Keep Safe: Evaluation of a Peer-Informed Suicide Prevention Program

Background and Purpose: Suicide in the United States rose at alarming rates during the last 15 years and is a major public health issue.  Serious mental illness (SMI) is a prime risk factor associated with suicidal ideation.  Although there is considerable research and study on mental illness and treatments, there are few evidence-based practices for suicide prevention among adults with SMI. In addition to the cost and training needed for existing EBPs, they do not address how clinicians should discuss suicide with clients or the types of skills necessary to facilitate these discussions among themselves. Consumers or clients, in addition to other important stakeholders, were not included in a systematic way in the process of creating these suicide prevention programs.  The purpose of this study was to assess the efficacy of KeepSafe a commnunity-informed intervention that promotes psychoeducation about suicide among clinicians and consumers.  

Methods: The KeepSafe curriculum was a unique collaboration between peer consumers, non-peer staff and consumers.  It consisted of four 90 minute sessions with an objective of creating a safe space to encourage conversation and awareness about suicide in order to prevent it. Researchers evaluated the pilot implementation of KeepSafe. Two 45 minute sessions were held weekly for one month at two different PROS sites. Implementation was facilitated by a peer specialist and a non-peer PROS staff member. Pre- and post- surveys were administered to measure socio-emotional outcomes of participating consumers and knowledge for the intervention. Feedback from participants and staff was also collected through surveys. 

Results: Forty-two consumers participated in the KeepSafe pilot study and most (55%) were female.  Bivariate analyses from pre- and post-survey data indicated participants increased their knowledge of relapse prevention and suicide awareness. They showed improvement on measures of self-esteem and social support. Statistically significant changes were noted in the Brief Cope Scale. In open-ended feedback about the program, participants and staff described the positive impact of the program and gains in knowledge and skills.

Conclusions: KeepSafe was created through a successful collaboration between consumers and clinical staff to reduce stigma and increase awareness around suicide. KeepSafe is a promising prevention program that can be further tested to address the suicide epidemic among community members that are highly vulnerable for suicide, specifically adults with SMI.