Can a Lecture Influence Attitudes to Suicide Prevention?

Are they ready yet?: A theory-driven evaluation of suicide risk assessment trainings in psychology graduate programs

OBJECTIVES

The present study sought to understand the state of suicide risk assessment trainings in clinical psychology graduate programs.

METHODS

We surveyed 167 clinical psychology doctoral students' behavioral competency in responding to suicidal clients and their attitudes, perceived behavioral control, subjective norms, and intentions related to suicide risk assessment. Hypotheses were tested using path analysis.

RESULTS

Ninety six percent of participants reported receiving some type of suicide risk assessment training at their program. Results provided partial support for significant relationships between attitudes, perceived behavioral control, subjective norms, and intentions. Unexpectedly, amount of training in suicide risk assessments was not related to theory of planned behavior variables including behavioral competency.

CONCLUSION

These findings have implications regarding the effectiveness of current suicide risk assessment training practices and ways to improve trainings to help increase the number of clinical psychologists competent in suicide risk assessment and management.

Management of suicide risk

The risk of suicide pervades much of day-to-day clinical practice. Effective management encompasses its recognition, evaluation of severity, and the use of techniques which reduce it to an acceptable level during treatment of the condition which it complicates.

Effects of education on attitudes to deliberate self-harm

Accident and emergency (A&E) staff completed a general knowledge and attitude questionnaire related to suicide and deliberate self-harm (DSH) before and after a teaching package. The results showed an increase in general knowledge while attitudes remained the same. Following the teaching package there was an increase in the number of patients who contacted the Specialist Service for DSH.

The Impact of Knowledge of Suicide Prevention and Work Experience among Clinical Staff on Attitudes towards Working with Suicidal Patients and Suicide Prevention

Suicide-preventive training has shown to influence attitudes. This study aimed at investigating what impact other factors than knowledge might have on attitudes towards work with suicidal patients and suicide prevention. In 2007, 500 health-care staff working in a psychiatric clinic in Stockholm received a questionnaire with items concerning work with suicidal patients to which 358 (71.6%) responded. A set of attitude items were tested using structural equation modelling (LISREL). Three models were found to be satisfactory valid and reliable: Job clarity, Job confidence and Attitudes towards prevention. These were then used in regression analyses as dependent variables with predictors such as experience of work with suicidal patients, perceived sufficient training,age and gender. Perceived sufficient training was consistently the most important predictor for all three attitude concepts (p < 0.01, β = 0.559 for Job clarity; p < 0.01, β = 0.53 for Job confidence; p < 0.01, β = 0.191 for Attitudes towards prevention). Age was another significant predictor for Job clarity (p < 0.05, β = 0.134), as was experience of patient suicide for Job confidence (p < 0.05, β = 0.137). It is concluded that providing suicide preventive education is likely to improve attitudes towards the prevention of suicide, clarity and confidence regarding their role in the care for suicidal patients. These improvements may contribute to the prevention of suicide in health care settings.

The attitudes of emergency staff toward attempted suicide patients: a comparative study before and after establishment of a psychiatric consultation service

BACKGROUND

The staff in the emergency room of general hospitals are under heavy work pressure and seem to reveal negative attitudes toward suicide attempters. From earlier studies there is indirect evidence that the attitudes of staff who have the opportunity to consult a psychiatrist are less negative.

AIMS

The study compare the attitudes of emergency room staff in a general hospital toward patients who had attempted suicide before and after establishment of a psychiatric consultation service.

METHODS

Attitudes were measured on the Understanding Suicidal Patients (USP) Scale. A total of 100 participants returned the questionnaire.

RESULTS

General understanding and willingness to nurse patients who attempted suicide did not increase.

CONCLUSION

The results suggest that providing a psychiatric consultation service did not significantly affect attitudes among general hospital emergency room staff toward attempted suicide patients during its first year of operation, but in general, the emergency room staff was content with the opportunity for psychiatric consultation.

Deliberate self-harm: emergency department nurses? attitudes, triage and care intentions

AIM AND OBJECTIVES

This exploratory study investigates emergency department nurses' attitudes towards patients who engage in deliberate self-harm. It examines their attitudes towards, and triage and care decisions with, patients who self-harm.

