University of Washington
Need help now?  Call the National Suicide Prevention Lifeline at 1.800.273.8255
Need Help Now? Call the National Suicide Prevention Lifeline. 1.800.273.8255

Suicide prevention trainings ramp up to meet demand

Suicide prevention trainings ramp up to meet demand

Training Director Sue Eastgard carries out Forefront's commitment to first-rate implementation of the state's new training requirements. — Photo by Katie M. Simmons

It can be hard to ask someone if he’s thinking of killing himself—especially if you don’t realize that asking is the right thing to do. It’s not easy to put your own fears or cultural biases aside and respond with the calm and compassion a suicidal person so desperately needs. Most front-line professionals will tell you it’s something they didn’t learn in school. So they’re learning and practicing in workshops like one I recently visited at the University of Washington.

It was one of many sessions taught this spring by Forefront Training Director Sue Eastgard. So far this year she has trained nearly 1,000 behavioral health professionals, social workers, graduate students and others seeking to improve their skills and meet the continuing education mandate of Washington’s Matt Adler Suicide Assessment, Management & Treatment Act (HB 2366), which went into effect in January 2014. The act requires at least six hours of training every six-year licensing cycle for approximately 26,000 social service and mental health workers.

“People want training,” Eastgard says, looking back on more than 30 years in mental health and suicide prevention. “Graduate education didn’t adequately prepare them, so they’ve operated by the seat of their pants. For some that’s worked OK, for others it’s been harrowing and heartbreaking.”

Almost all mental health professionals encounter suicidal clients, she notes.  A 2006 study reported that 86 percent of social workers had worked with a suicidal client within the past year and 97 percent of psychologists-in-training (in a 1993 study) had provided care to at least one suicidal patient during their training.    

Forefront’s founders and allies worked hard for passage of the Adler Act in 2012 and its 2014 successor, HB 2315, which set training requirements for an estimated 140,000 doctors and nurses. They also helped pass a 2013 law (HB 1336) to improve middle and high school efforts to prevent youth suicide, with specialized training for school psychologists, counselors, social workers and nurses. Now they are equally committed to following through with the essential, and somewhat daunting, task of helping ensure there are first-rate trainers and trainings for everyone covered by the three laws.

Eastgard is on the front lines, teaching workshops, training trainers and exploring ways to expand high quality options for providers. After the Adler bill passed in 2012, she spent more than a year vetting all available classes and curricula that meet state requirements for HB 2366. To meet her standards and be listed on Forefront’s website, a course must:

• Be interactive

• Offer opportunities for practice

• Use current information and statistics

• Be small enough for the instructor to engage with class members

• Cover assessing, managing and treating (at least in an introductory way) suicide risk.

For in-depth day-long clinical training, Eastgard favors the Assessing and Managing Suicide Risk (AMSR) curriculum developed by the Suicide Prevention Resource Center (SPRC). It combines basic facts, personal stories, video clips, reflection, discussion and practice designed to help behavioral health professionals probe and work with clients who are at risk. Eastgard adds her own stories and creates connections that will stick.

She told our AMSR class about her own despair when she lost a client to suicide fairly early in her career. There was little support from her employer, and no required training to help her assess and treat risk going forward. “It was tough! I wondered what I had done wrong that I couldn’t keep my patient alive.”

Eastgard went on to direct the Seattle-King County Crisis Clinic, then direct the Youth Suicide Prevention Project based out of the UW School of Nursing and ultimately found Washington’s Youth Suicide Prevention Program. Nationally recognized as a leader in suicide prevention, she still remembers the hollowness she felt after her client died. 

The lesson has been reinforced by years of walking alongside loss and attempt survivors and others affected by suicide. She quotes a young woman whose brother died by suicide: “‘My brother was like a racehorse running down a tunnel. He was wearing blinders that kept him from seeing the alternatives on either side. I was behind him waving my arms, but he couldn’t see me.’

“Training gives us the confidence to try and get out in front of the horse before it’s too late,” Eastgard says. “It helps us know we’ve done the best we know how to do.”

Then there’s the feedback from trainees, even those who come grudgingly.  One seasoned clinical social worker, with 40 years in the field, recalls being irritated when the legislature passed the suicide prevention rule, and even more irritated when he showed up for the 9 a.m. training. “By 10 my irritation had turned into interest,” he says. “By noon, I was excited by how much I was learning.

“What I did not know about suicide now frightens me. And how much I learned empowers me,” he says.

He’s not alone.  Other workshop alumni note that they seem to be seeing more suicidal patients now.  When Eastgard asks why that might be so, they often pause and realize that now they have the confidence to ask the hard questions, and to listen and respond more competently than before. 

That’s what keeps Eastgard and others training.  — By Sue Lockett John

For more information on suicide prevention training requirements and best-practice offerings by Forefront and others, go to Training/Healthcare Professionals on this website.

Resource: Zero Suicide means health system based approach to care

Training needs to be coupled with health systems based approaches to improving care for individuals at risk for suicide. The National Action Alliance for Suicide Prevention (Action Alliance) has developed an initiative called Zero Suicide to help support these efforts.   Click here for more information about the Zero Suicide initiative and how your healthcare organization can get involved.