Community Mental Health Journal

, Volume 55, Issue 2, pp 257–266 | Cite as

Community Mental Health Provider Responses to a Competency-Based Training in Suicide Risk Assessment and Prevention

  • Amanda C. La Guardia
  • Robert J. CramerEmail author
  • Michael Brubaker
  • Molly M. Long
Original Paper


The present study evaluates of a competency-based suicide prevention training. A sample of community mental healthcare providers took part in a suicide risk assessment and prevention training, completing pre-post measures of knowledge, competency/skill and attitudes, as well as baseline interprofessional education (IPE) socialization. Training yielded moderate-to-large improvements in suicide-related knowledge, perceived risk assessment/prevention skills, attitudes toward helping patients, and professional capacity to work with suicidal patients. Small pre-post differences were observed recognizing the need for additional training. IPE socialization moderated impacts on professional capacity. This study offers support for the promising impacts of competency-based and IPE-specific training.


Suicide prevention Training Competency Interprofessional education 



This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under Grant No. G02HP30588, “Behavioral Health Workforce Education and Training (BHWET) for Paraprofessionals and Professionals.” This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.


  1. Adams, S. (2015). APNA’s suicide competencies for inpatient psychiatric nurses: Saving lives… one at a time. Journal of the American Psychiatric Nurses Association, 21(2), 175–179. Scholar
  2. Ahmedani, B. K., Stewart, C., Simon, G. E., Lynch, F., Lu, C. Y., Waitzfelder B. E., et al. (2015). Racial/ethnic differences in health care visits made before suicide attempt across the United States. Medical Care, 53, 430–435. Scholar
  3. American Association of Suicidology. (2010). Some facts about suicide and depression. Retrieved from
  4. Baruch, Y., Swartz, M., Sirkis, S., Mirecki, I., & Barak, Y. (2013). Staff happiness and work satisfaction in a tertiary psychiatric centre. Occupational Medicine, 63, 442–444. Scholar
  5. Botega, N. J., Reginato, D. G., Silva, S. V., et al. (2005). Nursing personnel attitudes towards suicide: The development of a measure scale. Revista Brasileira de Psiquiatria, 27(4), 315–318. Scholar
  6. Botega, N. J., Silva, S. V., Reginato, D. G., et al. (2007). Maintained attitudinal changes in nursing personnel after a brief training on suicide prevention. Suicide and Life-Threatening Behavior, 37(2), 145–153. Scholar
  7. Brodsky, B. S., Spruch-Feiner, A., & Stanley, B. (2018). The Zero Suicide Model: Applying evidence-based suicide prevention practices to clinical care. Frontiers in Psychiatry, 9, 33. Scholar
  8. Centers for Disease Control and Prevention (CDC). (no date a). Suicide and self-inflicted injury. Retrieved from
  9. Centers for Disease Control and Prevention (CDC). (no date b). Uniform definitions for self-directed violence. Retrieved from https://
  10. Cipriano, A., Cella, S., & Cotrufo, P. (2017). Nonsuicidal self-injury: A systematic review. Frontiers in Psychology, 8, 1946. Scholar
  11. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: Lawrence Earlbaum Associates.Google Scholar
  12. Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences. Mahwah: Lawrence Erlbaum, Inc.Google Scholar
  13. Coopens, E., Van Audenhove, C., Iddi, S., Arensman, E., Gottlebe, K., et al. (2014). Effectiveness of community facilitator training in improving knowledge, attitudes, and confidence in relation to depression and suicidal behavior: Results of the OSPI-Europe intervention in four European countries. Journal of Affective Disorders, 165, 142–150. Scholar
  14. Cramer, R. J., Bryson, C. N., Eichorst, M. K., Keyes, L. N., & Ridge, B. E. (2017). Conceptualization and pilot testing of a core competency-based training workshop in suicide risk assessment and management. Journal of Clinical Psychology, 73(3), 233–238. Scholar
  15. Cramer, R. J., Bryson, C. N., Stroud, C. H., & Ridge, B. E. (2016). A pilot test of a graduate course in suicide theory, risk assessment, and management. Teaching of Psychology, 43, 238–242. Scholar
  16. Cramer, R. J., Johnson, S. M., McLaughlin, J., Rausch, E. M., & Conroy, M. A. (2013). Suicide risk assessment training for psychology doctoral programs: Core competencies and framework for training. Training and Education in Professional Psychology, 7(1), 1–11. Scholar
  17. Cubic, B., Mance, J., Turgesen, J. N., & Lamanna, J. D. (2012). Interprofessional education: Preparing psychologists for success in integrated primary care. Journal of Clinical Psychology in Medical Settings, 19(1), 84–92. Scholar
  18. Enders, C. K. (2017). Multiple imputation as a flexible tool for missing data handling in clinical research. Behaviour Research and Therapy, 98, 4–18. Scholar
