Feasibility and acceptability of the Multi-Modal Approach to Preventing Suicide in Schools (MAPSS) programme in England: a cluster-randomised controlled trial
Abstract
Background: The Multi-Modal Approach to Preventing Suicide in Schools (MAPSS) was initially developed and trialled in Australia. It consists of universal, selective, and indicated components, with evidence to suggest it may improve help-seeking and reduce suicide ideation. However, cultural transferability of interventions cannot be assumed, and so we needed to establish whether it would be feasible to trial MAPSS in English schools.
Aim: To assess the feasibility of delivering the MAPSS intervention in English secondary schools, including the acceptability and safety of delivering MAPSS, the social validity of MAPSS, and the feasibility of a future large-scale efficacy trial. Secondary aims were to assess changes over time in mental health and wellbeing outcomes for students.
Method: A 2-year cluster-randomised controlled trial (RCT) design was conducted. Schools ( n = 6) were randomly assigned to implement MAPSS ( n = 4) or continue their usual practice (UP) ( n = 2). Participants were students ( n = 887) in year 10 (aged 14–15 years) attending participating schools. Quantitative data were collected from participants online at four timepoints (baseline, post-universal component, post-indicated component, 1-year follow-up). Trial feasibility was assessed through monitoring of recruitment, attrition, missing data, participant engagement, acceptability of intervention components, and estimated change across time and variability in the primary outcome measures. Safety was assessed through the monitoring of adverse events.
Results: The progression criteria indicated strong feasibility for advancing MAPSS to a full effectiveness trial, with six of nine stop/go criteria fully achieved and three partially met but with solutions identified. The intervention was shown to be acceptable and safe, with no adverse events reported. Post-intervention, scores for suicidal ideation, depressive symptoms, and hopelessness in the MAPSS group were lower than in the control group, and help-seeking also improved in the MAPSS group.
Conclusion: All progression criteria were met or appropriate solutions were identified, supporting further evaluation of the intervention in a full-scale effectiveness trial. These findings add to the growing evidence base supporting the utility of multi-modal suicide prevention programmes in schools. MAPSS has potential as a school-based intervention for those struggling with suicidal thoughts and/or behaviours.
Trial registration: The trial was pre-registered on clinicaltrials.gov (ISRCTN41891301) on 9th February 2024.
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BibTeX
@article{saini2026feasibility,
title = {{Feasibility and acceptability of the Multi-Modal Approach to Preventing Suicide in Schools (MAPSS) programme in England: a cluster-randomised controlled trial}},
author = {Pooja Saini and Molly McCarthy and Sio Wynne and Laura Sambrook and Steven Lane and Ana Duarte and Kate Henderson and Neil Boardman and Sian Ibotson and Mike Palmer and Tim Owen and Andy Airey and Mani Priya Jalota and Vivienne Crosbie and Maria Michail and Samuel McKay and Neil Humphrey and Jo Robinson and Shuye Yu and Amy Barker and Emma Ashworth},
journal = {Trials},
year = {2026},
month = nov,
doi = {10.1186/s13063-026-10071-4},
url = {https://link.springer.com/article/10.1186/s13063-026-10071-4},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Feasibility and acceptability of the Multi-Modal Approach to Preventing Suicide in Schools (MAPSS) programme in England: a cluster-randomised controlled trial
AU - Pooja Saini
AU - Molly McCarthy
AU - Sio Wynne
AU - Laura Sambrook
AU - Steven Lane
AU - Ana Duarte
AU - Kate Henderson
AU - Neil Boardman
AU - Sian Ibotson
AU - Mike Palmer
AU - Tim Owen
AU - Andy Airey
AU - Mani Priya Jalota
AU - Vivienne Crosbie
AU - Maria Michail
AU - Samuel McKay
AU - Neil Humphrey
AU - Jo Robinson
AU - Shuye Yu
AU - Amy Barker
AU - Emma Ashworth
PY - 2026
DA - 2026/11/03
JO - Trials
DO - 10.1186/s13063-026-10071-4
UR - https://link.springer.com/article/10.1186/s13063-026-10071-4
AB - Background: The Multi-Modal Approach to Preventing Suicide in Schools (MAPSS) was initially developed and trialled in Australia. It consists of universal, selective, and indicated components, with evidence to suggest it may improve help-seeking and reduce suicide ideation. However, cultural transferability of interventions cannot be assumed, and so we needed to establish whether it would be feasible to trial MAPSS in English schools. Aim: To assess the feasibility of delivering the MAPSS intervention in English secondary schools, including the acceptability and safety of delivering MAPSS, the social validity of MAPSS, and the feasibility of a future large-scale efficacy trial. Secondary aims were to assess changes over time in mental health and wellbeing outcomes for students. Method: A 2-year cluster-randomised controlled trial (RCT) design was conducted. Schools ( n = 6) were randomly assigned to implement MAPSS ( n = 4) or continue their usual practice (UP) ( n = 2). Participants were students ( n = 887) in year 10 (aged 14–15 years) attending participating schools. Quantitative data were collected from participants online at four timepoints (baseline, post-universal component, post-indicated component, 1-year follow-up). Trial feasibility was assessed through monitoring of recruitment, attrition, missing data, participant engagement, acceptability of intervention components, and estimated change across time and variability in the primary outcome measures. Safety was assessed through the monitoring of adverse events. Results: The progression criteria indicated strong feasibility for advancing MAPSS to a full effectiveness trial, with six of nine stop/go criteria fully achieved and three partially met but with solutions identified. The intervention was shown to be acceptable and safe, with no adverse events reported. Post-intervention, scores for suicidal ideation, depressive symptoms, and hopelessness in the MAPSS group were lower than in the control group, and help-seeking also improved in the MAPSS group. Conclusion: All progression criteria were met or appropriate solutions were identified, supporting further evaluation of the intervention in a full-scale effectiveness trial. These findings add to the growing evidence base supporting the utility of multi-modal suicide prevention programmes in schools. MAPSS has potential as a school-based intervention for those struggling with suicidal thoughts and/or behaviours. Trial registration: The trial was pre-registered on clinicaltrials.gov (ISRCTN41891301) on 9th February 2024.
SN - 1745-6215
ER -