Suicide rates in the United States have been increasing in recent years, and the period after an inpatient psychiatric hospitalization is one of especially high risk for death by suicide. Peer support specialists may play an important role in addressing recommendations that suicide prevention activities focus on protective factors by improving hope and connectedness. The present study developed a peer specialist intervention titled Peers for Valued Living (PREVAIL) to reduce suicide risk, incorporating components of motivational interviewing and psychotherapies targeting suicide risk into recovery-based peer support. A randomized controlled pilot study was conducted to assess the acceptability, feasibility, and fidelity of the intervention. A total of 70 adult psychiatric inpatients at high risk for suicide were enrolled into the study. Participants were randomized to usual care (n = 36) or to the 12-week PREVAIL peer support intervention (n = 34). Those in the PREVAIL arm completed an average of 6.1 (SD = 5.0) peer sessions over the course of 12 weeks. Fidelity was rated for 20 peer support sessions, and 85% of the peer specialist sessions demonstrated adequate fidelity to administering a conversation tool regarding hope, belongingness, or safety, and 72.5% of general support skills (e.g., validation) were performed with adequate fidelity. Participants’ qualitative responses (n = 23) were highly positive regarding peer specialists’ ability to relate, listen, and advise and to provide support specifically during discussions about suicide. Findings demonstrate that a peer support specialist suicide prevention intervention is feasible and acceptable for patients at high risk for suicide.
Peers of individuals at risk for suicide may be able to play important roles in suicide prevention. The aim of the current study is to conduct a scoping review to characterize the breadth of peer‐delivered suicide prevention services and their outcomes to inform future service delivery and research. Articles were selected based on search terms related to peers, suicide, or crisis. After reviews of identified abstracts (N = 2681), selected full‐text articles (N = 286), and additional references (N = 62), a total of 84 articles were retained for the final review sample.
Types of suicide prevention services delivered by peers included being a gatekeeper, on‐demand crisis support, crisis support in acute care settings, and crisis or relapse prevention. Peer relationships employed in suicide prevention services included fellow laypersons; members of the same sociodemographic subgroup (e.g., racial minority), workplace, or institution (e.g., university, correctional facility); and the shared experience of having a mental condition. The majority of published studies were program descriptions or uncontrolled trials, with only three of 84 articles qualifying as randomized controlled trials. Despite a lack of methodological rigor in identified studies, peer support interventions for suicide prevention have been implemented utilizing a diverse range of peer provider types and functions. New and existing peer‐delivered suicide prevention services should incorporate more rigorous evaluation methods regarding acceptability and effectiveness.
Introduction. The concern that talking about suicide may intensify suicidal ideation is a common fear that has been dispelled by research, yet still lingers in popular consciousness. The aim of the current initiative was to develop a brief suicide prevention training for volunteers in a peer support program for veterans, given that layperson-facing approaches are critical to the U.S. national strategy for suicide prevention. Method. The study team adapted existing pedagogical approaches for use in a brief training and for a veteran population, and implemented the training with five new volunteer groups over 5 months ( N = 45). Results. Anonymous pre- and posttraining questionnaires indicated immediate statistically significant improvements in self-reported preparation to talk openly about suicide, likelihood of asking about suicide, confidence in recognizing warning signs of suicide, and confidence in intervening and involving the National Suicide Hotline. Discussion. The project begins to demonstrate that self-reported suicide prevention knowledge and skills show immediate improvements after a brief training module nested within a broader new volunteer training. This work should support efforts to develop and implement research studies on brief suicide prevention training approaches in order to determine the extent to which they change behavior longitudinally and, ultimately, reduce rates of suicide.
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