Impact of Applied Suicide Intervention Skills Training on the National Suicide Prevention Lifeline

We examined the impact of the implementation of Applied Suicide Intervention Skills Training (ASIST) across the National Suicide Prevention Lifeline's national network of crisis hotlines. Data were derived from 1,507 monitored calls from 1,410 suicidal individuals to 17 Lifeline centers in 2008–2009. Callers were significantly more likely to feel less depressed, less suicidal, less overwhelmed, and more hopeful by the end of calls handled by ASIST‐trained counselors. Few significant changes in ASIST‐trained counselors' interventions emerged; however, improvements in callers' outcomes were linked to ASIST‐related counselor interventions, including exploring reasons for living and informal support contacts. ASIST training did not yield more comprehensive suicide risk assessments.     

Educational psychology in England and Wales

This paper describes the work of educational psychologists in England and Wales, within the context of the educational system in this part of the United Kingdom. The school system and its relationship to local national control is discussed. The development of psychological services is considered from their origin in 1913 to the present day, and data are given concerning the demographic aspects of the profession and current patterns of training. Current major contributions of educational psychologists are reviewed in a context of change consequent upon development from within the profession and that forced upon the profession by recent legislation, in particular the 1981 Education Act which, for the first time, gives educational psychologists a statuary role, in the assessment of children's special educational needs.     

An Integrative Suicide Prevention Program for Visitor Charcoal Burning Suicide and Suicide Pact

An integrative suicide prevention program was implemented to tackle an outbreak of visitor charcoal burning suicides in Cheung Chau, an island in Hong Kong, in 2002. This study evaluated the effectiveness of the program. The numbers of visitor suicides reduced from 37 deaths in the 51 months prior to program implementation to 6 deaths in the 42 months post‐implementation period. The number of visitor suicide pacts decreased from 7 pacts (15 individuals) to 1 pact (2 individuals). No statistically significant differences in the numbers of visitor suicide attempts and resident suicides were observed in the two time periods. No statistically significant changes in visitor suicides during the study period were observed on the comparison islands. The consistency and timing of reduction in visitor suicides correlated with the development and delivery of the integrative program on the intervention island, suggesting a causal association between program delivery and reduction of visitor suicides. The possibility of displacement seems small because there was no increase in visitor suicides on the comparison islands during the study period. This integrative approach in preventing target‐specific suicides may serve as an example for other communities to develop suicide prevention programs that make use of the existing local resources.     

Mobilizing Schools for Suicide Prevention

ABSTRACT: Experience in providing consultation and survivor counseling to school personnel following student suicides led to the development of a program of prevention through training school personnel. The goal of the program was to increase the ability of resource persons available to adolescents—teachers, counselors and school nurses—to recognize signs of suicidal depression and to respond effectively to suicidal students. This report describes that program, the reaction of the participants and the observations of the project staff, and comments on the feasibility of this approach as a means of helping to prevent suicide among adolescents.     

Feasibility of a Web‐based Gatekeeper Training: Implications for Suicide Prevention

Web‐based training programs have advantages such as increased scheduling flexibility and decreased training costs. Yet the feasibility of applying them to injury prevention programs such as suicide prevention gatekeeper training has not been empirically verified. Two studies were conducted to assess the feasibility and effectiveness of a web‐based version of the Question, Persuade, and Refer (QPR) gatekeeper training program. Results of Study 1 revealed that participants in a web‐based training demonstrated significant gains in knowledge of suicide prevention, self‐efficacy for suicide prevention, and behavioral intentions to engage in suicide prevention, as compared to those in a control group. Results of Study 2 further showed that the web‐based training may be as effective as the face‐to‐face QPR training across pre‐ (T1) and post training (T2); however, knowledge, self‐efficacy, and behavioral intentions in both groups generally declined from T2 to 6‐months after the training. Overall, these results provide initial evidence to support the feasibility of adopting web‐based media to deliver gatekeeper training. Moreover, the present findings suggest the need to understand how to maintain gatekeepers’ knowledge, confidence, motivation, and skills after training.     

