Introduction Schools have an important role in recognising and preventing self-harm and suicidal behaviour in their students, however little is known about which educational factors are associated with heightened risk. We will systematically review the existing evidence on two key educational performance indicators that are routinely collected by school administrative systems: school attendance and exclusion. We will investigate their association with self-harm and suicidal behaviour in school-age children and adolescents. Knowledge of this association could help inform suicide prevention strategies at clinical, school and population levels.
Methods and analysis We will conduct a systematic search of Medline, EMBASE, PsycINFO, British Education Index and Education Resources Information Centre (ERIC) from 1 January 1990, and conduct a manual search for additional references. We aim to identify studies that explore the association between poor school attendance or exclusion and self-harm or suicidal behaviours in school-age children and adolescents. Two independent reviewers will screen titles, abstracts and full-text documents and independently extract relevant data for analysis. Study quality will be assessed using a modified Newcastle-Ottawa Scale. A descriptive analysis will be performed, and where appropriate, results will be combined in meta-analyses.
Ethics and dissemination This is a systematic review of published literature, and therefore ethical approval will not be sought. We will publish reports in health and education journals, present our work at conferences focused on school mental health and communicate our findings to practitioners and managers in public health, education and child mental health.
PROSPERO registration number CRD42018088608.
- school mental health
- systematic review protocol
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Contributors SE (guarantor) co-conceived and designed the review with support from other authors, wrote the initial draft of the manuscript, approved the final version and agrees to be accountable for its content. ER, RS, KF, TF and RD contributed to the design of the review, critically revised the manuscript, approved the final version and agree to be accountable for its content. JD co-conceived and designed the review with support from other authors, critically revised the drafts of the manuscript, approved the final version and agrees to be accountable for its content.
Funding SE has been employed as a National Institute of Health Research (NIHR) Academic Clinical Fellow and currently receives salary support from an MQ Data Science Award and from the Psychiatry Research Trust. ER is funded by a Medical Research Council (MRC) Addiction Research Clinical Training Fellowship. RS is employed as an NIHR Academic Clinical Fellow. KF’s PhD is funded by the University of Exeter, via the MYRIAD study (Wellcome Trust 107496/Z/15/Z). RD is funded by a Clinician Scientist Fellowship (research project e-HOST-IT) from the Health Foundation in partnership with the Academy of Medical Sciences. JD received support via an MRC Clinical Research Training Fellowship (MR/L017105/1), Psychiatry Research Trust Peggy Pollak Research Fellowship in Developmental Psychiatry and from the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. This paper represents independent research part funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London.
Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned; externally peer reviewed.