Prevention Plus Wellness (PPW) programs are designed to prevent substance use and promote healthy lifestyle behaviors.
In doing so, PPW programs are also uniquely equipped to prevent multiple risk and protective factors associated with suicide and mental health.
Some of the factors addressed in PPW programs include substance use, a known risk factor for suicide and mental health problems, as well as physical activity, healthy eating and sleep, which are increasingly supported by research as protective factors against suicide and mental health issues.
A sample of research supporting the association between both substance use and healthy habits and suicide as well as other mental health problems among youth are presented below.
Substance Use, Suicide & Mental Health
In an important review of research on adolescent substance use and suicidal behavior published in Alcohol Clinical and Experimental Research (2004), studies showed that substance use heightens statistical risk for suicidal behavior in adolescent clinical and community populations: https://onlinelibrary.wiley.com/doi/abs/10.1097/01.ALC.0000127417.99752.87
Also illustrating the connection between substance use and suicide, the US Department of Health and Human Services published an online article titled “Does alcohol and other drug abuse increase the risk for suicide?”
Research presented in this article shows that youth substance use and misuse are risk factors for suicide: https://www.hhs.gov/answers/mental-health-and-substance-abuse/does-alcohol-increase-risk-of-suicide/index.html
Reducing the risk of substance use, therefore, is a logical strategy in helping also prevent youth suicide.
However, youth substance use impacts more than suicide behavior when it comes to mental health.
For example, according to the Office of Juvenile Justice and Delinquency Prevention (OJJDP), substance-abusing youth are at higher risk than nonusers for mental health problems, including depression, conduct problems, personality disorders, suicidal thoughts, attempted suicide, and suicide: https://ojjdp.ojp.gov/sites/g/files/xyckuh176/files/pubs/drugid/ration-03.html#:~:text=Substance%2Dabusing%20youth%20are%20at,%2C%20attempted%20suicide%2C%20and%20suicide.
Healthy Behaviors, Suicide & Mental Health
A review of research on physical activity and suicide ideation published in the Journal of Affective Disorders (2018) showed that meeting physical activity guidelines had a significant protective effect against suicide ideation, while not meeting guidelines was associated with increased suicide ideation: https://www.sciencedirect.com/science/article/abs/pii/S0165032717313745
Meanwhile, a study examining breakfast consumption and suicide attempts among adolescents, published in Psychology Research and Behavior Management (2022), reported that adolescents who ate breakfast less than once a week had a stronger association with suicide attempts than the group of youth eating breakfast six or seven times a week: https://www.proquest.com/openview/5fb131dae37e02d93fc670649b7a38fa/1?pq-origsite=gscholar&cbl=3933299
Yet another review of healthy behavior research, this one examining sleep difficulties and suicidality in youth published in Sleep and Health Disparities (2022), found the data overwhelmingly support an association between suicidality and a range of sleep difficulties (e.g., insomnia, short/long sleep, weekend oversleep), above and beyond depressive symptoms: https://link.springer.com/article/10.1007/s40675-022-00222-9
Together, these two research reviews and one individual study highlight how healthy habits, namely physical activity, eating breakfast and getting adequate and sound sleep are linked to less risk of suicide among youth.
Other studies show that healthy behaviors also protect against other mental health problems.
A study on adolescent health behaviors and mental health published in the American Journal of Lifestyle Medicine (2021) found that meeting physical activity guidelines, consuming breakfast every day, sleeping at least 8 hours per night, and not smoking and/or consuming alcohol in the past 30 days were independently associated with lower odds of mental health problems.
In addition, for every additional positive health behavior met, there were significantly lower odds of reported mental health problems including self-reported difficulty concentrating, remembering, or making decisions among US adolescents: https://journals.sagepub.com/doi/10.1177/1559827619860067#
Another study on the lifestyle behaviors and mental health of young adolescents published in Pediatrics (2019) found that compared with meeting 1 to 3 health recommendations, meeting 7 to 9 health recommendations was associated with 56% fewer physician visits for mental illness during follow-up.
Also, every additional recommendation met was associated with 15% fewer physician visits for mental illnesses: https://pediatrics.aappublications.org/content/143/5/e20183307
The above cited research indicates that both substance use and healthy behaviors can influence suicide and other mental health indicators among young people.
By targeting both the prevention of substance use and the promotion of healthy behaviors, Prevention Plus Wellness programs are a cost-effective strategy for addressing multiple risk and protective factors associated with suicide and mental health of young people.