Suicide prevention training outside the mental health service system - Evaluation of a state-wide program in Australia for rehabilitation and disability staff in the field of traumatic brain injury

Liverpool Hospital, Liverpool, New South Wales, Australia
Crisis The Journal of Crisis Intervention and Suicide Prevention (Impact Factor: 1.09). 01/2007; 28(1):35-43. DOI: 10.1027/0227-5910.28.1.35
Source: PubMed


The training needs of staff working in mainstream (i.e., noncrisis) health settings with client groups that have moderate levels of suicide risk have not been extensively addressed. An initiative to train rehabilitation and disability staff working in the field of traumatic brain injury (TBI) is described. A program was adapted from a generic state health department training program, and disseminated by means of established training networks within the brain injury field. Program efficacy was evaluated as the training was provided across the state of Victoria in a series of 1-day workshops. Participants (n = 86) completed two evaluation measures designed for this purpose (objective knowledge test, self-rating of knowledge and skills) on three occasions (pre- and postworkshop, 6-month follow-up). Compared to a control group of rehabilitation and disability workers who did not receive the training (n = 27), the workshop participants made significant gains in objective knowledge and reported skills, and maintained these gains at the 6-month follow-up. The Suicide Interview Response Inventory-2 (Neimeyer & Pfeiffer, 1994) was administered to a subgroup of participants as a validating measure, and correlated significantly with scores from the objective knowledge test. This process may provide a template for developing more fine-grained suicide prevention strategies among other health-related at-risk groups.

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    ABSTRACT: In this, the last issue of the year, I am pleased to review the articles Crisis published in 2007. In this volume, the journal published papers from authors in 22 different countries, reflecting both the international reach of the journal and that of the International Association for Suicide Prevention. The published studies span a wide range of issues, from suicide mortality surveillance data in South Africa to helping those bereaved by suicide in Hong Kong, and draw on various methodologies including epidemiological, longitudinal, time series, econometric, content analytic, and qualitative approaches. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
    Crisis The Journal of Crisis Intervention and Suicide Prevention 07/2007; 28(4):159-164. DOI:10.1027/0227-5910.28.4.159 · 1.09 Impact Factor
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    ABSTRACT: A systematic search was conducted of the literature addressing suicidality after traumatic brain injury (TBI). Results from population-based studies found that people with TBI have an increased risk of death by suicide (3-4 times greater than for the general population), as well as significantly higher levels of suicide attempts and suicide ideation. Clinical studies have also reported high levels of suicide attempts (18%) and clinically significant suicide ideation (21-22%) in TBI samples. In reviewing risk factors, two prognostic studies using multivariate analysis were identified. Adjusted risk statistics from these studies found an elevated risk of suicide for people with severe TBI in comparison to concussion (hazard ratio 1.4, 95% CI 1.15-1.75) and an elevated risk of suicide attempts among people displaying post-injury suicide ideation (adjusted odds ratio 4.9, 95% CI 1.79-13.17) and psychiatric/emotional distress (adjusted odds ratio 7.8, 95% CI 2.11-29.04). To date, little evidence exists for the role of pre-morbid psychopathology, neuropathology, neuropsychological impairments or post-injury psychosocial factors as major risk factors for post-injury suicidality. Finally, there has been little empirical examination of approaches to suicide prevention. Therefore, current best practice is based on clinical judgement and the untested extrapolation of prevention approaches from other clinical populations.
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