Following the WHO adolescent age range, this review will include studies that focus on school-aged adolescents between the ages of 10 and 19 years (27). Eligible studies specifically targeted school age adolescents, without restrictions based on gender, ethnicity, or other sociocultural factors.

The primary focus was on the implementation and effectiveness of suicide prevention interventions (SPI) for school aged adolescents. Eligible interventions included educational, supportive, counseling, therapeutic, and psychological strategies, while pharmacological interventions were explicitly excluded. Outcome measures assessed changes in suicidal behaviors (Self injuries, self-harm attitudes, suicidal thoughts, and completed attempts) and overall mental wellbeing. Eligible studies were scholarly, peer-reviewed articles that detailed an intervention study with pre-and-post outcome assessments, focused primarily on suicide prevention interventions targeting any type of suicidal behavior, involved school-aged adolescents (10–19 years), and were published in English between 2015 and February 2025.

The review included studies from all geographical regions, focusing on interventions implemented within school settings in both high income countries and low- and middle-income countries (LMICs). No restrictions were placed on provider type, delivery methods, duration, or implementation strategies. A systematic approach was employed to examine and compare suicide prevention strategies across diverse contexts, assessing intervention effectiveness through narrative synthesis. Both quasi-experimental studies and randomized controlled trials (RCTs) were included, given their ability to provide robust evidence. Systematic and scoping reviews were also considered to capture broader insights into existing intervention strategies. However, qualitative studies, cross-sectional studies, study protocols, pilot studies, conference proceedings, and non-peer-reviewed articles were excluded to maintain methodological rigor.

A comprehensive literature review was conducted to examine the research topic from multiple angles. Data were retrieved using Boolean operators (AND, OR) with a combination of key terms; for example, (“Prevention Program” OR “strategies” OR “intervention” OR “measures”) combined with (“Adolescent” OR “Teenage” OR “school age”), along with terms related to self-injurious behavior and suicide (e.g., “suicide,” “suicidal,” “suicidality,” “Suicidal Behaviors”) and mental health aspects (e.g., “mental wellbeing,” “mental health,” “psychological health”), further paired with (“interventional” OR “Reviews”). A 20-year filter was applied. For Science Direct, the search was modified to “Suicide” AND “Mental Wellbeing” AND (“Prevention Program” OR “intervention”) AND (“Adolescent”) (see Appendix).

A total of 1,571 articles were initially obtained, after applying additional filters: English language, last 20 years, human subjects, adolescents, and full text, Of these, 961 articles were removed from various databases, leaving 610 articles after duplicate removal and screening titles. After applying the inclusion and exclusion criteria and screening abstract, 87 publications were determined to be relevant and included in the review. The 87 articles were then screened full text in detail, which narrowed the pool to 62 articles. Following this, 25 articles were excluded because they did not address the specific research topic, lacked rigorous methodology, or did not align with the required study types, with some being dismissed for insufficient data or low quality.

Ultimately, 37 articles were fully reviewed to extract meaningful data. These articles included 14 quantitative studies, comprising, 11 randomized controlled trials (RCTs), 3 quasi-experimental studies and 11 reviews (including systematic and meta-analytic studies) that synthesized evidence from multiple primary studies to assess the effectiveness of various interventions. Figure 1 represents a summary of the search strategy process.

Data was collected from the studies included in the scoping review by two independent reviewers using a data collection template. It includes information on study identifiers, such as the first author, title, year of publication, country of study, and article type. The form also collects data on the type of intervention or prevention, including its preventive components, clinical outcomes, frequency and duration, setting, and target audience. In addition, the methods section captures the aims and objectives of the study, as well as its design. Information on the measures or tools used in the study, along with process and sample characteristics, is also documented. Finally, the results section gathers details on characteristics and outcomes, process outcomes, fidelity or adaptation of the intervention, any contextual changes, facilitators, barriers, potential harms, and recommendations for future research.

Narrative synthesis was employed to summarize the findings by: (1) constructing an initial synthesis of the included studies by organizing data into codes that enhance the researchers’ ability to detect patterns across studies; (2) analyzing relationships within the data while considering various factors that could influence the magnitude or direction of the intervention’s effects across studies; and (3) evaluating the reliability of the data by discussing its strengths and limitations, as well as identifying study-specific factors or implementation barriers that may account for inconsistencies in findings (33).

