Immediate post intervention effects of two brief youth suicide prevention interventions

This study evaluated the immediate postintervention effects of two brief suicide prevention protocols: a brief interview--Counselors CARE (C-CARE)--and C-CARE plus a 12-session Coping and Support Training (CAST) peer-group intervention. Subjects were students "at risk" of high school dropout and suicide potential in Grades 9-12 from seven high schools (N = 341). Students were assigned randomly to C-CARE plus CAST, C-CARE only, or "intervention as usual." The predicted patterns of change were assessed using trend analyses on data available from three repeated measures. C-CARE and CAST led to increases in personal control, problem-solving coping, and perceived family support. Both C-CARE plus CAST and C-CARE only led to decreases in depression, and to enhanced self-esteem and family goals met. All three groups showed equivalent decreases in suicide risk behaviors, anger control problems, and family distress.     

Proximate outcomes of gatekeeper training for suicide prevention in the workplace

In this pilot study we report on proximate outcomes of a 1-hour community gatekeeper training in-service for 76 nonclinical employees in a university hospital workplace setting. Pre-post analyses resulted in positive changes in participants' knowledge about suicide and attitudes (self-efficacy) about intervening with suicidal individuals. A subset of participants engaged in role play practice of gatekeeper skills following training and rated the experience positively. Fifty-five observations were rated using an observational measure developed for this study and approximately half of these demonstrated satisfactory skills post training. Participants in this workplace gatekeeper training reported sharing new knowledge and skills with family, friends, and coworkers.     

Helpline: suicide prevention at a suicide site

In an effort to reduce the number of suicides from the Mid-Hutson Bridge in Poughkeepsie, New York, the Dutchess County Department of Mental Hygiene and the New York State Bridge Authority jointly established a suicide prevention phone on the bridge, which is directly connected to a 24-hour psychiatric emergency service. This program is the first known one in which a dedicated suicide prevention helpline has been installed at a site of known suicides and linked with a mental health service. After 2 years of operation, the phone has been used 30 times; the data suggest that most would-be jumpers are ambivalent enough about dying that they will reach out for help/contact if the opportunity exists, and, as a consequence, can be saved.     

Pilot study evaluation of suicide prevention gatekeeper training utilising STORM in a British university setting

Recent years have seen increasing awareness of the wide range of mental health problems faced by students. Gatekeeper training has been shown to have a positive impact on knowledge and attitudes about suicide prevention, although the evidence for skills acquisition is limited. We utilised the STORM® training package in an exploratory study to determine explore whether skills training could be successfully implemented in an educational establishment in the United Kingdom. In a pilot study assessing competence before and after the intervention there was evidence of acquisition of skills, improved attitudes and increased confidence. Further research should include a randomised controlled trial of such training.     

Alberta's suicide prevention training programs: a retrospective comparison with Rothman's developmental research model

Developmental research is used to transform existing knowledge into applied programs. A social research and development (R&D) method, developed by Rothman for the human service professions, is compared with the method used to develop the Suicide Prevention Training Programs in Alberta, Canada. A retrospective review compares the development of these programs, which have since been implemented both nationally and internationally, with Rothman's model; discusses social R&D as a transformation methodology; and draws conclusions about the probable success of using developmental research methods in the human services. The review finds that the Alberta method closely paralleled the phases of Rothman's model. Results show that the transformation of knowledge about suicide into widely disseminated suicide prevention training programs can be attributed to the application of social R&D principles. The study concludes that the use of developmental research methods to establish human service programs should increase the probability of their success.     

Control-group study of an intervention training program for youth suicide prevention

Few studies have examined whether training can improve competency in intervening with suicidal youths. In this study we attempted to verify the effectiveness of such a training program on helper competency. Forty-three helpers who received the training were compared with 28 helpers who did not. Participants who received the training improved in knowledge, attitudes, and intervention skills following the training, compared with the control group across measures. Their gains were maintained at 6-month follow-up. In this sample, implementation of a one-time training program improved helpers' competencies in youth suicide intervention.     

Depression, suicide, and suicide prevention in schizophrenia

Suicide is the single largest cause of premature death among individuals with schizophrenia. Furthermore, epidemiological data indicate that nearly 80% of patients with the diagnosis of schizophrenia will experience a major depressive episode at some time during their lifetime. This report reviews recent findings relative to the risk of suicide in schizophrenia, including data from the Chestnut Lodge longitudinal study of schizophrenia subtypes and symptom domains. Paradoxically, those patients with schizophrenia who are most likely to recover or experience a good outcome are also those at greatest risk for suicide. The reduction of morbidity and mortality in schizophrenia should include depression and suicidality as targets for both psychopharmacological and psychosocial treatment.     

