Resource Types: Program/Practice

Developed by Pace University, the Suicide Prevention Multicultural Competence Kit is geared toward developing multicultural competence among mental health professionals who work with diverse college students, and also among community members of a college or university (i.e., faculty, staff, administrators, and students). Its aim is to help people understand the mental health needs of diverse students in order to prevent suicide. Through an interactive one-hour PowerPoint presentation, participants learn about how discrimination of all kinds leads to negative mental health outcomes, how stigma prevents help-seeking, and how an understanding of diversity can help people connect a depressed or suicidal student with the help they need. The presentation comes with ancillary training resources including fact sheets (with self-study quizzes), training vignettes, bibliographies, student and parent brochures, resource lists, public service announcement suggestions, and a poster.

Multicultural Competence Kit materials are based on a literature review of topic areas, a search of suicide education and prevention websites, and focus groups with faculty, staff, administrators, students, mental health professionals, and suicide prevention experts.

Program Objectives

At the end of training, participants will have:

1. Increased knowledge of suicide facts and trends with diverse populations.
2. Increased knowledge about suicide warning signs and risk factors for minority students.
3. Increased knowledge of the impact of hate and discrimination on the mental health of minority students.
4. Increased ability to facilitate help-seeking behavior of minority students.

Implementation Essentials

• Trainers should be aware of available resources for minority students who may be at risk for suicide, and should provide trainees with this information.
• Trainers should be aware of relevant institutional protocols and guidelines regarding the identification, referral, and care of students who are at risk for suicide, and make these part of their training.

2012 NSSP Objectives Addressed: 

Objective 7.1: Provide training on suicide prevention to community groups that have a role in the prevention of suicide and related behaviors.

Recognizing and Responding to Suicide Risk in Primary Care (RRSR—PC) is a one-hour facilitated training for primary care physicians, physician assistants, and others who work in primary care settings. The training will help them better identify, manage, and treat adult patients who are at risk for suicide. Training is deliverable face-to-face or by webinar.

Features of RRSR—PC training include:

• One-hour PowerPoint presentation
• Video vignettes demonstrating suicide risk assessment and management skills
• Suicide Risk Assessment & Triage Pocket Card
• Seven resource sheet handouts

RRSR—PC training was developed by a collaborative task force composed of suicidologists and primary care practitioners. Suicidologists and primary care professionals crafted the presentation content and created the pocket card and resource sheets. Focus groups with primary care physicians, physician assistants, and nurses informed the training structure. The training was pilot tested and corresponding improvements made. An adolescent version featuring video vignettes of teens in primary care settings is also available.

Program Objectives

After training, participants will be able to:

1. Understand why and how routine suicide risk screening can be incorporated into routine medical visits.
2. Understand what constitutes appropriate risk management strategies and crisis response planning.
3. Know how to effectively document a suicide risk assessment in a medical chart.
4. Have increased confidence in initiating and discussing the topic of suicide with their patients.
5. Understand how to use algorithms and decision-making tools to identify a patient at risk for suicide.
6. Apply principles of crisis management to appropriately triage a primary care patient at risk for suicide.
7. Deliver brief interventions to manage a primary care patient at risk for suicide.

Implementation Essentials

• Training must be conducted by an authorized RRSR—PC trainer.

2012 NSSP Objectives Addressed: 

Objective 7.2: Provide training to mental health and substance abuse providers on the recognition, assessment, and management of at-risk behavior, and the delivery of effective clinical care for people with suicide risk.

S.A.V.E. is a one- to two-hour gatekeeper training program provided by VA suicide prevention coordinators to veterans and those who serve veterans. Optional role-playing exercises are included. S.A.V.E consists of the following five components:

1. Brief overview of suicide in the veteran population
2. Suicide myths and misinformation
3. Risk factors for suicide
4. Components of the S.A.V.E. model (Signs of suicide, Asking about suicide, Validating feelings, Encouraging help and Expediting treatment)

S.A.V.E. was developed by the Education Corps of the VA Center of Excellence for Suicide Prevention and consists of a PowerPoint presentation, training script, instructors guide and toolkit, pre- and post-evaluation instructions, evaluation forms, tracking sheets and S.A.V.E. brochures.