Mental wellbeing is essential for optimal mental health, impacting health-seeking behaviors, decision-making, interpersonal communication, and resilience in crisis. Moreover, it plays a vital role in the overall wellbeing of an individual by enhances emotional wellbeing, promoting proactive management of mental illness and fostering a culture of acceptance (49). A pilot study, to assess the impact of the suicide prevention intervention “Kooth,” that focuses on the wellbeing of young individuals by instilling purpose through helping others and by boosting self-help strategies and social confidence in adolescents, was found to be cost-effective preventive mental health support (50). Likewise, a review of 15 studies underscores the benefits of school mental health programs focusing on holistic wellbeing, revealing enhanced mental health outcomes for adolescents when emphasis shifts from prevention to promotion (51). Whereas, school based mental health interventions are mostly school-based life skills and resilience programs, which have shown positive effects on students’ self-esteem, motivation, and self-efficacy (51).

Furthermore, a four phase LEAP (Learn, Explore, Assess Your Options, and Plan) intervention, rooted in the cognitive-behavioral theory, was designed to address perceived burdensomeness among adolescents (52). In the Learn phase, adolescents were taught how thoughts, emotions, and actions influence each other, and that these can be intentionally modified to promote positive mental health. During the Explore phase, adolescents were taught to identify individuals and situations that felt like a burden. While, during the “Assess Options” phase they were involved in challenging distorted cognition through reality-checking, and by scheduling activities that were aimed at reducing perceptions of burdensomeness. In the Plan phase, adolescents were asked to schedule specific activities, and to plan reminders to ensure completion, which was likely to increase the likelihood of completing the planned activities (52).

Yet another study was done by Pannebakker et al. (53), to evaluate the impact of the Skills 4 Life (S4L), Social Emotional Learning program on secondary school students. The intervention focused on mental wellbeing and associated risk factors, such as self-esteem, self-efficacy, and social skills. The initial four lessons of the S4L curriculum aimed to introduce students to its center rules, by enhancing their cognizance of thoughts, feelings, and behavior, providing alternatives for thinking, and correcting illogical thinking. The program was found to be particularly effective for adolescents with lower educational levels, emphasizing the value of implementing Social Emotional Learning programs for this vulnerable group.

Refer to Tables 2, 3 for details and Nature of intervention in empirical and non-empirical record.

Table 1 offers a comprehensive overview of the focus areas embedded in various suicide prevention programs, categorizing each study based on whether it addressed dimensions such as suicidal ideation/planning, suicidal attempt, suicidal behavior/action, suicidal death, self-injury risk, suicidal stigma, health-seeking intention/behavior, and suicide literacy (with a “y” indicating inclusion). The analysis reveals a predominant emphasis on early intervention, as evidenced by the majority of studies (54, 55) focusing on early-stage indicators like ideation and attempts, suggesting that these programs are designed primarily to detect and intervene before the escalation of suicidal behavior. In contrast, fewer studies address later-stage outcomes such as suicidal behavior/action and suicidal death, likely due to the challenges in measuring these outcomes or a deliberate focus on earlier prevention. Moreover, while some programs incorporate dimensions of self-injury risk and psychosocial factors such as suicidal stigma, health-seeking behavior, and suicide literacy, these elements are not uniformly represented, indicating that although they are recognized as important, they remain underemphasized. This variability in program scope points clear need for integrated approaches in future research that combine clinical indicators with broader psychosocial factors and adopt standardized metrics to better evaluate and compare the effectiveness of suicide prevention strategies.

The scoping review reveals a diverse array of suicide prevention interventions organized by target population and delivery method. Universal prevention efforts target the general population for mental health promotion through multimodal, school-based programs that combine screening, gatekeeper training (e.g., QPR), and interactive educational modules (56), as well as specific programs like YAM, SOS, and SEYLE, which incorporate classroom sessions, role-plays, lectures, and digital videos to promote mental health awareness and behavior change (41, 42, 57, 123). Selective prevention strategies, aimed at at-risk groups, include personality-targeted psychoeducation delivered through face-to-face sessions in schools (59) and mind-based interventions with group and individual sessions (60), as well as cognitive behavioral therapy with peer leadership (61). Indicated prevention interventions focus on individuals exhibiting early symptoms in past or at high risk, utilizing approaches such as motivational interviewing paired with text messages and individualized safety plans (62), family-focused SAFETY interventions (63), telehealth education via audiovisual connections (64), and cognitive behavioral therapy combined with skills training (24). Additionally, the STAT-ED intervention integrates motivational interviewing, family engagement, and structured follow-up calls (61). This spectrum of interventions, varying in strategy and frequency; from weekly sessions to follow-up messaging, underscores the multifaceted and context-specific nature of suicide prevention efforts.

