Despite prevention efforts, suicide remains a leading cause of death for adolescents. A key aspect of suicide prevention is identifying youth at risk, providing immediate support, and connecting them with appropriate re- sources. While schools are an ideal place for such prevention activities, for the most part prevention programs have not been translated adequately from the research to school setting. A critical prevention challenge is to create school capacity to implement and sustain efficacious suicide prevention programs. The goal of this developmental project is to implement a program that will increase the capacity of school districts to respond effectively to youth suicide risk behaviors, and to assess the feasibility of this capacity-building program. Capacity to respond will be increased by training school personnel to implement and sustain prevention interventions at three levels of expertise: awareness and case finding by all school staff members (Level I), intermediate assessment for all counselors (Level II), and advanced assessment/brief intervention for select counselors/mental health professionals (Level III). A secondary goal of this project is to develop and pilot a student surveillance model that assesses school climate.
Study aims are to: (1) examine the feasibility of school-wide gatekeeper training (Level I) for increasing staff knowledge about warning signs for suicide risk and capacity to take action with students, (2) assess the feasibility of tiered assessment/brief intervention training (Levels II &III) by conducting in-depth assessments of trainees'opinions of and responses to training, (3) pilot a student surveillance model for assessing school climate characteristics, and (4) evaluate the feasibility of this focused capacity building approach from the perspective of school and district administrators. In Phase I of the study a combination of qualitative analyses and a limited, quasi-experimental pre-post test design are used. Focus groups will be conducted to assess Level II and Level III participants'perceptions about the training format, content, and utility. A within setting pre-post design and between setting post-test to pre-test with a selected comparison school district will be used to explore effects of training on Level I staff members'knowledge, skills, and willingness to intervene. In Phase II, we use a comparison school district to re-evaluate program changes made in the first implementation phase. We conclude by conducting interviews with school and district administrators to inquire about their perceptions of the overall feasibility of the project. This study responds to recommendations for systematic training in suicide prevention interventions through continuing education opportunities;addresses Healthy Youth 2010 objectives to reduce suicide rates and suicide attempts, and to increase the number of adolescents who receive treatment for mental health problems. It also responds to the Surgeon General's Call to Action recommendations to enhance community resources and train 'natural'gatekeepers. Findings will provide the foundation for an R01efficacy trial of the proposed capacity building model.

Public Health Relevance

The purpose of this developmental grant application is to assess the feasibility of a program of suicide prevention activities designed to increase the capacity of high schools to respond effectively to youth suicide risk behaviors. In addition, we will pilot a student survey for assessing related school climate and organizational characteristics. All school staff members will be trained as gatekeepers who can identify and approach a distressed young person, provide support, and refer the young person to a school counselor for further evaluation. School counselors will be trained in suicide prevention assessment and intervention methods. Evaluation will include: changes in school personnel knowledge, willingness to take action and provision of help and support;trainee feedback on the format, content and utility of training;and successful administration of survey activities.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21HD058164-02
Application #
7901457
Study Section
Community-Level Health Promotion Study Section (CLHP)
Program Officer
Haverkos, Lynne
Project Start
2009-08-01
Project End
2012-07-31
Budget Start
2010-08-01
Budget End
2012-07-31
Support Year
2
Fiscal Year
2010
Total Cost
$226,116
Indirect Cost
Name
University of Washington
Department
Other Health Professions
Type
Schools of Nursing
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195
Walsh, Elaine; Hooven, Carole; Kronick, Barbara (2013) School-wide staff and faculty training in suicide risk awareness: successes and challenges. J Child Adolesc Psychiatr Nurs 26:53-61