Publication Date
Winter 3-5-2025
Item Type
Collection
Executive Summary
Implementation of Staff Education on Suicide Prevention
Kelsey Crosby, Hannah Cryder, Julianne Ji, Trista Joy, Ashlyn Mulcahey, Isabel Pfingston, and Jaylen Wilson
School of Health Sciences, Seattle Pacific University
NUR4153: Nursing Leadership in Community Engagement
Dr. Bomin Shim
February 26, 2025
Implementation of Staff Education on Suicide Prevention
Our group, consisting of seven nursing students, partnered with an agency dedicated to supporting individuals in recovery from addictions of all forms, including substance use, gambling, and alcohol dependence. The agency focuses on helping them reach their full potential, minimize relapse, and maintain recovery. Elements of the agency’s work include providing two nutritious meals per day, recovery groups, volunteer opportunities, twelve-step meetings, referral services, and more. During our assessment, we found that staff members were concerned about suicide among their members, referring to individuals who regularly utilize the agency’s services and participate in its programs. Therefore, the purpose of this project was to educate agency staff on suicidality in individuals with a history of substance use disorders (SUD), who face a higher risk compared to those without, and to equip them with resources to support members during crises (Poorolajal, 2016). We created evidence-based education materials through a video presentation, pamphlets, and a poster with a survey to evaluate short-term outcomes. While working with the agency, our outcome goal was to improve staff knowledge and their confidence to approach members who display warning signs of suicidality or are in an active crisis.
Background
A death by suicide occurs every 11 minutes, accounting for 49,000 deaths a year, and 1.6 million suicide attempts (Center for Disease Control and Prevention, 2024). Of these, people with substance use disorder are approximately two times more likely to have a suicide attempt than those without (Poorolajal, 2016). Suicide is strongly associated with substance use, with males who misuse drugs being two to three times more likely to complete suicide compared to those who do not (Dragisic, 2015). For females, the risk increases even further, making them 6.5 to nine times more likely. This disparity can be linked to the evidence that males are more likely to have a fatal suicide attempt, while women are more likely to have suicidal ideation and nonfatal attempts (Berardelli, 2022). Therefore, the data is deceiving due to the higher baseline rate. Furthermore, those who use opiates are at a 14-fold risk of dying by suicide versus the general population (Rizk, 2021). This itself can be attributed to the physiological changes perpetuated by opiates. Opiates alter the limbic and striatal circuitry in the brain, leading to negative emotions being felt more strongly. It also stimulates amygdala activation, which is inculpated in negative emotional reactivity and suicidal ideation. Therefore, causing an increase in the occurrence and strength of suicidal ideation.
Activities with Rationale
During our assessment, the agency’s staff members expressed a strong concern related to suicide risk among the members due to a history of substance use disorders. A study conducted in 2024 by Hawley et al. highlights the effectiveness of suicide prevention education for multiple subgroups in enhancing knowledge, awareness, and intention to act. This education program covered topics such as suicide risk, statistics, warning signs, stigma reduction, and crisis resources. It provided online education, allowing flexibility among participants to complete the training at their convenience.
For the intervention, we decided to formulate an evidence-based education for staff members related to suicide risk. The intervention was presented through a video presentation that was seven minutes in length. A video presentation was confirmed as an ideal method by the agency coordinator as the staff members could view it at a time that was suitable for them. The topics covered in the presentation include the correlation between suicide and substance use disorder, signs of suicidal ideation, and how to respond to a crisis. We also created physical deliverables for the agency, including pamphlets and a large poster to make key information readily accessible. Our group created evaluation surveys for the staff members. This allowed us to determine if they developed a greater knowledge and/or confidence in identifying warning signs for suicide and/or responding to a mental health crisis. Our goal was to have 80% of staff indicate increased knowledge and confidence in addressing suicidality in members with SUD. Access to the video presentation and evaluation was available in staff members’ emails and through QR codes presented on the poster and pamphlets.
Outcomes
On the day of the intervention, eight staff members received the educational materials, and our group engaged in a discussion with them about the information. Following the implementation of the intervention, five staff members completed a five-question survey by scanning a QR code. The results indicate that 80% of respondents reported increased confidence in their ability to care for individuals experiencing suicidal ideation or crisis. Additionally, 100% of staff members felt they had been provided with the necessary resources to assist someone in crisis. Furthermore, 80% of staff members stated that their understanding of the importance of suicide prevention had increased as a result of the information provided in the pamphlet. However, only 60% reported an improvement in their ability to identify individuals experiencing suicidal ideation or crisis. While two staff members found the intervention's resources helpful, they noted that much of the information was already familiar to them.