Table 3 categorizes a wide range of suicide prevention interventions in non-empirical records, primarily emphasize preventive, educational, and systemic approaches, underscoring the importance of mental health literacy, resilience-building, and community engagement. A recurring theme is the universal application of interventions, advocating for school-wide implementation rather than targeting at-risk individuals alone. The literature supports gatekeeper training for educators, structured socio-emotional learning (SEL) programs, and multi-tiered interventions, such as the SEYLE model, which integrates awareness, screening, and referral mechanisms. Additionally, emphasis is placed on cross-sector collaboration, highlighting the role of teachers, caregivers, and healthcare professionals in a holistic, school-based mental health framework.

There are several barriers in the implementation of suicide prevention programs for adolescents. These include individual, organizational, socio-cultural, and ethical barriers. Individual barriers can be sleeping problems, chronic illness, engagement in self-harming behaviors, and developmental disabilities. Organizational barriers encompass limited availability of qualified personnel, brief follow-up periods, and lack of specialized training for teachers and counselors (65). Socio-cultural barriers include inadequate parental involvement, stigma surrounding mental health issues, and differing perspectives between parents and adolescents. Ethical barriers include concerns about privacy, confidentiality, and obtaining parental consent for young adolescents (Tables 4, 5). These barriers can hinder the effectiveness and accessibility of suicide intervention efforts (66).

Nonetheless, various personal, organizational/institutional, socio-cultural, and ethical, facilitators can help overcome the challenges mentioned above. These include implementing school-based suicide awareness programs, early identification and management of high-risk groups, fostering socio-emotional life skills, and involving families in prevention plans. Additionally, the use of validated screening tools, collaboration among multidisciplinary teams, and the provision of long-term post-discharge support can enhance the sustainability and effectiveness of suicide prevention efforts (67). Furthermore, contextually relevant interventions, digital health tools, and individualized safety plans can address specific needs and promote engagement and ongoing support for at-risk adolescents.

A diverse array of interventions targeting adolescent mental health and suicide prevention has been evaluated using multiple research designs. The studies encompass school-based programs, digital and online approaches, therapeutic/psychosocial treatments, family and community-based initiatives, as well as screening and comprehensive review efforts. Outcomes were measured using standardized instruments such as the Strengths and Difficulties Questionnaire, Beck scales, Hamilton Depression Scale, and various mental health literacy and help-seeking questionnaires.

Research consistently shows that school-based interventions can enhance help-seeking behaviors and reduce suicidal ideation among adolescents (76). However, their implementation faces significant barriers, largely due to persistent misconceptions such as the belief that discussing suicide may increase suicidal thoughts (77). Contrary to this concern, evidence suggests that structured screening programs do not heighten distress or suicidal behavior. However, screening for suicidal thoughts and behaviors does not have harmful effects or increase distress (56, 68). Suicide literacy involves understanding its four components; warning signals, causes, risk factors/treatments, and preventive approaches. Ludwig et al.’s study among German adults revealed average literacy with low stigma and minimal normalization (78), while research among Arab youth noted high stigma, limited literacy, and negative views on seeking mental health support (79). Similarly, a cross-sectional study involving 616 participants in Bangladesh revealed that increased understanding of suicide was associated with reduced stigmatizing attitudes (80). Hence, future studies should place greater emphasis on exploring the potential benefits of suicide prevention interventions to increase suicidal literacy and enhancing wellbeing for young populations in developing countries.

A major research gap exists in the underrepresentation of studies from low- and middle-income countries (LMICs), which make up 73% of the global population (81) Despite accounting for 75% of suicides, LMICs receive limited attention in suicide prevention research. Around 90% of suicide cases involve a psychiatric condition, with untreated severe depression being the most common at the time of death (82). Given that two-thirds of countries fall into the LMIC category, there is an urgent need for targeted research and culturally relevant interventions to address depression and suicide in these regions (24).

Stigma remains a significant barrier to effective suicide prevention. Although increasing public awareness and psychological health literacy has helped diminish the stigma around mental illness, enhancing the availability of mental health services remains essential to effectively support adolescents and young adults (43). Moreover, taboos surrounding suicidal thoughts often instill fear of societal judgment and discrimination among those having such thoughts, which further discourage seeking essential professional intervention (83). These taboos and stigmas influence attitudes and behaviors toward seeking assistance especially in LMICs (41, 42). The stigma surrounding suicide has led to a hidden crisis, preventing many individuals from seeking support for the psychological distress that often precedes suicidal behavior (84).