Program Objectives

After training, the participant will be able to:

1. Identify the scope of the problem of suicide among the veteran population.
2. Identify the importance of suicide prevention.
3. Discuss myths and misinformation about suicide.
4. Identify a veteran who may be at risk for suicide.
5. Discuss signs and symptoms of suicidal thinking.
6. Ask questions about suicide in an objective and non-threatening way.
7. Refer a veteran for evaluation and treatment.

Implementation Essentials

• S.A.V.E. training should be conducted by trained VA suicide prevention coordinators or other qualified professionals.

2012 NSSP Objectives Addressed: 

Objective 5.3: Intervene to reduce suicidal thoughts and behaviors in populations with suicide risk.

Objective 7.1: Provide training on suicide prevention to community groups that have a role in the prevention of suicide and related behaviors.

Objective 7.2: Provide training to mental health and substance abuse providers on the recognition, assessment, and management of at-risk behavior, and the delivery of effective clinical care for people with suicide risk.

Developed by the American Foundation for Suicide Prevention, More Than Sad: Suicide Prevention Education for Teachers and Other School Personnel is designed to help educators better understand suicidal behavior in adolescents, including its causes, treatment and prevention. The program is built around two 25-minute DVDs: More Than Sad: Preventing Teen Suicide and More Than Sad: Teen Depression. (In the current program, Teen Depression is used to show adults how a potentially life-threatening mental disorder can present in teens.) The facilitator materials are downloadable from the AFSP website and include a Facilitator’s Guide, slides for teacher trainers, instructional manual for program participants, and other resources. An expert advisory panel guided the development of the program. The materials were updated in 2015. The program is also suitable for parents and other adults who care for or work with youth.

The program answers the following questions:

• How big a problem is youth suicide?
• How can teachers help prevent youth suicide?
• What puts teens at risk for suicide?
• What treatments are available?
• How can teachers identify at-risk students?
• How else can schools decrease risk?

Program Objectives

After completing the program, participants will have

1. Increased awareness of the problem of teen suicide and how it can be effectively treated and prevented.
2. Increased understanding of mental disorders and other risk factors for teen suicide, so that they are better prepared to identify and refer students who may be at risk.
3. Increased knowledge of their school’s resources, policies, and protocols for identifying and assisting youth at risk of suicide.

Implementation Essentials

• Program presenters should first carefully prepare by reviewing the Facilitator’s Guide and other program materials and follow the outlined recommendations for delivering the program.
• Educators who participate in the More Than Sad educational program should be made aware of their school’s crisis management plan, policies on bullying and harassment, and procedures for referring students for mental health evaluation.

2012 NSSP Objectives Addressed: 

Objective 7.1: Provide training on suicide prevention to community groups that have a role in the prevention of suicide and related behaviors.

Developed by the American Association for Suicidology, the School Suicide Prevention Accreditation Program is a self-study course for school professionals who want to increase their knowledge of school-based suicide prevention issues. The course is appropriate for those who work in school settings or work with school-age youth, including school psychologists, social workers, counselors, nurses, and others who may be responsible for reducing suicide and suicide-related behaviors. Participants receive a school suicide prevention resource guide, recommended reading list, and sample exam. Participants study at their own pace. When ready, participants take an online accreditation exam. Upon successful completion of the exam, participants receive a certificate of accreditation by the American Association of Suicidology (AAS). In addition to the course, participants receive a one-year membership in AAS and an accompanying one-year subscription to Suicide and Life-Threatening Behavior.

Among the topics covered by the course are the following:

• Risk factors for youth suicide
• Warning signs for suicide
• Triaging and making referrals
• Crisis assessment and intervention
• Prevention principles and models
• Legal issues and best practices
• Evidence-based practices
• Postvention
• Involving parents
• School reintegration after a suicide attempt
• Trauma and youth
• Suicide contagion and clusters
• Safety plans
• Self-injury
• Additional resources

The School Suicide Prevention Accreditation Program was developed using a consensus process involving adolescent and school-based professionals who defined the universe of necessary and sufficient knowledge for competency in this area, developed teaching materials, and built examination questions.

