Psychological Medicine



An educational intervention for front-line health professionals in the assessment and management of suicidal patients (The STORM Project)


L. APPLEBY a1c1, R. MORRISS a1, L. GASK a1, M. ROLAND a1, B. LEWIS a1, A. PERRY a1, L. BATTERSBY a1, N. COLBERT a1, G. GREEN a1, T. AMOS a1, L. DAVIES a1 and B. FARAGHER a1
a1 School of Psychiatry and Behavioural Sciences, Withington Hospital and Department of Community Psychiatry, Royal Preston Hospital, National Primary Care Research and Development Centre, Department of Postgraduate Medicine and Dentistry, and Research Support Unit, Medical School, University of Manchester; and Centre for Health Economics, University of York

Abstract

Background. Suicide prevention is a health priority in many countries. Improved management of suicide risk may improve suicide prevention. This study aimed to assess the feasibility of health district-wide training in the assessment and management of people at risk of suicide; and to assess the impact of training on assessment and management skills.

Methods. Staff in three health care settings, namely primary care, accident and emergency departments and mental health services (N = 359), were offered suicide risk management training in a district-wide programme, using a flexible ‘facilitator’ approach. The main outcomes were the rate of attendance at training, and changes in suicide risk assessment and management skills following training.

Results. It was possible to deliver training to 167 health professionals (47% of those eligible) during a 6 month training period. This included 95 primary care staff (39%), 21 accident and emergency staff (42%) and 51 mental health staff (78%). Of these, 103 (69%) attended all training. A volunteer sample of 28 staff who underwent training showed improvements in skills in the assessment and management of suicide risk. Satisfaction with training was high. The expected costs of district-wide training, if it were able to produce a 2·5% reduction in the suicide rate, would be £99747 per suicide prevented and £3391 per life year gained.

Conclusions. Training in the assessment and management of suicide risk can be delivered to approximately half the targeted staff in primary care, accident and emergency departments and mental health services. The current training package can improve skills and is well accepted. If it were to produce a modest fall in the suicide rate, such training would be cost-effective. However, a future training programme should develop a broader training package to reach those who will not attend.


Correspondence:
c1 Address for correspondence: Professor Louis Appleby, School of Psychiatry and Behavioural Sciences, University of Manchester, Withington Hospital, Manchester M20 8LR.


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