Research among Arab youth and South Asian communities underscores deeply ingrained stigma and limited suicide literacy, which discourage help-seeking behaviors (85). Suicide prevention efforts must incorporate educational programs to enhance awareness, challenge misconceptions, and foster open discussions about mental health (76). Additionally, culturally tailored interventions such as role-playing exercises, peer-led discussions, and gatekeeper training for educators have shown promise in indigenous and marginalized communities, reinforcing the importance of context-sensitive approaches (86).

Parents, educators, and communities play a crucial role in suicide prevention. Studies indicate that equipping parents and teachers with knowledge on recognizing warning signs and fostering open communication can significantly reduce suicide risk among adolescents (74). Furthermore, school-based gatekeeper programs have demonstrated effectiveness in improving early detection and intervention (87). Despite their proven benefits, sustaining and systematizing these programs remains a challenge. Strengthening school-based support systems through collaboration with mental health professionals can enhance intervention effectiveness, particularly in resource-constrained settings. Educating parents and teachers on effectively responding to, and supporting, youth experiencing suicidal thoughts or self-harm can play a pivotal role in fostering open communication and reducing suicide risk. As Adolescents are greatly impacted by societal factors, with isolation being a major predictor of self-harm tendencies especially in LMIC’s (88). Nurturing family bonds and stable parental wellbeing lower suicide risk, whereas parental mental disorders and self-inflicted death heighten susceptibility (89).

To alleviate parental apprehensions about revealing suicide risks, school-based SPI should maintain strict confidentiality and participation protocols while ensuring both parents and adolescents are well-informed. Strengthening gatekeeper programs for educators is crucial, as they play a significant role in detecting both risk and protective factors related to adolescent suicide (90). Cooperation among government agencies, communities, religious leaders, schools, and parents is vital for setting long-term objectives and effective strategies for adolescent suicide prevention and intervention. Furthermore, research on school-based SPI must be more systematic and comprehensive.

Various approaches like cultural resource personnel, teacher capacity-building, and culturally tailored role-playing for problem-solving with peer feedback. A study supported this point that culturally adapted suicide prevention programs in schools and communities are particularly vital for indigenous youth, given the limited availability of primary healthcare in indigenous areas (11). Although culturally tailored and community-based psychosocial programs, along with engagement with skilled mental health professionals, could greatly benefit the most at-risk young individuals. However, implementing such strategies may be challenging in low- and middle-income countries (LMICs) due to limited resources and restricted access to qualified healthcare providers and services, suicide prevention in these regions must remain a top priority (91).

Successful cross-cultural adaptation in suicide prevention requires aligning initiatives with local principles, customs, and needs. Nevertheless, low and middle-income nations encounter difficulties in prioritizing suicide deterrence due to scarce assets (92). Merely 10% possess a national suicide prevention framework, and the availability of mental health personnel is considerably lower than in developed nations (91). Given these limitations and the fluctuation of suicide occurrences, regionally suitable, culturally sensitive, and economical solutions are crucial (92).

A study of 134,228 youths aged 14 in LMICs revealed that harassment exposure tripled the likelihood of suicide attempts in 47 out of 48 nations. This connection appeared dose-responsive, with a 12-month attempt rate of 5.9% for non-victims, surging fivefold to 32.7% for those harassed 20–30 days monthly (93). The punishment of suicide attempts in 35 LMICs, with consequences like fines or jail time, is linked to higher suicide rates, especially among women in less-developed countries. Fear of punishment stops people from seeking help, delays medical care, and may lead to more deadly suicide methods and inaccurate reporting (94).

In Pakistan, implementing universal suicide risk screening for adolescents in schools could help early detection, and 24/7 rapid and prompt access services but challenges remain due to stigma, lack of mental health policies, and limited healthcare resources (95). Suicide rates differ significantly between countries, indicating that sociocultural factors may play a role in suicidal behavior. Goldston et al. (96) emphasize the need to consider cultural differences in suicide triggers, responses, help-seeking behaviors, and risk/protective factors. Thus, research should focus on interventions tailored to diverse cultural environments, ensuring that programs are culturally relevant and thoroughly assessed. The absence of culturally sensitive prevention programs in educational settings represents a major limitation, potentially leading to both economic and human costs, highlighting the importance of addressing this gap to develop more effective and inclusive suicide prevention approaches (97).