Advancing prevention research on the role of culture in suicide prevention

Despite evidence of considerable racial/ethnic variation in adolescent suicidal behavior in the United States, research on youth of European American descent accounts for much of what is know about preventing adolescent suicide. In response to the need to advance research on the phenomenology and prevention of suicidal behavior among ethnic minority populations, NIMH co-sponsored the "Pragmatic Considerations of Culture in Preventing Suicide" workshop to elicit through interdisciplinary dialogue how culture can be considered in the design, development, and implementation of suicidal behavior prevention programs. In this discussion paper we consider the three ethnic minority suicide prevention efforts described in the articles appearing in this issue, along with workshop participants' comments, and propose six major areas where issues of culture need to be better integrated into suicidal behavior research.     

Young suicide attempters compared with a control group: psychological, affective, and attitudinal variables

Suicide attempters admitted to a general hospital psychiatric ward completed questionnaires to elicit information following their suicide attempt. Compared to normal controls who had never attempted suicide, suicide attempters were significantly more hopeless, depressed, and hostile. The suicide attempts seemed to occur in response to stress. A crisis intervention model was suggested as the most appropriate way of managing these patients.     

Evaluation of a youth suicide prevention school program

Adolescent suicide is a subject of increasing national concern. In California, this problem was addressed through the implementation of a three-year youth suicide prevention school program established by legislative mandate in 1983. Findings for the first two years of the program indicate significant gains in understanding of youth suicide prevention techniques for those high school students who completed a four-hour training course. School staff and parents completing 90-minute youth suicide awareness seminars indicated that they most appreciated receiving practical advice and resources they could use in responding to a potentially suicidal young person.     

Efficacy of brief telephone psychotherapy with callers to a suicide hotline

The efficacy of two types of theapy conducted exclusively over the telephone was studied. Clients (N=55) were recruited from a pool of callers to a suicide hotline and were randomly assigned to a waiting list control (WC) or Solution Focused Brief Therapy (SFBT) or Common Factors Therapy (CFT). It was hypothesized that improvements would be significantly higher in the two therapy conditions compared to the waitlist control and SFBT would be significantly more efficacious than CFT. Results confirmed that improvement was significantly higher in the two treatment conditions compared to the waitlist control, but no difference in improvement was found between SFBT and CFT. The implications of these findings for suicide hotlines are discussed.     

Maturational changes in Canadian adolescents' cognitive attitudinal structure concerning marijuana

Thirty-four items concerning marijuana use were administered three times to a cohort of Canadian high school students between Grades 11 and 13, in 1977 (n = 439), 1978 (n = 419), and 1979 (n = 167). These items were designed to measure four distinct constructs: attitude, perceived peer approval or disapproval, concern about risks, and symbolic protest against conventional society. A cross-sectional factor analysis of the Grade 13 data supported the hypothesized factor structure, as had earlier work with college students. However, analogous analyses on the Grade 11 and Grade 12 data contradicted the hypothesized factor structure. Most notably, separate factors for positive and negative attitude appeared in the Grade 11 and 12 analyses. The data were interpreted primarily in terms of maturational changes, largely through elimination of alternative interpretations by internal analyses and previous findings. Implications were discussed for adolescent cognitive-attitudinal development, attitude theory, and analysis of panel data.     

Toward a psychoeducational curriculum for training sport-injury rehabilitation personnel

Abstract

This paper addresses significant gaps in the wining programs of sport-injury rehabilitation personnel (SIRPs) in the psychology ma. The main aim of the article is to offer for consideration a psychoeducational curriculum that is specifically designed for the training of professionals who work with injured athletes. In addition to describing the applied implications of research on the psychological aspects of sport injuries for professional practitioners. reviews of what SIRPs consider is missing-but-desirable in their professional wining. and the effectiveness of certain psychological strategies, are presented. Finally. an overview of a prototypical three-year curriculum for professional training programs is outlined.     

Starting a therapy group in a suicide prevention and crisis center.

This report outlines the experience of one center in establishing a group therapy program, discussing the "readiness" of the center, reservations of the governing board, qualifications and number of group leaders, composition of the group, time-place-duration of meetings, "open" versus "closed" structure, vagaries of obtaining participants, integration with the 24-hour telephone crisis service, problems of confidentiality, and dealing with the suicide of a group member.     

Examining a brief suicide screening tool in older adults engaging in risky alcohol use

Alcohol misuse increases risk of suicidal behavior in older adults. The Depressive Symptom Inventory‐Suicidality Subscale (DSI‐SS; Metalsky & Joiner, 1997) and its relation to suicide attempt history was examined to see if it differed for older adults as a function of their alcohol use. Structural equation modeling was used in a sample (N = 1,061) of older adult outpatients to examine the scale’s measurement invariance and population heterogeneity and its relation to suicide attempt history. Analyses supported the equivalence of the DSI‐SS in risky and nonrisky drinkers. The DSI‐SS significantly predicted past suicide attempts. Findings support the viability of the DSI‐SS as suicide screening tool for older adults.     

Naturally occurring language as a source of evidence in suicide prevention

We discuss computational language analysis as it pertains to suicide prevention research, with an emphasis on providing non‐technologists with an understanding of key issues and, equally important, considering its relation to the broader enterprise of suicide prevention. Our emphasis here is on naturally occurring language in social media, motivated by its non‐intrusive ability to yield high‐value information that in the past has been largely unavailable to clinicians.