Abstract: Impact of Applied Suicide Intervention Skills Training in Army Reserve Units (Society for Social Work and Research 20th Annual Conference - Grand Challenges for Social Work: Setting a Research Agenda for the Future)

Schedule:

Saturday, January 16, 2016: 2:00 PM

Meeting Room Level-Meeting Room 4 (Renaissance Washington, DC Downtown Hotel)

* noted as presenting author

Alexa Smith-Osborne, PhD, Associate Professor, Director, Center for Clinical Social WOrk, University of Texas at Arlington, Arlington, TX

Arati Maleku, MSW, Doctoral student, University of Texas at Arlington, Arlington, TX

Background and Purpose: Suicide is a concern in the armed forces both because of the increased risk due to the high prevalence of mental health issues and its ripple effect. Increasing protective factors against suicide then, becomes crucial in reducing military suicide. Following the approval for a service-wide training-the-trainers initiative, the U.S. Army Reserves 807th Medical Command has been involved in the implementation of the peer model Applied Suicide Intervention Skills Training (ASIST) initiative since 2009 and in the Army National Guard since 2012. At the time of this study, total force in the Army Reserves had received ASIST training.

Although, studies on peer-led prevention programs reinforce justification for peer-led modules, studies examining effectiveness of peer training prevention programs on the target community suicide risk factors including depression, hopelessness, suicidal ideation, attempt, and completion is null. This presentation will discuss results of a pilot study conducted to examine the efficacy of ASIST in reducing risk factors for suicide in one ASIST-trained Army Reserve sub-division with varying levels of training compared with one Army National Guard unit prior to training.

Method: This study utilized a pre/post two-group quasi-experimental design to investigate two hypotheses over a four month intervention period. The two groups are Army Reserve platoons (N = 131) which have received more ASIST training and a comparison group of Army Reserve platoons which have received less. Since all Reservists had received training, characteristics available from a descriptive study of an Army National Guard (N = 38) prior to onset of their ASIST training were also examined for a baseline comparison. Resilience was measured by the self-report Resilience Scale for Adults, Negative future expectations were measured by the self-report Beck Hopelessness Scale, and suicidal ideation was measured at time 1 for Reservists and for Guardists by the self-report Beck Scale for Suicide Ideation.

Results: National Guard (untrained) and pretest Army Reserve low training group demographic characteristics were similar. Their clinical characteristics differed in that Guardists’ resilience (mean scores of 179.13 and 186. 66 respectively) and suicidal ideation (mean scores of .55 and 4.40 respectively) were lower than Reservists’. Pretest hopelessness scores were significantly negatively correlated with pretest resilience scores (r = -.59; p = .01), while pretest suicidality scores were not significantly correlated with any predictors. Posttest hopelessness scores decreased for both training groups, and resilience scores decreased for the high training group. However, post-training clinical scores were not correlated with training group, except that higher resilience scores were associated with the low training group, which was significantly older (t = 2.34; p = 02) and had fewer females (df 1; Χ²<.0001) , rather than the high training group (t = 56.51; p<.0001), contrary to hypothesis. Nevertheless, administrative records documented that the high training group had fewer reported suicide attempts and reports of suicidal ideation than the low training group.

Conclusions: Results support the need for direct investigation on efficacy of such primary prevention programs on target community suicide risk factors and whether they are ameliorated by peer model interventions..