Gatekeeper training utilizes peer-to-peer support, equipping non-mental health professionals to intervene during suicidal crises, making it a practical approach in resource-limited settings with a shortage of mental health specialists. It aligns with task-shifting strategies, underscoring the necessity for more randomized controlled trials (RCTs) in LMICs (33). Likewise, several universal interventions focus on enhancing help-seeking behaviors and disseminating information about available services, but they assume the presence of accessible and affordable mental healthcare, which may be lacking in certain regions (87).

Mental health interventions must be tailored to reflect cultural contexts, societal conditions, and specific perceptions of depression and suicidal behaviors. Numerous low- and middle-income countries allocate minimal resources to mental health care, with India investing only $0.22 per capita and Pakistan designating merely 0.4% of its healthcare budget to these services (98). Future research should prioritize examining the potential impact of a country’s economic standing on mental health prevention and intervention outcomes, particularly for adolescents experiencing depression and/or suicidal tendencies (24). Integrating mental health into primary care has several benefits. First, it helps provide more complete, patient-centered care by addressing both physical and mental health needs together. Second, it can reduce stigma and encourage more people and their families to seek mental health support. Additionally, combining therapy with skills like communication, problem-solving, and social development may be more effective than therapy alone (24). A review of suicide prevention interventions in South Korea emphasizes the importance of culturally tailored SPI modifications to better assist researchers, mental health professionals, educators, parents, and policymakers (90).

Government recognize that fostering adolescent health leads to healthier adults who contribute to their communities while reducing costs associated with lost productivity and healthcare. Therefore, they support and invest in preventive mental health interventions. It is essential to develop comprehensive mental wellbeing programs that are effective in low- and middle-income countries (99).

A review of 27 studies recommended that Suicide prevention programs are most effective in enhancing awareness and helping skills, with comparatively smaller effects on suicide behavior, psychological wellness, and distress (100).

Integrating suicide prevention into national health primary care programs necessitates the design and implementation of evidence-based interventions both established and innovative (19). While comprehensive mental health care is crucial, it is equally imperative to have access to timely, responsive, and quality clinical care for early recognition and referral to counselors, for individuals showing suicidal behaviors (101).

The economic classification of countries, as defined by the World Bank, significantly influences healthcare investment and access to mental health services. Nations with a Gross National Income (GNI) of $1,005 or less are categorized as low-income, while those with a GNI between $1,006 and $3,955 fall into the lower-middle-income bracket (102). Many LMICs struggle to prioritize suicide prevention due to financial constraints, with only 10% possessing a national suicide prevention strategy (91). The availability of mental health professionals remains significantly lower in these regions compared to high-income countries, further exacerbating gaps in care. Given these limitations, suicide prevention efforts in LMICs must focus on developing cost-effective, culturally sensitive, and scalable interventions. Regional adaptation of strategies such as: community-based gatekeeper programs, integration of mental health into primary care, and the use of digital health solutions can enhance intervention sustainability (92).

A stark disparity exists between high- and low-income countries in suicide prevention efforts. Only 10% of LMICs have a national suicide prevention strategy, and mental health funding remains critically low (1). For instance, India allocates only $0.22 per capita to mental health care, while Pakistan dedicates a mere 0.4% of its healthcare budget to mental health services (103). Integrating suicide prevention into primary healthcare and adopting task-shifting strategies—such as gatekeeper training for non-specialist health workers, could help bridge this gap and expand access to care (104).

Moreover, in 35 LMICs, suicide attempts remain criminalized, deterring individuals from seeking help and exacerbating suicide-related mortality (105). Legislative reforms, coupled with public awareness campaigns, are necessary to shift societal perceptions of suicide from a criminal offense to a public health priority. Restricting access to lethal means—such as pesticides, firearms, and high-risk locations—has been identified as one of the most cost-effective suicide prevention strategies worldwide (21). In Bangladesh, the 2000 ban on WHO Class 1 pesticides led to a 37% drop in self-poisoning fatalities, preventing an estimated 35,000 suicides between 2001 and 2014 (106). Likewise, India’s 2011 endosulfan prohibition resulted in approximately 28,600 fewer pesticide-related suicides. In Sri Lanka, successive restrictions on Class 1 pesticides in the 1980s and 1990s, followed by additional bans (2008–2010), led to a 50% decline in pesticide suicides (2011–2015), particularly among young adults. Conversely, Iran reported a rise in aluminum phosphide poisonings after banning the substance in 2007 (107). The elimination of highly hazardous pesticides from agricultural use is expected to be a more effective suicide prevention strategy in rural Asia (108). While pesticide bans substantially reduced suicide rates, some declines were counterbalanced by increases in other suicide methods, emphasizing the need for comprehensive prevention strategies.