The educational psychologist in England and Wales

This article reviews the background to the development of the profession in England and Wales. It traces the recent pressures for expanding the size of the profession which led to the establishement of a working party by the British Government's Department of Education and Science, under the chairmanship of Professor Summerfield. The recent report of this working party (Department of Education and Science, 1968) is discussed and its analysis of the functions of the educational psychologist is summarized. The article selects a few of the report's main recommendations for the future. Those recommendations relating to training, numbers of educational psychologists required, the nature of the work, and the structure of the profession are outlined. Finally the article discusses initial reactions to the recommendations of the report.     

Treating the Capability for Suicide: A Vital and Understudied Frontier in Suicide Prevention

Current efforts at suicide prevention center largely on reducing suicidal desire among individuals hospitalized for suicidality or being treated for related psychopathology. Such efforts have yielded evidence‐based treatments, and yet the national suicide rate has continued to climb. We propose that this disconnect is heavily influenced by an unmet need to consider population‐level interventions aimed at reducing the capability for suicide. Drawing on lessons learned from other public health phenomena that have seen drastic declines in frequency in recent decades (HIV, lung cancer, motor vehicle accidents), we propose that current suicidality treatment efforts trail current suicidality theories in their lack of focus on the extent to which individuals thinking about suicide are capable of transitioning from ideation to attempt. We summarize extant evidence for specific capability‐centered approaches (e.g., means safety) and propose other options for improving our ability to address this largely overlooked variable. We also note that population‐level approaches in this regard would represent an important opportunity to decrease risk in individuals who either lack access to evidence‐based care or underreport suicidal ideation, as a reduced capability for suicide would theoretically diminish the potency of suicidal desire and, in this sense, lower the odds of a transition from ideation to attempt.     

Chronic Callers to a Suicide Prevention Center

ABSTRACT: Records of 67 chronic callers to the Cleveland Suicide Prevention Centers over the past 9 years are reviewed. Of this group, 51% were diagnosed as drug or alcohol dependent. It was also noted that 4 of the 67 were known to have committed suicide and that another 37 (55%) had made suicide attempts. A surprising finding was that 47% of the group was eventually referred to an ongoing treatment resource. Agency strategies for dealing with the chronic caller are discussed.     

Myths and Facts about Suicide from Individuals Involved in Suicide Prevention

Myth‐busting, in which a so‐called myth is presented and dispelled by facts, is used in suicide prevention gatekeeper trainings such as QPR. Evidence from other areas of public health shows this technique leads to memory for myths and not facts. An internet survey was used to determine if the “myths” and “facts” presented in QPR are endorsed as such by the suicidology community and to determine if demographics influenced statement identification. Overall, statements did reflect the opinions of the suicidology community and any type of training increased correct identification. Future research should focus on whether myth‐busting is an appropriate strategy for suicidology.     

New Directions for Suicide Prevention Centers*

ABSTRACT: This paper considers a number of questions regarding the epidemiology of suicidal phenomena and discusses some of the efforts of the Cornell Program in Social Psychiatry to study these questions and to explore new directions for suicide prevention work. Particular attention is paid to high suicide risk groups that are outside the network of existing medical services. Strategies for extending the clinical picture differentiating between syndromes assessing individual risk, clarifying etiological factors, and improving the working of the health services are considered.     

Suicide Prevention in a Treatment Setting

Reducing the suicide rate through treatment depends on the development of new knowledge and new technology with emphasis on early intervention and continuing lowintensity contact for many troubled suicidal people, rather than the current preoccupation with detecting and hospitalizing the “highest risk.” I anticipate that sophisticated interactive computer programs will be effective in improving screening and case finding, thus bringing many more suicidal persons into contact with primary care physicians and outpatient mental health services for the purpose of relieving psychological pain. Computer programs will be invaluable in improving training for both primary care providers and outpatient mental health workers. Improved communication networks will prove to be useful resources for maintaining continuity of care and consultation, which is important in long-term treatment. Other technical developments include simplifying and making explicit various treatment approaches, in both psychotherapy and drug therapy, so that research can proceed to clarify what type of treatment helps which type of suicidal patient.