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A nonrandomized controlled trial was conducted in elementary schools serving higher-risk areas in Seattle, Washington (during ages 6\u201313, grades 1\u20136) and followed up at ages 21\u201339. The panel originated in Seattle but was followed in and out of state. This study examines participants who had been in the intervention (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009156) vs. control (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009220) conditions in grades 1\u20136. The intervention provided teachers with methods of classroom management, parents with family management skills, and children with social-emotional skills training. Outcomes examined were ever suicide ideation, attempt, or completion, and DSM-IV-based criterion counts for depression, generalized anxiety disorder, PTSD, and social phobia across 6 waves, ages 21\u201339. At follow-up, the intervention group showed significantly lower suicide ideation and behavior, depression, generalized anxiety disorder, PTSD, and social phobia than the control group. Universal childhood preventive intervention can reduce suicide ideation and behaviors and related mental health problems in adulthood. Clinical Trials.gov ID: NCT04075019.\n                  <\/jats:p>","DOI":"10.1007\/s11121-025-01834-7","type":"journal-article","created":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T07:04:31Z","timestamp":1760771071000},"page":"1033-1044","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Addressing Suicide and Mental Health Through Universal Childhood Intervention: Results from The Seattle Social Development Project"],"prefix":"10.1007","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8342-1561","authenticated-orcid":false,"given":"Karl G.","family":"Hill","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine M.","family":"Steeger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Epstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A.","family":"Bailey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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All procedures were in accordance with the ethical standards of the Human Subjects Review Committee at the University of Washington (STUDY00002228) and with the 1964 Helsinki Declaration and its later amendments.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval and Consent to Participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}}]}}