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Q: Suicide Prevention - Program Evaluation ( No Answer,   1 Comment )
Question  
Subject: Suicide Prevention - Program Evaluation
Category: Science > Social Sciences
Asked by: basenjiguy-ga
List Price: $60.00
Posted: 18 Jun 2005 06:59 PDT
Expires: 18 Jul 2005 06:59 PDT
Question ID: 534523
Friend of mine is running suicide prevention programs for the
military. Most of it educational -- how to identify a possible risk
for: yourself, your friend, someone in your command. And, of course
what to do about it. Because it is difficult to easily show cause (his
programs) and effect (reduced suicide), he has a difficult time
setting program goals or, even, justifying his programs financially.

So, my question is: What approaches to programmatic evaluation of
mental health educational programs have succeeded in the past? Spot-on
would be examples of program evaluation for suicide prevention
education. But useful parallels may exist in parenting education,
relationship education, and so on. Please bear in mind that none of
the individuals involved are trained researchers (he is a chaplain and
his superiors are military officers who are trained in other fields).
So, subtle, esoteric methodologies won't help much.
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There is no answer at this time.

Comments  
Subject: Re: Suicide Prevention - Program Evaluation
From: umiat-ga on 18 Jul 2005 10:12 PDT
 
Hello, basenjiguy-ga!

 Unfortunately, your question expired before I could post an answer. I
just saw it yesterday and thought it expired this evening. I hope you
have an opportunity to see this as I believe it will prove useful.

Successful Suicide Prevention Programs
=======================================

The following study outlines results from a high-school suicide
intervention program. Although there is an age difference between
these subjects and the military personnel, the tactics used in the
program should still be useful.

From "An Outcome Evaluation of the SOS Suicide Prevention Program," by
Robert H. Aseltine Jr, PhD and Robert DeMartino, MD. American Journal
of Public Health. March 2004, Vol 94, No. 3
http://www.mentalhealthscreening.org/downloads/sites/docs/sos/AJPHarticle.pdf

Excerpt:

Objectives: "We examined the effectiveness of the Signs of Suicide
(SOS) prevention program in reducing suicidal behavior."

Methods: "Twenty-one hundred students in 5 high schools in Columbus,
Ga, and Hartford, Conn, were randomly assigned to intervention and
control groups. Self-administered questionnaires were completed by
students in both groups approximately 3 months after program
implementation."

Results: "Significantly lower rates of suicide attempts and greater
knowledge and more adaptive attitudes about depression and suicide
were observed among students in the intervention group. The modest
changes in knowledge and attitudes partially explained the beneficial
effects of the program."

Conclusions: "SOS is the first school-based suicide prevention program
to demonstrate sig-nificant reductions in self-reported suicide
attempts. (Am J Public Health. 2004;94:446-451)"

(Read entire study on linked site)


==

Another article which highlights the success of the SOS program reference above:

From "School-Based Suicide Prevention Program Shows Success - First
Study to Look at Innovative Program to Prevent Suicide in Young
People. University of Connecticut Health Center. March 3, 2004
http://www.uchc.edu/ocomm/newsreleases04/march04/suicide.html

"For the first time, a school-based suicide prevention program has
been shown to reduce suicidal behavior in high school students.
Students who participated in the program, called "SOS [Signs of
Suicide] High School Suicide Prevention Program," showed a 40 percent
reduction in suicide attempts according to a study published in the
February 26 edition of the American Journal of Public Health."

"Our analysis suggests that many of the positive results of the SOS
program on self-reported suicide attempts are a result of improved
understanding and attitudes about depression and suicide learned
through the program," said lead author and principal investigator
Robert Aseltine, Ph.D., associate professor in the Department of
Behavioral Sciences and Community Health at the University of
Connecticut Health Center."

"For the first time in 20 years of research on school-based suicide
prevention programs, we are seeing a program that is not just
increasing knowledge and changing attitudes about suicide - it is
actually reducing suicidal behavior," Dr. Aseltine said. "That is
unique."

===


The Maryland Suicide Prevention Program

According to statistics, the Maryland Suicide Prevention program has
been successful, but I have found little detail concerning the
"nitty-gritty" about program design. You might have to contact the
state for details.

From "The Maryland Suicide Prevention Model - A Caring Community Saves
Lives."Henry Westray Jr., MSS
http://www.sprc.org/statepages/stateplans/plan_md.pdf

Excerpt:

"The Maryland model has primarily targeted programs to youth 15 to 24
years of age. Focusing on middle, high school, and college students. 
This program has also targeted "at risk" populations as gay and
lesbian, those institutionalized, and African American youth. 
Recognizing the high rate of suicide among adults, particularly the
elderly, in 1999 this program began to educate the public on the issue
of suicide among adults as well."

Maryland's Success: "Over the past twelve years many have worked
diligently in our state to save lives. According to a recent study
conducted by the Big Horn Center for Public Policy (using data from
the Federal Center for Disease Control and Prevention), Maryland's
suicide rate declined in every age group, most significantly among
15-24 year olds targeted by the program. Youth suicide rates showed
dramatic reduction reductions, down 21.4 percent overall, while
nationally rates increased 11 percent.  The Maryland Suicide
Prevention Program has been a model for other states in developing
prevention, intervention, and postvention services."



