Suicide prevention literacy : the role of knowledge, stigma, attitudes, experience and training on skills, intentions and confidence

Abstract

Suicide is a significant public health issue in Australia with 2,361 deaths from suicide in 2010. The evidence suggests increasing the suicide prevention literacy of the community and health and other gatekeeping professions may contribute to the prevention of suicide. Suicide prevention literacy is conceptualised as comprising a number of different components, namely, knowledge about suicide prevention, attitudes towards people who attempt and complete suicide, attitudes towards suicide in general, suicide intervention skills, intentions to assist someone at risk of suicide and confidence in assisting. A lack of knowledge, stigma and permissive attitudes towards suicide have been associated with lower suicide intervention skills, lower intent to assist and lower confidence in assisting someone at risk. Training programs have been shown to increase participants' suicide prevention literacy, but training has varied in structure and focus and it is not known for whom training works best nor whether improvements in knowledge and attitudes contribute to improvements in skill, intentions and confidence. The present research aims to further the understanding of suicide prevention literacy in the Australian population with two studies. Study one (n=228) examines the nature of suicide prevention literacy in a group of psychology students and practising psychologists. Study one examines all the components of suicide prevention literacy concurrently and investigates predictors of suicide intervention skills, intentions to assist someone at risk and confidence in assisting. Results reveal the suicide prevention literacy of Australian psychology students and practising psychologists is reasonably strong, particularly suicide intervention skills, but further improvement is required in some areas, particularly knowledge, stigma and confidence. Age, experience, beliefs about one's experience and skills with suicidal clients, knowledge, stigma and attitudes emerged as important predictors of skills, intentions or confidence. Study two (n=62) investigated the effectiveness of the Applied Suicide Intervention Skills Training (ASIST) workshop on suicide prevention literacy and which individual characteristics predict improvement in suicide intervention skills, intentions to assist someone at risk and confidence in assisting. Results revealed intentions, confidence, knowledge, stigma and attitudes towards suicide all improved following the workshop. Suicide intervention skills did not change significantly. Enhancement of suicide intervention skills was predicted by a decrease in stigma towards people who complete suicide, an increase in the attitude suicide is a right, and surprisingly, a decrease in knowledge about suicide. Change in knowledge and attitudes following the workshop did not predict changes in intentions or confidence. This research represents the first comprehensive examination of suicide prevention literacy as well as the potential impact of training on enhancing suicide prevention literacy. Collectively, the results reveal knowledge about suicide prevention, stigma towards those who attempt or complete suicide and attitudes towards suicide in general are important in their own right but also contribute to suicide intervention skills, intentions to assist someone at risk and confidence in assisting and should be a focus of suicide prevention training programs. The importance of further research into the suicide prevention literacy of different subpopulations within Australia, including youth and other gatekeeping professions is highlighted.