How effective are suicide prevention education programs for nurses?

Suicide is a significant public health concern, with ongoing individual, social and economic costs across communities. Globally, it is estimated that in excess of 800,000 people die by suicide each year, and that for every person who dies by suicide, there are another 20 who attempt to take their lives (WHO, 2014). Rates of suicide deaths are elevated among certain groups, such as males and those of indigenous background (WHO, 2014). In response, significant effort has been devoted to understanding the multidimensional contributors to suicide. However, recent evidence suggests that predicting risk of suicide is fraught with difficulty, particularly given the relative rarity of suicide deaths and the common occurrence of risk factors, such as male gender and previous self-harm incidences, in clinical populations (Chan et al., 2016). While indicated interventions are aimed at reducing suicide among those who are most vulnerable, contemporary suicide prevention strategies also highlight the importance of educational initiatives as an important component of multi-sectorial suicide prevention responses (WHO, 2014). Multiple systematic reviews have found that education programs can make a positive contribution to suicide prevention, both for gatekeepers working across a range of settings (Isaac et al., 2009), and for specific vulnerable groups, such as indigenous people (Clifford et al., 2013) and youth (Robinson et al., 2013). These reviews indicate that education programs can contribute to favourable shifts in attendee knowledge, attitudes, skills and confidence when supporting people vulnerable to suicide, particularly in the short-term. There is also strong evidence to support the role of training general practitioners to recognise and treat depression and anxiety as a suicide prevention strategy (Van Der Feltz-Cornelis et al., 2011).Less is known about the value of suicide-specific education programs for other health professionals, particularly nurses. This is surprising, given that together with midwives, nurses constitute more than 50% of the health workforce in many countries worldwide (WHO, 2016). Nurses are therefore at the forefront of providing health care across a diversity of settings, for a wide range of patient groups (Mills, Birks, & Hegney, 2010), and have high exposure to people vulnerable to suicide (Palmieri et al., 2008). Yet suicide prevention is often excluded from their training, and studies stress the need for more education on this topic for this professional group (Samuelsson et al., 1997; Sun 2007). The nursing profession has been responding with a growing number of education programs being implemented and evaluated. Whilst this is a positive step, the effectiveness of these programs across a range of nursing settings is yet to be determined.