Article Developing a Comprehensive School Suicide Prevention Program Paul F. Granello 1 and Brett Zyromski 1 Abstract Suicide is the third most common cause of death for youth aged 14–19. School counselors need a school-wide prevention plan to address the mental and emotional needs of students experiencing suicidal ideation and behaviors. Although researchers have suggested that suicide prevention programming and suicide screening programs lower the rate of adolescent deaths, a paucity of evidence-based, school-wide, comprehensive suicide prevention programs exists. Therefore, to fill a gap in research and training resources, we propose four different types of research-supported suicide prevention programs. We also propose a common standard for the development of an effective, comprehensive school suicide prevention program using a five-step process and frame these approaches within the American School Counselor Association National Model. Keywords comprehensive school counseling, school counseling prevention programing, suicide prevention Adolescent suicide is tragic and far too common in the United States. Suicide is the third leading cause of death for youth aged 14–19 (Substance Abuse and Mental Health Services Admin- istration [SAMHSA], 2015). Although alarming, suicide deaths, unfortunately, represent the tip of the iceberg when it comes to the epidemic of suicidal and self-harm behaviors in schools (Juhnke, Granello, & Granello, 2011). In a national review of data gathered from the Youth Risk Behavior Surveil- lance System (YRBSS) that asked participants about their feel- ings and behaviors in the 12 months prior to completing the survey, the Centers for Disease Control and Prevention (CDC, 2012) found that 28.5% of students expressed feeling so sad or hopeless almost every day for 2 weeks in a row that they stopped doing usual activities (find specifics on the YRBSS at https://www.cdc.gov/healthyyouth/data/yrbs/overview.htm). The rate of students’ reported feelings of sadness and/or hope- lessness increased from 26.1% in 2009 to 28.5% in 2011. This increase may reflect underlying mental health conditions like depression and anxiety that are the basis of most suicidal beha- viors (Granello & Granello, 2007). Results from the YRBSS also revealed that in the 12 months prior to the study, 15.8% of students nationwide reported seri- ously considering attempting suicide (CDC, 2012). Further, 12.8% of students had made a suicidal plan and 7.8% had attempted suicide one or more times during the 12 months prior to the survey. Although not all attempts received medical atten- tion, 2.4% of students had made a suicide attempt that resulted in an injury or poisoning that required medical treatment (CDC, 2012). School counselors should be informed about the significant role social media may play as a potential suicide risk factor and as a platform for suicide prevention efforts (Robinson et al., 2016). The rise in suicide deaths among adolescents has been in conjunction with the rise in social media use by this population (Twenge, Joiner, Rogers, & Martin, 2018). This has led to the hypothesis that social media use has adverse effects on adoles- cents (Berryman, Ferguson, & Negy, 2017); specifically, that large amounts of social media use, especially by adolescent girls, lead to increased depression and suicide. A recent large-scale study using a nationally representative sample of adolescents aged 13–18 demonstrated a positive correlation between the amount of screen time adolescents spend and the risk of depression and suicidality (Twenge et al., 2018). The results of the study were based on self-reports and noted that social media use and screen time had a significantly larger negative impact on females than males. Twenge, Joiner, Rogers, and Martin (2018) found that those adolescents who spent 5 or more hours per day on their devices were 66% more likely to have at least one suicide risk factor present than those who spent only 1 hr. Generally, social media use, electronic device use, and reading Internet news predicted higher depres- sive symptoms or suicide-related outcomes, while conversely, 1 The Ohio State University, Columbus, OH, USA Corresponding Author: Paul F. Granello, PhD, The Ohio State University, Columbus, OH, USA. Email: granello.2@osu.edu Professional School Counseling Volume 22(1): 1-11 ª 2019 American School Counselor Association Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/2156759X18808128 journals.sagepub.com/home/pcx