Collaboration and cooperation systems to prevent suicide among children in Japan: effective use of the Observe-Orient-Decide-Act loop

Suicide among school-age children is a serious issue in Japan, exacerbated by the COVID-19 pandemic. Collaboration between schools and medical/welfare services is indispensable, yet teachers are overworked and stressed. This study proposes effective use of the Observe-Orient-Decide-Act (OODA) loop for timely collaboration between schools and medical institutions to manage high-risk children as a suicide-prevention measure. Questionnaires were administered to 205 professionals (teachers, nurses, welfare professionals, school counsellors); 171 valid responses were analyzed. Measures included self-rated health, attitudes towards the OODA loop, depressive symptoms (K6), satisfaction with current collaboration/cooperation, and reasons. Comparing those satisfied versus dissatisfied with current collaboration revealed no significant differences in depressive symptoms, but poorer self-rated health among the dissatisfied. Factor analysis of attitudes towards the OODA loop identified three factors—flexible and independent situational assessment, group monitoring and sharing, and self-monitoring—with lower scores across all among dissatisfied respondents. Reasons for satisfaction/dissatisfaction clustered into: details, methods, and organisations for collaboration/cooperation, showing clear differences. Satisfaction with collaboration correlated with mental health and with more positive OODA attitudes. Raising awareness of OODA among teaching personnel, creating organisational structures, establishing systems for appropriate/organic collaboration between schools and medical/welfare institutions, and external reviews are necessary to effectively use the OODA loop.

Michiyo Okada, Takeshi Suzue, Harumi Katayama, Yoshihiro Nakadoi, Ai Fujikawa