Suicide-related Knowledge Research Articles

Validation of a 9-item Perceived Suicide Awareness Scale (PSAS-9) for adolescents

BackgroundRobust empirical data on suicide awareness are needed, to better plan and evaluate suicide prevention interventions. However, there is a lack of validated measures of suicide awareness. This is especially true for perceived suicide awareness, which focuses on perceived knowledge about suicide, willingness, and confidence to talk about suicide and get help. Using the theoretical framework of Social Cognitive Theory, this study aimed to validate a measure of perceived suicide awareness. MethodsWe re-used data from a suicide prevention trial conducted in Swiss secondary schools (n = 366). Baseline and one-month follow-up data were used to validate the scale. The main measure was an initial 14-item Perceived Suicide Awareness Scale (PSAS). Perceived knowledge of help-seeking resources, suicide-related knowledge, and support networks were used to assess convergent validity. ResultsA nine-item version, the PSAS-9, showed satisfactory psychometric properties, including high internal consistency (α = 0.78), acceptable test-retest (r = 0.68), and a one-factor structure explaining 95 % of the variance. The convergent validity was acceptable (0.19 ≤ r ≤ 0.40). The PSAS-9 was not correlated with suicide-related knowledge (r = 0.02). LimitationsThe study missed a similar construct to properly assess convergent validity and had a modest sample size. In addition, it only included secondary school adolescents, so further research in other samples of youths is needed to robustly validate the PSAS-9. ConclusionsThis study was an important step towards validating a perceived suicide awareness scale, which appears as a new dimension of suicidality, distinct from suicide-related knowledge. The PSAS-9 could be used to develop, evaluate, and improve suicide prevention efforts.

Effectiveness of Gatekeeper Training for Families of People With Mental Disorders in Korea: A Randomized Controlled Trial.

Given the high suicide risk among people with schizophrenia and other mental disorders and the significance of intervention in the daily life setting, tailored gatekeeper training is necessary for families of people with mental disorders. This study evaluated the effectiveness of a suicide prevention education program for families of people with mental disorders (SPEM-F), developed by the Korea Foundation for Suicide Prevention. Fifty-nine family members of people with mental disorders were recruited from eight community psychiatric rehabilitation centers in Korea and enrolled in a cluster randomized controlled trial. Four facilities were randomized to the experimental group (n=30) and four to the control group (n=29). The study parameters were measured at baseline, post-intervention, and 1-month follow-up; the effects of SPEM-F (90 minutes, conducted offline) were analyzed using repeated-measures analysis of variance. The dependent variables were suicide-related knowledge, attitude, self-efficacy, preventive behavioral intention, and family problem-solving communication. The experimental group showed significant increases in suicide-related knowledge (p<0.001), self-efficacy (p<0.05), and preventive behavioral intention (p<0.01) compared with the control group until the 1-month follow-up, including an upward trend in improved family problem-solving communication (p=0.069). The results confirm that SPEM-F is an effective evidence-based gatekeeper training program for families of people with mental disorders, as it focuses on knowledge, self-efficacy, preventive behavioral intention, and communication improvement. As families of people with mental disorders including schizophrenia, are both highly motivated and close to people at high risk for suicide, SPEM-F can effectively promote suicide prevention and gatekeeper activities.

Understanding the utility of "Talk-to-Me" an online suicide prevention program for Australian university students.

Australian university students are at risk of experiencing poor mental health, being vulnerable to self-harm and suicidal ideation. "Talk-to-Me" is a suicide ideation prevention Massive open online course (MOOC) previously showing it can support Western Australian university students' knowledge of identifying and responding to suicide ideation in themselves and others. A multi-site one-group pre-test/post-test design with a 12-week follow-up explored the efficacy of "Talk-to-Me" for university students Australia-wide, evaluating the influence of COVID-19 and location. Overall, 217 students (55% female; mage = 24.93 years [18, 60]) enrolled in this study from 2020 to 2021. Participants' responses to suicidal statements, mental health literacy, generalized self-efficacy, help-seeking behavior, and overall utility of the program were collected at baseline, post-MOOC (10 weeks from baseline) and 12-week follow-up. The effect of time and location interaction was explored using a random-effects regression model. Findings indicated significant improvement in participants' knowledge of positive mental health support strategies (ES = 0.42, p < 0.001) and recognizing appropriate responses to suicidal statements (ES = 0.37, p < 0.001) at 10-weeks, with further improvement at 12 weeks follow-up (ES = 0.47 and 0.46, p < 0.001). Students reported higher generalized self-efficacy at the 12-week follow-up compared to baseline (ES = 0.19, p = 0.03) and an increased tendency to seek professional help for mental health issues (ES = 0.22, p = 0.02). These findings provide preliminary evidence of the efficacy of the "Talk-to-Me" program in supporting ‎university students across Australia to increase their suicide-related knowledge and skills, ‎general self-efficacy, and overall mental fitness.

