Training Youth Services Workers to Identify, Assess, and Intervene when Working with Youth at High Risk for Suicide

Research suggests that youth in the child welfare system are at an elevated risk of suicide ideation and behavior due to the numerous physical and psychological challenges they face, including victimization, unstable housing, mental health challenges including depression and substance abuse, and reduced access to needed services. This study was a longitudinal assessment of the impact of suicide intervention training on providers’ abilities to identify, assess, and intervene when working with youth in the child welfare system who were at high risk for suicide ideation and behaviors. It was hypothesized that participation in a 4-hour “Youth Depression and Suicide: Let’s Talk” (YDS) gatekeeper training suicide intervention curriculum would yield improvements in participants’ attitudes toward suicide intervention, knowledge about suicide intervention, self-efficacy for engaging in intervention behaviors, and increased use of assessment and intervention behaviors over time. Primary analyses utilized repeated measures ANOVA techniques for testing for mean differences in target study outcomes over time. Overall the results support the use of the YDS gatekeeper training as an effective tool for increasing knowledge and self-efficacy for suicide intervention. Small changes were observed in attitudes, but attitudes were very positive even before training. Results for changes in the use of assessment and intervention skills were more modest but demonstrated some improvements from pre-training to post-training. Further refinement of the curriculum may yield larger and consistent improvements in intervention behaviors. March 15, 2017 Principal Investigator: Philip Osteen, PhD, Assistant Professor Florida State University College of Social Work Key Project Staff: Rachel Greene, MSW, Clinical Director Residential Services, Capital City Youth Services Jeff Lacasse, PhD, Assistant Professor Florida State University College of Social Work MaKenna Woods, MSW, Trainer Florida State University College of Social Work Lane Forsman, MSW, Data Analyst Florida State University College of Social Work Funded through a contract with the Florida Institute for Child Welfare CONTENTS Abstract ..........................................................................................................................................1 Project Description ........................................................................................................................2 Purpose .......................................................................................................................... 2 Mental Health Services for Children and Adolescents ................................................... 2 Florida’s Response to Youth Suicide .............................................................................. 2 Suicide Intervention Training .......................................................................................... 3 Suicide Intervention Curriculum Overview ..................................................................... 3 Training Innovation and Adaptation ................................................................................ 3 Research Design ...........................................................................................................................3 Sample ........................................................................................................................... 3 Procedures for Intervention Implementation .................................................................. 4 Measures ....................................................................................................................... 4 Data Collection ............................................................................................................... 5 Data Analysis Plan ......................................................................................................... 5 Results ...........................................................................................................................................6 Previous Training and Agency Protocols........................................................................ 6 Encounters with Youth at Risk for Suicide Behaviors..................................................... 6 Knowledge about Suicide and Suicide Intervention ....................................................... 6 Attitudes Regarding Suicide and Suicide Intervention ................................................... 7 Self-Efficacy for Engaging in Suicide Intervention ......................................................... 8 Behavioral Outcomes ..................................................................................................... 9 Youth Outcomes ........................................................................................................... 11 Discussion ................................................................................................................................... 11 Utilization of the Components of Successful Suicide Intervention ............................... 11 Policy Recommendations ........................................................................................................... 11 Consistency in Suicide Intervention Training ............................................................... 11 Curriculum ............................................................................................................... 11 Trainers ................................................................................................................... 11 Timing ......................................................................................................................12 Training Modalities .................................................................................................. 12 Target Population .................................................................................................... 12 Data Monitoring ............................................................................................................ 12 Fatal Suicide Behavior ............................................................................................ 12 Non-Fatal Suicide Behavior Requiring Medical Treatment ...................................... 12 Service Utilization and Follow-Up Care ................................................................... 12 Appendix 1 ...................................................................................................................................13 References ..................................................................................................................................14 RESEARCH REPORT