BACKGROUND

Emergency department nurses sometimes show unsympathetic attitudes towards patients who present with self-harm and these can contribute to difficulties in assessing and providing appropriate care.

DESIGN

A modified version of the Suicide Opinion Questionnaire was used. A non-probability sample of 43 emergency department nurses from a large Australian hospital participated in the study. Data were analysed using SPSS.

RESULTS

Most nurses had received no educational preparation to care for patients with self-harm; over 20% claimed that the department either had no practice guidelines for deliberate self-harm or they did not know of their existence and one-third who knew of them had not read them. Overall, nurses had sympathetic attitudes towards patients who self-harm, including both professional and lay conceptualizations of deliberate self-harm. They did not discriminate against this group of patients in their triage and care decisions.

CONCLUSIONS

The findings of this exploratory study are important because attitudes can affect care decisions. Recommendations are made for improving the educational preparation of emergency department nurses, for improving awareness and implementation of practice guidelines, and for improving attitudes towards patients with deliberate self-harm. Further research is needed to confirm these results.

Accident and emergency nurses’ attitudes towards patients who self-harm

The study aimed to assess if accident and emergency (A&E) nurses have positive or negative attitudes towards patients with deliberate self-harm, and to assess if nurses' age, length of A&E experience, or in-service education influence their attitudes towards these patients. An adapted version of the Suicide Opinion Questionnaire was used to assess attitudes towards patients with deliberate self-harm. Data were collected from 43 Registered Nurses in the A&E department of a major city hospital in Australia. Data were analysed using SPSS. Most nurses had received no educational preparation to care for patients with self-harm. Over 20% claimed the department either had no practice guidelines for DSH or they did not know of their existence; one-third who knew about them had not read them. There were significant differences between respondents on several variables. Older and more experienced nurses had more supportive attitudes than younger and less experienced nurses. Nurses who had attended in-service education on DSH had more positive attitudes than non-attendees. Overall, the findings have implications for improving the educational preparation of A&E nurses, improving awareness and adoption of practice guidelines, mentoring nurses, and improving attitudes towards patients who self-harm.

Benefits of implementing an academic training of trainers program to promote knowledge and clarity in work with psychiatric suicidal patients

A 200-hour academic, postgraduate training-of-trainers program in suicide prevention at Karolinska Institute for key mental healthcare staff, designed to enable them to enhance their co-workers' knowledge and job clarity, was evaluated in a panel study by means of questionnaires. Psychiatric staff working regularly with suicidal patients in clinics where key persons attended the course (n = 134, intervention group) were compared with staff working in clinics without participants (n = 166, control group). Perceptions of being sufficiently trained (p < .01) improved significantly among staff working in intervention clinics. Compared with the control group, the intervention group had a better understanding of essentials (p < .05); found instructions clearer (p < .01) and experienced fewer problems with superiors' differing views (p < .05) at follow up. Assistant nurses working in intervention clinics seem to have benefited most.

Suicide prevention training after traumatic brain injury: evaluation of a staff training workshop

OBJECTIVES

To evaluate a suicide prevention training workshop for staff working in the field of traumatic brain injury (TBI) and to develop new measures for evaluation of similar training in the future.

DESIGN

A prospective controlled pre- and posttest evaluation with a 6-month follow-up.

SUBJECTS

Multidisciplinary TBI rehabilitation and disability staff from the state of Victoria attending the workshop (n=50) and an equivalent control group (n=28) recruited from New South Wales.

SETTING

A statewide training workshop was held at a major rehabilitation center in Melbourne.

OUTCOME MEASURES

Three designed measures including an objective knowledge test, a self-assessment inventory of knowledge/skills and an attitudinal inventory.

RESULTS

Participants recorded statistically significant increases in their scores comparing the pre- to postworkshop evaluations. Many of these gains were maintained at the 6-month follow-up evaluation. In contrast, the control group had scores equivalent to those of workshop participants on the pretest evaluations but recorded no similar increase at follow-up. Factor analysis found that the knowledge and skills self-assessment inventory had 2 factors, each having good internal reliability.

CONCLUSION

The current workshop has proved effective in increasing staff knowledge and skills in the assessment and management of people with TBI exhibiting suicidal behaviors. Finally, the initial development of a knowledge and skills self-assessment measure shows promise, providing a resource for the ongoing evaluation of suicide prevention training in the TBI field.