Suicide-Related Knowledge among Italian Early Career Psychiatrists and Trainees: Results from a Cross-Sectional Survey.

The training of mental health professionals is an important component of suicide-prevention programs. A cross-sectional survey was conducted in different Italian regions to evaluate knowledge of, and attitudes toward, suicide as well as the experience of a patient's suicide or a suicide attempt in early career psychiatrists (ECPs) and trainees (N = 338). The Suicide Knowledge and Skills Questionnaire and the Impact of a Patient's Suicide on Professional and Personal Lives scale were administered. Furthermore, symptoms of intrusion, avoidance, and arousal were examined through the Impact of Event Scale in ECPs and trainees who had experienced the suicide of a patient or a suicide attempt. Participants with training were more confident in the clinical management of suicide-risk patients. The group with experience of a patient's suicide reported more suicide skills except for support and supervision. Finally, the participants who reported a patient's suicide presented a more conservative patient selection, difficulties in relationships, loss of self-esteem, dreams linked to suicide, intrusive thoughts of suicide, guilt, and anger. Our results show that knowledge of, and attitudes toward, suicide are essential in the management of suicide-risk patients.

Evaluation of a brief universal suicide prevention programme in young people: a cluster-controlled trial in Swiss schools

Suicide is one of the leading causes of death in young people. Therefore, suicide prevention in this age group is a public health priority. There is increasing evidence of the efficacy of suicide prevention programmes, but robust empirical studies are still needed. More precisely, data are needed for school-aged children, brief interventions and distal outcomes such as psychological distress or suicidal thoughts. In addition, to our knowledge, no study has yet scientifically evaluated a brief universal suicide prevention programme in Switzerland. This study investigated the efficacy and acceptability of a brief universal suicide prevention programme for school-aged youths. Primary outcomes included knowledge on suicide, perceived suicide awareness and knowledge of help-seeking resources. Secondary outcomes included acceptability coping skills, suicide-related behaviours and psychological distress. This non-randomised cluster-controlled trial was conducted in Swiss schools. A 90-minute workshop for universal suicide prevention was delivered to the intervention group (n = 209), and the control group had no intervention (n = 96). Measures were assessed at baseline and after one month. Acceptability was assessed at follow-up in the intervention group only. Data were analysed using three-level mixed effect models with an interaction term between group and time. There were interaction effects between group and time for most outcomes: perceived suicide awareness (p <0.010), knowledge of help-seeking resources (p <0.001), coping planning (p = 0.039), suicidal ideation (p = 0.019) and psychological distress (p = 0.012). There were no interaction effects on suicide-related knowledge (p = 0.312) and coping for social support (p >0.388). Participants found the workshop enjoyable, not upsetting, and worthwhile. This study suggested that a brief suicide prevention programme could be beneficial and safe for school-aged youths. This brief programme may contribute to suicide prevention efforts.

Evaluation of a Suicide Prevention Program Encompassing Both Student and Teacher Training Components.

Background: Although suicide prevention programs have been shown to change suicide-related knowledge and attitudes, relatively little is known about their effects on actual behavior. Aims: Therefore, the focus of the present study was on improving participating school staff's practical and communication skills. Method: Suicide prevention workshops for students in grades 8-10 (N = 200) and a gatekeeper training program for school staff (N = 150) were conducted in 12 secondary schools in Germany. Schools were alternately assigned to one of three interventions (staff, students, or both trained) or to a waitlist control group. Results: School staff undergoing the training showed increased action-related knowledge, greater self-efficacy when counseling students in need and augmented counseling skills, and also had more conversations with students in need. Although students participating in the workshops did not seek help more frequently, they provided help to their peers more often in the conditions in which both students and school staff or only the latter had been trained. Limitations: The generalizability of the results is constrained by high dropout rates due to the COVID-19 pandemic and the relatively small sample size. Conclusion: A combination of suicide prevention programs for school staff and students appears to be most effective.

