Fujita, K., Murayama, Y., Sato, K., Matsunaga, H., Motohashi, Y., Fujiwara, Y. (2022). Suicide prevention program with cooperation from senior volunteers, governments, and schools: A study of the intervention effects of “Educational lessons regarding SOS output” focusing on junior high school students. Children, 9(541).

Schilling, E. A., Aseltine, R., & James, A. (2015). The SOS suicide prevention program: Further evidence of efficacy and effectiveness. Prevention Science, 17. 157-166. DOI 10.1007/s11121-015-0594-3

Schilling, E. A., Lawless, M., Buchanan, L., Aseltine, R. H. (2014). “Signs of suicide” shows promise as a middle school suicide prevention program. Suicide and Life-Threatening Behavior, 44(6). 653-667. DOI: 10.1111/sltb.12097

Volungis, A. M. (2020). The signs of suicide (SOS) prevention program pilot study: High school implementation recommendations. North American Journal of Psychology 22(3).

Additional Sources:

Supported By Research

WV Rating:
Supported by Research
»WV Ratings Info

Rationale for Rating:

Multiple studies show that there were very specific, consistent outcomes for the program. These include: increased adaptive attitudes toward suicide and an increased knowledge of depression and suicide. These outcomes were strongest for high school populations and the older youth in the sample, ages 13+.

Contraindications or Concerns:
None identified

Other Registries/Ratings

The California Evidence-Based Clearinghouse for Child Welfare:
Not On Registry

Blueprints for Healthy Youth Development:
Not On Registry

Clearinghouse for Military Family Readiness:
Unclear +

Office of Juvenile Justice and Delinquency Prevention Model Programs Guide:
Not On Registry

Washington State Institute for Public Policy:
Not On Registry