(WITHDRAWN) Self-Efficacy in Suicide Risk Assessment and Management: Provider Perspectives

Background and Purpose:

Approximately 129 individuals die by suicide per day (ASFP, 2019). In 2018 in the United States, suicide was the 2^nd leading cause of death for ages 10 to 24 and the 4^th leading cause among adults between ages 35-54 (CDC, 2018). To rapidly decrease suicide attempts and death, increasing the number of people with skills in risk assessment and management is necessary (National Action Alliance for Suicide Prevention, (2014).  Mental health professionals must keep up with recommendations to continue providing quality care of suicidal individuals. Providers need to be prepared to detect risk and intervene.  To improve training in this area, researchers, clinicians and other service providers need to continue to explore and understand factors which impact providers conducting suicide risk assessment and managing suicidal behaviors.  The purpose of this study was to examine what sources of general self-efficacy give rise to higher self-efficacy in risk assessment and management of suicidal individuals.

Method: In collaboration with a Department of Mental Health, a free training on suicide risk assessment and management was offered to mental health providers state wide. In our study, we have a sample of 340 mental health providers who attended  this Statewide training (85% female, 54% professionally licensed) . They completed a paper based pre-and post-test survey on the day of the training. The facilitator of the training used didactic and experiential strategies to disseminate the material.  At the end of the training, participants received 6.5 CEU credit hours for attending the training. The training utilized the Linehan Risk Assessment and Management Protocol as the suicide assessment tool.  The Wilcoxon Signed Ranked test was used to examine the difference in the outcome variables between the two points in time. In addition, we used logistic regression analyses  to investigate which source of self-efficacy predicated the likelihood of perceiving efficacy in suicide assessment tasks.

Results: Slightly less than half used cognitive behavioral therapy (40%) as their primary approach to practice and over half of the participants had experience working with a suicidal client (80%). Most of the participants had prior training (82%).  On average participants reported they had a training 1.3 years prior this training. The posttest scores of general assessment, high risk assessment, suicide history assessment and management of suicidal behaviors were significantly higher than the pretest scores. Results of the regression analyses showed that ten or more years of practice experience, along with high sources of mastery and general-self efficacy significantly predicted efficacy in suicide assessment and management after controlling for demographics.

Conclusions: Our study shows that providers who have more field experience, believe they are capable of completing difficult tasks and have repeatedly had opportunities to practice assessment, are more capable of completing suicide assessments and managing a client with suicidal behaviors. Thus, comprehension in this area may provide significant information regarding where to focus our training efforts. More implications will be discussed.