  19. Frank, J. R., Snell, L. S., Cate, O. T., Holmboe, E. S., Carraccio, C., Swing, S. R., et al. (2010). Competency-based medical education: Theory to practice. Medical Teacher, 32(8), 638–645. Scholar
  20. Gibb, S. J., Beautrais, A. L., & Surgenor, L. J. (2010). Health-care staff attitudes towards self-harm patients. Australian and New Zealand Journal of Psychiatry, 44, 713–720. Scholar
  21. Grant, C. L., & Lusk, J. L. (2015). A multidisciplinary approach to therapeutic risk management of the suicidal patient. Journal of Multidisciplinary Healthcare, 8, 291–298. Scholar
  22. Hung, E. K., Binder, R. L., Fordwood, S. R., Hall, S. E., Cramer, R. J., & McNiel, D. E. (2012). A method for evaluating competency in assessment and management of suicide risk. Academic Psychiatry, 36, 23–28. Scholar
  23. Jiao, Y., Phillips, M. R., Sheng, Y., Wu, G., Li, X., Xiong, W., & Wang, L. (2014). Cross-sectional study of attitudes about psychiatrists in Shanghai. BMC Psychiatry, 14, 87–96. Scholar
  24. Jobes, D. A. (2012). The Collaborative Assessment and Management of Suicidality (CAMS): An evolving evidence-based clinical approach to suicide risk. Suicide and Life-Threatening Behavior, 42, 640–653. Scholar
  25. Johnson, K., & Freeman, K. (2014). Integrating interprofessional education and collaboration competencies (IPEC) into mental health counselor education. Journal of Mental Health Counseling, 36(4), 328–344. Scholar
  26. Joiner, T. E. (2005). Why people die by suicide. Cambridge: Harvard University Press.Google Scholar
  27. King, G., Orchard, C., Khalili, H., & Avery, L. (2016). Refinement of the Interprofessional Socialization and Valuing Scale (ISVS-21) and development of 9-item equivalent versions. Journal of Continuing Education in the Health Professions, 36, 171–177. Scholar
  28. King, G., Shaw, L., Orchard, C. A., & Miller, S. (2010). The Interprofessional Socialization and Valuing Scale: A tool for evaluating the shift toward collaborative care approaches in health care settings. Work, 35, 77–85.Google Scholar
  29. Larkin, G. L., & Beautrais, A. L. (2010). Emergency departments are underutilized sites for suicide prevention. Crisis, 31, 1–6.CrossRefGoogle Scholar
  30. Leung, W.-C. (2002). Competency based medical training: Review. British Medical Journal, 325(7366), 693–696.
  31. Liebling-Boccio, D. A., & Jennings, H. R. (2013). The current status of graduate training in suicide risk assessment. Psychology in the Schools, 50, 72–86. Scholar
  32. Mental Health Commission. (2006). Multidisciplinary team working: From theory to practice. Dublin: St Martin’s House.Google Scholar
  33. Oranye, N. O., Arumugam, U., Ahmad, N., & Arumugam, M. E. (2016). Perceived training needs of nurses working with mentally ill patients. Contemporary Nursing, 13, 1–12. Scholar
  34. Puntil, C., York, J., Limandri, B., Greene, P., Arauz, E., & Hobbs, D. (2013). Competency-based training for PMH nurse generalists: Inpatient intervention and prevention of suicide. Journal of the American Psychiatric Nurses Association, 19(4), 205–210. Scholar
  35. Reeves, S. Perrier, L. Goldman, J. Freeth, D. Zwarenstein, M. (2013). Interprofessional education: Effects on professional practice and healthcare outcomes (update). Cochrane Database of Systematic Reviews. Scholar
  36. Rose, P. R. (2018). Health disparities, diversity, and inclusion: Context, controversies, and solutions. Miami, FL: Jones & Bartlett.Google Scholar
  37. Scholmer, G. L., Bauman, S., & Card, N. A. (2010). Best practices for missing data management in counseling psychology. Journal of Counseling Psychology, 57, 1–10. Scholar
  38. Silva, C., Smith, A. R., Dodd, D. R., Covington, D. W., & Joiner, T. E. (2016). Suicide-related knowledge and confidence among behavioral health care staff in seven states. Psychiatric Services, 67, 1240–1245. Scholar
  39. Smith, A. R., Silva, C., Covington, D. W., & Joiner, T. E. (2014). An assessment of suicide-related knowledge and skills among health professionals. Health Psychology, 33, 110–119. Scholar
  40. Suicide Prevention Resource Center (SPRC). (no date). Zero Suicide in health and behavioral health care. Retrieved from
  41. World Health Organization. (2010). Framework for action on interprofessional education and collaborative practice. Geneva: Department for Human Resources for Health.Google Scholar
  42. Wortzel, H. S., Matarazzo, B., & Homaifar, B. (2013). A model for therapeutic risk management. Journal of Psychiatric Practice, 19, 323–326.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Amanda C. La Guardia
    • 1
  • Robert J. Cramer
    • 2
    • 3
    Email author
  • Michael Brubaker
    • 1
  • Molly M. Long
    • 2
  1. 1.University of CincinnatiCincinnatiUSA
  2. 2.School of Community & Environmental HealthOld Dominion UniversityNorfolkUSA
  3. 3.Virginia Clinical Psychology Consortium ProgramNorfolkUSA

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