The COVID pandemic has brought heightened attention to mental health disorders and suicide, as well as persistent social inequalities that increase suicide risk among vulnerable populations. In 2020, suicide was the 12th leading cause of death and the 3rd leading cause among youth ages 15-24 (Drapeau & McIntosh, 2021). Higher suicide risk has been found for people who are immigrants, homeless, have substance use disorders, or identify as sexual or gender minorities (Amiri & Behnezhad, 2020; Ayano et al., 2019; Forte et al., 2018; Nystedt et al., 2019). Most social workers report encountering clients contemplating suicide but receive inadequate educational or professional preparation. To effectively use science to address this complex problem, battle iniquities, and build solutions, we engaged in state and local partnerships to provide and test a suicide intervention training model. This poster illustrates the mechanisms through which suicide intervention training facilitates practitioner skill development and confidence in using suicide-specific skills.
We used path analysis to model the change process among participants who completed an intensive suicide intervention training. Participants included 150 practitioners in a Midwestern state who were either current practitioners or preparing for this role. Reliable and validated scales were used to measure self-reported fear (Fear of Talking About Suicide Scale), how direct to be with the person (Problem-Solving Directness Scale), confidence (Suicide Counseling Confidence Scale), and suicide-specific intervention skills (Suicide Counseling Skills Inventory), before and following the intervention training. Graduate-level training was controlled in the model because it is likely to affect the level of change in skills. We also examined whether the path model demonstrated differences by race/ethnicity, gender/gender identity, and age.
The path model found that the largest impact of training was that reducing participants’ fear of talking about suicide improved their confidence in intervening with potentially suicidal individuals. Fear reduction had a large effect on improving confidence in suicide counseling (B = -7.65, z = -6.47, p < .001.) Reducing fear also had a significant, though much smaller direct effect on improvement in skills (B = 0.08, z = 2.95, p = .003). In contrast, beliefs about using a more directive helping style and graduate-level training did not significantly affect improvement in suicide-specific skills. The model operated similarly regardless of race/ethnicity, gender, gender identity, or age. Fit indices, including the RMSEA index of less than .08, CFI of .92, SRMR of .08, and Chi-square goodness of fit test (p=.098), all indicate that model fits the data adequately.
Conclusions and Implications:
Reducing practitioners’ fear of talking about suicide had a strong impact on their confidence in helping individuals contemplating suicide and a smaller but significant impact on their skill development within a brief, intensive training program. Results offer implications for using science to help practitioners and trainees learn skills to respond appropriately to a highly complex and stigmatized population. The study also highlights methods for building and sustaining community-based research partnerships to strengthen the science of social work practice.