Contextually relevant and tailored interventions, addressing the unique needs of adolescents, coupled with ongoing evaluation, and collaboration among stakeholders, are essential for advancing suicide prevention efforts. Recommendations include the implementation of school-based mental health services, screening programs, and interventions targeting specific risk factors, such as substance use and interpersonal conflicts. Additionally, efforts are needed to destigmatize mental health issues, enhance access to support services at the school level, and to empower adolescents through resilience-building programs, for promoting mental wellbeing and for preventing suicide among this vulnerable population. To effectively prevent adolescent suicidality in LMICs, practitioners should collaborate across fields such as nursing, teaching, and counseling for capacity building to strengthen school-based support and improve access to care for at-risk youth (109). Mental health challenges significantly affect individuals, families, and communities, influencing societal aspects such as social and economic stability (104). Addressing this issue requires not only healthcare interventions but also school-based mental health programs, which play a vital role in promoting wellbeing and fostering a more equitable society (110).

Online interventions be utilized as a cost-effective and scalable means to support at-risk individuals. Additionally, the potential of passive smartphone monitoring as an inexpensive method for assessing risk warrants further investigation to establish its effectiveness (82). Limiting access to highly fatal suicide methods is a proven prevention approach especially in LMICs, as most survivors do not attempt again (82). Globally, restricting pesticides has significantly reduced suicide rates, particularly in rural areas of China, India, and Sri Lanka. Installing barriers, safety nets, surveillance, and conducting regular patrols at high-risk drowning sites can help prevent impulsive suicides (111).

Future suicide prevention efforts should focus on contextually relevant, culturally adapted, and sustainable interventions. Longitudinal studies are necessary to assess the long-term effectiveness of school-based, community-driven, and digital interventions in various socio-economic settings (112). The integration of digital innovations, including AI-driven mental health support, passive smartphone monitoring, and telehealth services, offers scalable and cost-effective solutions to bridge gaps in mental health care (113). Policy development remains crucial, with LMIC governments needing to prioritize national suicide prevention strategies and integrate mental health services into primary healthcare (1). Moreover, cultural adaptation is essential, as interventions must align with local beliefs, traditions, and economic conditions to maximize impact and community engagement (86). Improving mental health literacy through awareness campaigns is another key approach to reducing stigma and fostering proactive help-seeking behaviors (114). Additionally, limiting access to lethal means, such as pesticide bans, firearm control, and safety barriers at high-risk locations, has proven effective in reducing suicide rates, particularly in rural areas of China, India, and Sri Lanka (82, 111). Lastly, multisectoral collaboration among governments, educators, healthcare professionals, and policymakers is essential to develop sustainable, evidence-based strategies that comprehensively address adolescent suicide prevention.

This scoping review provides a robust synthesis of peer-reviewed literature on adolescent suicide prevention interventions, with a particular emphasis on LMICs. The review employed a rigorous methodology, utilizing systematic searches across major health databases to ensure a comprehensive evaluation of available interventions. One of the primary strengths of this study is its focus on suicide prevention strategies tailored to resource-limited settings, offering critical insights into culturally and economically viable approaches. Additionally, the review identified the use of validated outcome measures, ensuring reliability and accuracy in assessing intervention effectiveness. By incorporating an interdisciplinary perspective, the review highlights the crucial roles of educators, mental health professionals, policymakers, and researchers in designing and implementing suicide prevention programs. Moreover, the emphasis on school-based and community-driven interventions reinforces the importance of engaging adolescents directly in mental health promotion and suicide prevention efforts.

Despite its contributions, this review has several limitations. The exclusion of non-English studies may have resulted in the omission of valuable research, particularly from LMICs where regional languages dominate academic discourse. Additionally, while multiple databases were searched, the inclusion of gray literature, unpublished dissertations, and institutional reports could have further enriched the analysis. The limited scope of included studies and the 40% inclusion threshold may have restricted the dataset, potentially impacting the generalizability of findings. Furthermore, the review does not conduct direct assessments of intervention effectiveness, relying instead on secondary data, which may introduce biases related to study design and reporting. Given the vast socio-economic and cultural diversity among LMICs, the generalizability of findings across different regions remains a challenge, necessitating localized research to tailor interventions more effectively.