Program Objectives

After training, participants will have:

1. Increased knowledge of suicide prevention issues as they pertain to youth and schools.
2. Increased awareness of best practices and evidence-based programs for youth and school-based suicide prevention.

2012 NSSP Objectives Addressed: 

Objective 5.2: Encourage community-based settings to implement effective programs and provide education that promote wellness and prevent suicide and related behaviors.

Objective 7.1: Provide training on suicide prevention to community groups that have a role in the prevention of suicide and related behaviors.

The QPRT Suicide Risk Assessment and Management Training Program is designed to reduce mental health consumer morbidity and mortality by standardizing the detection, assessment, and management of patients at elevated risk for suicidal behaviors in all settings and across the age span. The QPRT suicide risk assessment protocols are guided clinical interviews developed through expert opinion and anchored in the scientific literature on suicide risk assessment. Protocol questions produce a standardized suicide risk assessment that includes documentation of risk and protective factors, current suicidal ideation, desire, intent, planning, past attempts and other self-report of suicide capability. Third-party input to the final risk assessment is encouraged, and the pediatric version of the program includes a family-centric interview protocol. A collaborative crisis management, monitoring, and safety plan (based on data gathered from the QPRT protocol by a trained practitioner) is integrated into the medical record and treatment and/or referral plan.

The QPRT Suicide Risk Assessment and Management Training Program was developed by a multidisciplinary team of psychiatrists, psychologists, nurses, and mental health therapists at Spokane Mental Health, Spokane, Washington, in response to fatality review reports indicating that a lack of standardized suicide risk assessment may have contributed to preventable patient deaths. Beta testing of expert opinion protocol questions were solicited from members of the American Association of Suicidology and vetted by external records review.

Program Objectives

At the end of the training, QPRT participants will have increased:

1. Competence and confidence in the assessment and management of those at risk for suicide.
2. Ability to document suicide risk assessment and clinical decision making.
3. Skills to conduct a suicide risk assessment.
4. Ability to produce a standardized suicide risk assessment.

Implementation Essentials

• Training must be conducted by a certified QPRT trainer.

2012 NSSP Objectives Addressed: 

Objective 7.2: Provide training to mental health and substance abuse providers on the recognition, assessment, and management of at-risk behavior, and the delivery of effective clinical care for people with suicide risk.

The Gryphon Place Gatekeeper Suicide Prevention Program: A Middle School Curriculum is a universal prevention program for Grades 7-8, developed by Gryphon Place. The program is comprised of a three-lesson curriculum delivered on three consecutive days. Schools host the program, which is delivered by Gryphon Place employees. In addition to the curriculum, staff and parent awareness presentations are offered to schools.

The primary goal of the Gryphon Place Gatekeeper Suicide Prevention Program is to increase the likelihood that school gatekeepers—administrators, faculty, staff, and students—can identify, intervene, and obtain help for at-risk youth. Additional goals are to educate about issues of mental illness, depression, and substance abuse in a manner that reduces stigma and encourages help-seeking behaviors; and to develop coping, self-esteem, asset-building, stress reduction, and communication skills. Students receive information about local resources available to help them or their friends.

The program has been in operation continuously since 1998 and was developed to serve as a companion program to the Gryphon Place High School Gatekeeper Curriculum. The middle school program was developed at the request of local schools, which provided teacher and counselor input to ensure it was developmentally appropriate.

Program Objectives

After training, students should have:

1. Increased knowledge about suicide, substance abuse and common teen stressors.
2. Increased knowledge of how to seek help for themselves or others.
3. Increased knowledge of helping resources.

Implementation Essentials

• The program must be presented by personnel trained by Gryphon Place.
• Specific school referral points for at-risk students and linkages to helping services must be identified and incorporated into the curriculum content prior to implementation.

