ASIST (Applied Suicide Intervention Skills Training)

Categories

Categories associated with best practice:

  • PP-icon1
  • Young Adult (ages 19-24) icon
  • Adult (ages 25-64) icon
  • Seniors (ages 65+) icon
  • Education and literacy
  • Health Care Setting
  • Mental Health Icon 2
  • Personal health practices and coping skills
  • Secondary School Icon 1
  • Workplace

Determinants of Health: Personal health practices and coping skills, Education, literacy and life-long learning

Overview

The ASIST workshop is a two day training program for professionals, paraprofessionals and lay people who want to feel more comfortable, confident and competent in helping to prevent the immediate risk of suicide. ASIST participants include mental health professionals, nurses, physicians, pharmacists, teachers, counselors, youth workers, police and correctional staff, school support staff, clergy, community volunteers and caregivers (any person in a position of trust). In ASIST, concepts are translated into generic language, and multidisciplinary training sessions are preferred to enhance shared learning and development of local networks. Emphasizing structured small-group discussions and practice, the course uses a workbook and two audiovisuals. Participants receive a Suicide Intervention Handbook and a pocket card featuring intervention, and risk review and safeplan development principles. Although it is highly standardized, ASIST training has been used in a variety of settings with trainees from a variety of backgrounds and countries. ASIST has been implemented in secondary and post-secondary schools, mental health centers, hospitals, social service and public safety agencies and numerous other community settings. Evaluations of ASIST have found that individuals who have received ASIST are generally very satisfied with the training; demonstrate greater relevant knowledge and positive attitudes; demonstrate increased intervention skills; and report increased interventions with those possibly at risk for suicide, when compared to pre-training states or non-trainees.

Primary Source Document

P Rodgers , Review of the Applied Suicide Intervention Skills Training Program (ASIST) Rationale, Evaluation Results, and Directions for Future Research Living Works

Contact information of developer(s) and/or implementer(s)

Contact (Canada):

LivingWorks Education Inc.

4303D 11 Street SE

Calgary, Alberta

Canada T2G 4X1

Tel: 403 209 0242

Toll Free (in NA): 1 888 733 5484

Fax: 403 209 0259

Intervention Focus

Intervention Goal / ObjectiveLevel(s) TargetedEquity Focus
Participants will be able to make a commitment to improving community resources.
  • Community level
  • Individual level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.
Participants will be able to list the types of resources available to a person at risk of suicide, including themselves.
  • Individual level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.
Participants will be able to demonstrate the skills required to intervene with a person at risk of suicide.
  • Individual level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.
Participants will be able to identify risk alerts and develop safe plans related to them.
  • Individual level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.
Participants will be able to discuss suicide with a person at risk in a direct manner.
  • Individual level
  • Interpersonal level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.
Participants will be able to recognize that caregivers and persons at risk are affected by personal and societal attitudes about suicide.
  • Individual level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.

Health Issue(s) that is/are addressed by the Intervention

Health Promotion

  • Mental Health

Risk Reduction

  • Prevent suicide

Specific Activities of the Intervention

  • Training offered in prevention and policy development
  • Information sessions offered about a risk factor or condition
  • Group process/program
  • Other training session

Priority/Target Population for Intervention Delivery

Life Stage

  • Young adult (age 19-24 years)
  • Adults (age 25-64 years)
  • Seniors (age 65+ years)

Settings

Educational Settings

  • Secondary/Middle school
  • Post secondary education institution

Community Setting

  • Workplace
  • Community/neighbourhood
  • Health care setting

Outcomes

Outcomes and Impact Chart
Level of ImpactDescription of OutcomeEquity Focus
Individual LevelPrior to ASIST, 81.7% of participants had been in contact with someone they believed to be at risk of suicide, and 77.6% of them intervened. Three to six months post-ASIST, 94.9% of those exposed to individuals they believed to be at risk of suicide intervened (p <=0.001). Differences with respect to mental health qualifications measured at baseline disappeared follow-up. These findings were supported by qualitative interviews with stakeholders.Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.
Individual LevelA highly significant change in attitude (preventability of suicide; caregiver comfort and confidence in intervening; willingness to be involved; issues of responsibility and infringement of individual rights) was measured between baseline and follow-up (from 3.67 to 4.07, p<=0.001) for matched cases (again, differences between those with and without a mental health qualification measured at baseline disappeared at follow-up). These findings were supported by qualitative interviews with stakeholders.Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.
Individual LevelKnowledge and skills scores improved between baseline and follow- up from a mean of 2.33 to 3.42 (p<=0.001). Significant baseline differences existed in relation to whether or not the participant had a mental health qualification, in both the cross-sectional and matched samples. Participants with a mental health qualification had a significantly higher knowledge and skills score at baseline. However, analysis shows that all baseline differences had disappeared post-ASIST (by follow-up) for those with a mental health qualification, indicating that ASIST brings all participants to a similar knowledge and skills level. These findings were supported by qualitative interviews with stakeholders. Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.

Adaptability

Implementation History

  • Multiple implementations - Different settings/populations/providers - The intervention showed significant adaptability as it has been implemented in different settings or with different populations or by different provider(s). This can include multiple implementations during the same time period. Each implementation of the intervention must have been substantially the same and must have demonstrated positive results for the primary objectives of the intervention.

Expertise Required for Implementation within the Context of the Intervention

  • Specialized skills training provided as part of the Intervention - The intervention does not require individuals or groups with highly specialized training, but requires that individuals or groups be trained as part of the implementation of the intervention.

Are there supports available for implementation

No.

Are there resources and/or products associated with the interventions

Yes.

  • 20-page workbook
  • two audiovisuals
  • 152-page Suicide Intervention Handbook
  • full color, tear-resistant pocket card featuring intervention, and risk review and safeplan development principles
  • Organizer tools (e.g., organizer guide, nametags, pamphlets schedule, setup and material requirements)
  • Participate certificate template
  • Continuing Education template