Suicide Awareness and Prevention Workshop for Social Workers and Paraprofessionals
Levitt, Aaron J., Lorenzo, Julie, Yu, Van, Wean, Caren, Miller-Solarino, Sophie, Journal of Social Work Education
SUICIDE IS A MAJOR public health problem, with particularly high relative incidence among mentally ill homeless individuals (Desai, Liu-Mares, Dausey, & Rosenheck, 2003). The social workers and paraprofessionals who commonly serve this population, however, often receive little, if any, training in suicide awareness, assessment, and prevention (Feldman & Freedenthal, 2006). In 2005, a nonprofit provider of services to the homeless and previously homeless mentally ill experienced two client suicides in a brief period, which prompted a wide-reaching internal evaluation of the agency's work in detecting and addressing client suicidality
Following the evaluation, a group of senior social workers met with the agency's medical director and director of research, over a period of several months, to develop a manual for training agency service staff in basic suicide awareness and prevention as a first step towards improving agency practice in this area. The group reviewed materials on suicide risk and prevention, most notably the Practice Guideline for the Assessment and Treatment of Patients With Suicidal Behaviors (American Psychiatric Association, 2003) and various statistics published on the website of the Centers for Disease Control and Prevention, and met with staff from the American Foundation for Suicide Prevention in order to solicit input on the training process and appropriate material. A 46-slide computer presentation and 31-page training manual were produced along with a 23-item, multiple-choice test of covered materials.
The goal of the workshops was to assist staff members to recognize indicators of and risk factors for suicidality, obtain and coordinate care for suicidal clients, document this work appropriately, and communicate effectively with coworkers and external service providers concerning these issues. The workshops did not provide skills training in either clinical assessment or treatment, and were explicitly not provided as a substitute for adequate clinical training and/or ongoing clinical supervision in these or other practice areas. Workshop content was organized around a 46-slide computer presentation, comprising a brief introduction and overview (national, community, and organizational context and safety gatekeepers); a more substantive review of epidemiology and risk factors (geography, gender, age, race/ethnicity, homelessness, medical illness, psychiatric illness, and heritability); a basic overview of intervention/ prevention issues (urban areas, firearms access, services/treatment issues [access, stigma, and fragmentation], limits of prediction, early intervention, therapeutic alliance, collaboration, modifiable risk factors, modifiable protective factors, crisis management, brief description of assessment procedures, hospitalization and communicating with emergency services, contingency/safety planning, documentation, service provider needs and responses, continuing education); a brief section on "postvention" with service providers and recipients when a suicide does occur; and a concluding question and answer period. The workshops were primarily didactic, with limited interactive elements intended to promote trainee interest and engagement.
The knowledge test items were initially drafted by an experienced clinical social worker, after which they were reviewed and revised by the agency medical director and director of research, and then subjected to two additional rounds of comments and revisions by all members of the project team. All items on the final revision were multiple-choice, each with five possible responses. Of the 23 items on the test, 9 included an "all of the above" or "none of the above" option, and 6 of those 9 included both. The test covered material on both epidemiology and prevention, with roughly half the test items addressing each area.
Workshops were conducted at each of the agency's service sites in September and October of 2006. …