Our group partially succeeded at increasing the knowledge and confidence about suicide prevention among staff at the agency, therefore making progress toward our outcome goal. The agency was short-staffed on our intervention day, and therefore we were only able to collect data from five staff members. Through the survey and verbal conversations with the staff, they found the most helpful portion of the pamphlet to be the resources portion. In the survey, one of the anonymous staff members wrote that they “love having one pamphlet with several pieces of useful information rather than searching through multiple resources to be able to help someone in crisis”. We were able to evaluate the initial impact of the intervention through the survey results and verbal conversations.
With the educational materials, referrals to local resources, and facility staff training, our impact goal was to reduce suicide rates among members of the agency. To monitor the effectiveness of our impact goal, we can communicate with the agency over the next several years to confirm a decrease in suicide rates.
Conclusion
We were unable to analyze the long-term impact of the project, however, the desired impact of the interventions was to aid in reducing the rate of suicide in people with SUD in Seattle. The project is meant to be a consistent resource for the staff at the facility, used as continuing education for long-term staff, new hire orientation, and any volunteers who would like further education on suicidality and SUD. However, there are limitations to our resources for long-term use. The information in the video, pamphlet, and poster will need to be reviewed and edited every five to ten years with more relevant and accurate data and resources. Further evaluation of efficacy and accuracy would need to be conducted with the updated data, however, the format and general overview of the resources can remain the same.
Educating staff does not guarantee a decrease in suicides or suicidal attempts in people with a history of substance use, however, with increased confidence and knowledge, we hope that staff are able to identify clients at a high risk of suicidality and take action early on before any attempts on life occur.
References
Berardelli, I., Rogante, E., Sarubbi, S., Erbuto, D., Cifrodelli, M., Concolato, C., Pasquini, M., Lester, D., Innamorati, M., & Pompili, M. (2022). Is lethality different between males and females? Clinical and gender differences in inpatient suicide attempters. International Journal of Environmental Research and Public Health, 19(20), 13309. https://doi.org/10.3390/ijerph192013309
Center for Disease Control and Prevention. (2024, June 17). Suicide data and statistics. https://www.cdc.gov/suicide/facts/data.html
Dragisic, T., Dickov, A., Dickov, V., & Mijatovic. (2015). Drug addiction as risk for suicide attempts. Mater socio-medica, 27(3), 188-191. https://doi.org/10.5455/msm.2015.27.188-191
Esang, M., & Ahmed, S. (2018). A closer look at substance use and suicide. American Journal of Psychiatry Residents’ Journal, 13(6), 6-8. https://doi.org/10.1176/appi.ajp-rj.2018.130603
Hawley, S. R., Skinner, T., Young, M., Romain, T. S., Provines, J. (2024). Suicide prevention across the community: Evaluation of mental health training for multiple gatekeeper groups. Kansas Journal of Medicine, 17(6), 127-132. https://doi.org/10.17161/kjm.vol17.22524
Lopez-Goni, J. J., Fernandez-Montalvo, J., Arteaga, A., & Haro, B. (2018). Suicidal ideation and attempts in patients who seek treatment for substance use disorder. Psychiatry Research, 269, 542-548. https://doi.org/10.1016/j.psychres.2018.08.100
Poorolajal, J., Haghtalab, T., Farhadi, M., & Darvishi, N. (2016). Substance use disorder and risk of suicidal ideation, suicide attempt and suicide death: A meta-analysis. Journal of Public Health, 38(3), e282–e291, https://doi.org/10.1093/pubmed/fdv148
Rizk, M. M., Herzog, S., Dugad, S., & Stanley, B. (2021). Suicide risk and addiction: The impact of alcohol and opioid use disorders. Current Addiction Reports, 8(2), 194–207. https://doi.org/10.1007/s40429-021-00361-z
Recommended Citation
Ji, Julianne; Cryder, Hannah; Joy, Trista; Pfingston, Isabel; Wilson, Jaylen; Crosby, Kelsey; and Mulcahey, Ashlyn, "Implementation of Staff Education on Suicide Prevention" (2025). Nursing Leadership in Community Engagement Projects. 59.
https://digitalcommons.spu.edu/shs_nlce/59
Pamphlet
suicide prevention.png (523 kB)
Poster
Executive Summary.pdf (132 kB)
Executive Summary
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