From Determinants to Action: Reframing and Clustering Suicide Risk and Protective Factors for Suicide Prevention among the Youth

Abstract

Suicide among young people is a major yet preventable public health issue. Existing national and international policies and guidelines advocate to implement suicide prevention efforts within educational institutions, emphasizing on mental health promotion, early identification, and structured referral pathways through institutional mechanisms such as student wellness teams (SWTs). However, implementation of these efforts may remain challenging due to multiple systemic and operational barriers. One key limitation is the reliance on traditional categorization of determinants of suicide into “risk” and “protective” factors, which is inadequate to capture and address the dynamic, contextual, and time-sensitive nature of student distress within academic environments. In this article, we propose reorganizing these determinants into distinct categories across three operational dimensions – stability, predictability, and modifiability to better reflect the temporal and contextual characteristics of stressors within educational settings. Furthermore, these determinant categories can be grouped into three strategic clusters – Structural Baseline, Stress Wave, and Acute Escalation – to guide SWT-based interventions. The new framework conceptualizes suicide among students as a dynamic and evolving trajectory shaped by continuous interactions among multiple factors across structural, cyclical, and acute domains. By moving beyond traditional categorization, this conceptual reframing will enable the development of more actionable, context-sensitive, and time-responsive prevention strategies based on the realities of educational settings. In addition, the new framework offers a multidimensional, governance-informed, and operationally actionable model for suicide prevention in educational institutions. Furthermore, it provides a practical roadmap for strengthening institutional mental health systems and improving the effectiveness of SWT-led interventions.