U.S. Air Force Suicide Prevention Program
==========================================

The US Air Force Suicide Prevention program has been highlighted as a
success. These references may prove to be the most helpful to your
friend since it inovlves the same niche of clientele.


From "Registry of Evidence-Based Suicide Prevention Programs - U.S.
Air Force Program." http://www.sprc.org/whatweoffer/factsheets/airforce.pdf

"The U.S. Air Force suicide prevention program is a comprehensive,
institution-wide intervention that focuses on enhancing protective
factors and decreasing risk factors for suicide. Major goals of the
program include:
* Promoting awareness of the range of risk factors related to suicide; 
* Educating the community regarding available mental-health services; and, 
* Reducing the stigma related to help-seeking behavior

"The U.S. Air Force program was evaluated using an interrupted time
series design (Knox, et al., 2003).  Rates of suicide deaths, as well
as other violence-related statistics, were examined for 6 years prior
to and after program implementation (see Figure 1). Analysis of
post-implementation rates (1997-2002) revealed a 33% risk reduction
for suicide. Reductions in rates of homicide (-51%), accidental death
(-18%), and severe and moderate family violence (-54% and -30%
respectively) were also observed."

==

From "Air Force Suicide Prevention Program - A Population-based,
Community Approach." The United States Air Force Medical Service
(2002)
http://www.osophs.dhhs.gov/ophs/BestPractice/usaf.htm

"When the project began in 1995, suicide was the second leading cause
of death among the 350,000 Air Force members, occurring at an annual
rate of 15.8/100,000. Since then, the suicide rate declined
statistically significantly over three consecutive years, and for the
first six months in 1999 the annualized rate fell below 3.5/100,000.
This is more than fifty percent less than the lowest rate on record
prior to 1995 and an 80 percent drop from the peak rates in the
mid-90s. The suicide rates increased in ?00 and early ?01, but have
declined again since April ?01 and have remained much lower than rates
prior to 1995. Statistically significant declines in violent crime,
family violence and deaths due to unintentional injuries have also
been measured concurrently with the intervention. Air Force leaders
have emphasized community-wide involvement in every aspect of the
project. The providers of community-based human services have made
significant progress in coordinating their resources for the purpose
of building stronger individuals and more resilient communities."

==

Unfortunately, suicide rates were on the rise again in 2004, although
it was noted that the rates were about the same for the national
average:

From "Suicide Rate on the Rise in U.S. Air Force," by Kevin Caruso.
Prevent Suicide Now. July 15, 2004
http://www.preventsuicidenow.com/suicide-rate-us-air-force.html

"Twenty-six Air Force members have died by suicide so far this year,
compared with 37 for all of 2003. The reason for the increase is not
known. None of the suicides involved personnel who were deployed to
Iraq or Afghanistan or who returned from those countries."

"The Air Force is distressed at its high suicide rate, and we wish
there was a magic solution, but there isn?t," said Lt. Col. Rick
Campise, who manages the Air Force's suicide prevention program.
"We?re used to seeing the rate dropping, so having it go up is not
very pleasing to us."

"The Air Force suicide prevention program started in 1996 when a group
of 75 military and civilian mental health specialists began
collaborating on 11 suicide prevention initiatives to be implemented
by the Air Force. The suicide prevention program resulted in a decline
in the suicide rate by 38 percent through 2003. "It?s really unique.
There?s no program like it; so the 2004 rates are causing us great
distress," said Campise. "So, the Air Force is getting back to the
roots of its 11 initiative. We don?t know which of those actually
accounted for the reduction from 1997 to 2003, but we want to get back
on track. The literature is full of successful programs that are no
longer effective because either the leadership has moved on or the
community felt that the problem was solved."

* "One important revision that has already been implemented will
improve the privacy of personnel who seek help."

* "Additionally, improvements in the review of health records and the
communication among commanders and support agencies are being put into
effect."

* "And two important informational booklets have been distributed that
should help improve the management of suicidal individuals as well as
improve communication between commanders and the mental-health staff

Read further...

==

Also read "Leaders Call for Re-Energized Suicide-Prevention Efforts,"
by g.w. pomeroy. Deployment Quarterly. Winter 2004.
http://deploymentlink.osd.mil/news/dquarterly/winter04/suicide_prevention.htm

===


The Air Force Suicide Prevention Program Website:
http://afspp.afms.mil/idc/groups/public/documents/webcontent/knowledgejunction.hcst?
functionalarea=AFSuicidePreventionPrgm&doctype=subpage&docname=CTB_018094&incbanner=0


Suicide Programs and Evaluation
=================================

The following document highlights the need for effective evaluation of
suicide programs. It provides some background and guidelines for
evaluating success the might add a bit of insight into formulating
program goals.

"Suicide Prevention: Prevention Effectiveness and Evaluation." SPAN USA.
http://www.suicidology.org/associations/1045/files/LPBooklet.pdf

* Scroll down to "Section 2. Evaluating Suicide Prevention Programs."

==

Again, I hope you can use what I have compiled.

umiat

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