Helping callers to the National Suicide Prevention Lifeline who are at imminent risk of suicide: the importance of active engagement, active rescue, and collaboration between crisis and emergency services.

In 2012, the SAMHSA-funded National Suicide Prevention Lifeline (Lifeline) completed implementation of the first national Policy for Helping Callers at Imminent Risk of Suicide across its network of crisis centers. The policy sought to: (1) provide a clear definition of imminent risk; (2) reflect the state of evidence, field experience, and promising practices related to reducing imminent risk through hotline interventions; and (3) provide a uniform policy and approach that could be applied across crisis center settings. The resulting policy established three essential principles: active engagement, active rescue, and collaboration between crisis and emergency services. A sample of the research and rationale that underpinned the development of this policy is provided here. In addition, policy implementation, challenges and successes, and implications for interventions to help Lifeline callers at imminent risk of suicide are detailed.

An assessment of suicide-related knowledge and skills among health professionals.

OBJECTIVE: The present studies sought to examine the association between gatekeeper training and suicide knowledge among a diverse set of health care workers (case managers, clinicians, administrators, nurses, physicians, support staff). An additional aim of the current studies was to investigate knowledge about suicide among health care workers as well as their confidence in their training and skills. METHOD: A naturalistic and uncontrolled group comparison study of two large groups (n = 1,336 and 1,507) of community health workers was conducted by having participants complete a brief online survey that assessed suicide-related knowledge, as well as confidence in training, skills, and support. RESULTS: In Study 1, participants with Applied Suicide Intervention Skills Training (ASIST) outperformed those without ASIST training in terms of their knowledge about suicidal behavior and their confidence in their skills. In Study 2, participants with Question, Persuade, and Refer (QPR) training outperformed those with Essential Learning's Suicide Prevention (Online) training and those with No Training on suicide knowledge items; both QPR and Online trained workers reported greater confidence in their skills than workers with No Training. Across both studies, physicians and clinicians tended to score the highest on suicide knowledge and skills items. CONCLUSIONS: Overall, health care workers appear to be knowledgeable about suicidal behavior, but there are some specific gaps in their knowledge, such as the rates of suicide in special populations. Participants with ASIST and QPR training demonstrated greater knowledge and skills related to suicidal behavior as compared with participants without gatekeeper training.