2012 NSSP Objectives Addressed: 

Objective 7.1: Provide training on suicide prevention to community groups that have a role in the prevention of suicide and related behaviors.

Recognizing and Responding to Suicide Risk: Essential Skills for Clinicians (RRSR – MH) is an advanced two-day interactive training for mental health clinicians who want to acquire competency-based skills for working with clients at risk for suicide. RRSR training is based on a set of 24 core clinical competencies, developed by a task force of clinical experts collaborating with the American Association of Suicidology (AAS) and the Suicide Prevention Resource Center. These competencies comprehensively define the knowledge, skills and attitudes required to effectively assess, manage, and treat individuals at risk for suicide. The goal of the training is for clinicians to become more confident, competent, and prepared to meet the needs of distressed clients and their families.

Features of RRSR training include:

• Two-day face-to-face workshop;
• Online post-workshop mentoring;
• Participant manuals with resource materials;
• Continuing education credits;
• Web-based assessment;
• Highly qualified trainers.

Program Objectives

After training, participants should be able to:

1. Competently conduct a suicide risk assessment.
2. Formulate level of risk for suicide.
3. Develop a treatment and services plan to address suicide risk.

Implementation Essentials

• Training must be conducted by an authorized RRSR trainer.

2012 NSSP Objectives Addressed: 

Objective 7.2: Provide training to mental health and substance abuse providers on the recognition, assessment, and management of at-risk behavior, and the delivery of effective clinical care for people with suicide risk.

Emergency Department Means Restriction Education is an intervention for the adult caregivers of youth (aged 6 to 19 years) who are seen in an emergency department (ED) and determined through a mental health assessment to be at risk for suicide. This intervention is designed to help parents and adult caregivers of at-risk youth recognize the importance of taking immediate, new action to restrict access to firearms, alcohol, and prescription and over-the-counter drugs in the home. It also gives parents and caregivers specific, practical advice on how to dispose of or lock up firearms and substances that may be used in a suicide attempt. The intervention is designed to be delivered in a brief period consistent with the demands of busy EDs. It consists of three components or messages that can be delivered by a trained health care professional, such as a physician, nurse, social worker, or mental health specialist. The three components are (1) informing parents, when their child is not present, that the child is at increased suicide risk and why (e.g., “Adolescents who have made a suicide attempt are at risk for another attempt”); (2) telling parents they can reduce this risk by limiting their child’s access to lethal means; and (3) educating parents and problem solving with them about how to limit access to lethal means.

Designation as a “Program with Evidence of Effectiveness”

SPRC designated this intervention as a “program with evidence of effectiveness” based on its inclusion in SAMHSA’s National Registry of Evidence-Based Programs and Practices (NREPP).

Outcome(s) Reviewed (Overall Quality of Research Rating-scale of 0 to 4)*

1: Access to medications that can be used in an overdose suicide attempt (2.5)
2: Access to firearms (2.7)

Read more about this program’s ratings.

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* NREPP changed its review criteria in 2015. This program is a “legacy program,” meaning that it was reviewed under the post-2015 criteria. The evidence for each outcome was reviewed and scored on a scale of 0-4, with 4 indicating the highest quality of evidence and 0 indicating very poor quality of evidence. The overall rating was based on ratings of six criteria: 1) reliability of measures, 2) validity of measures, 3) intervention fidelity, 4) missing data and attrition, 5) potential confounding variables, and 6) appropriateness of analysis. When considering programs, we recommend (a) assessing whether the specific outcomes achieved by the program are a fit for your needs; and (b) examining the strength of evidence for each outcome. 

2012 NSSP Objectives Addressed: 

Objective 6.1: Encourage providers who interact with individuals at risk for suicide to routinely assess for access to lethal means.

Objective 8.4: Promote continuity of care and the safety and well-being of all patients treated for suicide risk in emergency departments or hospital inpatient units.

Objective 9.4: Adopt and implement guidelines to effectively engage families and concerned others, when appropriate, throughout entire episodes of care for persons with suicide risk.