Preventing suicide in post-secondary students: a scoping review of suicide prevention programs.

Suicide among students enrolled in post-secondary education, including university or college, is a major public health concern. Previous research has examined the effectiveness of suicide prevention programs for this population. However, the effective elements of these interventions remain unknown. This study reviewed the literature on suicide prevention programs for post-secondary students, exploring and identifying those elements likely contributing to their effectiveness. A scoping review process was undertaken exploring suicide prevention programs for post-secondary students. Methodological quality of the articles was assessed, and content analysis was used to explore the programs and their effective elements. Twenty seven articles were included in this review, covering a variety of approaches. Gatekeeper training programs were the most common type of suicide prevention program. Programs for post-secondary students may be effective in improving student rates of engagement with mental health services and were associated with greater knowledge, and help-seeking attitudes and behaviors, and gatekeeper-related outcomes. While evidence was found supporting the effectiveness of some interventions such as gatekeeper programs to influence suicide-related knowledge, attitudes and behaviour, further and more rigorous research surrounding suicide prevention programs for post-secondary students is required, with a particular emphasis on student outcomes.

Efficient, yet Effective: Improvements in Suicide-related Knowledge, Confidence, and Preparedness after the Deployment of a Brief Online Module on Suicide in a Required MSW Course

ABSTRACT Although social workers are increasingly likely to encounter suicidal clients in their practice, many are under-prepared to address the issue of suicide, and significant deficiencies in suicide education exist in social work graduate programs. This study examined the acceptability and effectiveness of a brief yet comprehensive online module covering suicide risk assessment and treatment deployed as part of a required master’s level social work course. Students completed online pre- and posttest surveys that measured suicide-related knowledge, perceived preparedness, and confidence, and rated various elements of the module. A total of N =53 MSW students participated in the study, of whom N = 45 completed both the pre- and posttests. Scores for suicide-related knowledge, perceived preparedness, and confidence increased significantly from pre- to posttest (p’s < .001). The majority of students (95.7%) were satisfied or highly satisfied with the overall content, comprehensiveness, and format of the module. However, most (70.2%) reported a preference for face-to-face or hybrid delivery methods for suicide-related material. Implications discussed include the use of synchronous elements to address student anxiety related to suicide-related content, the utility of pre-prepared online learning modules to address curriculum related barriers, and the importance of well-designed online materials.

Suicide-Related Knowledge and Attitudes among a Sample of Mental Health Professionals.

Inadequate knowledge of the potential signs and risk factors of suicide negatively affects the ability of healthcare professionals to recognize patients at risk of suicide. The principal aim of the present study is to assess the attitudes and knowledge about suicide in a large sample of mental health professionals. We examined the relationship between Suicide Knowledge and Skills Questionnaire items and the experience of a patient dying by suicide. We also examined whether various healthcare professionals respond differently to the items of the Impact of a Patient’s Suicide on Professional and Personal Lives Scale. Results demonstrated that healthcare professionals who had experienced a patient suicide reported greater skills than professionals who had not experienced a patient suicide. However, 44% of professionals who had experienced a patient suicide felt that they did not have adequate training on this particular issue. Among those who had experienced a patient suicide, there was an increased tendency to hospitalize patients with suicide risk and an increased use of collegial consultation. Concerning personal emotions, healthcare professionals reported troubled relationships with family members and friends and the loss of self-esteem. In conclusion, better knowledge and attitudes about suicide are necessary for suicide-prevention strategies.

Systematic review and narrative synthesis of suicide prevention in high-schools and universities: a research agenda for evidence-based practice

BackgroundYouth suicide prevention in high-schools and universities is a public health priority. Our aim was to propose a research agenda to advance evidence-based suicide prevention in high-schools and universities by synthesizing and critically reviewing the research focus and methodologies used in existing intervention studies.MethodsFourteen databases were systematically searched to identify studies which evaluate suicide prevention interventions delivered on high-school or university campuses, with before and after measures. Data from included studies (n = 43) were extracted to identify what, where, how and for whom interventions have been tested. Narrative synthesis was used to critically evaluate research focus and methodology. Study quality was assessed.ResultsResearch has focused primarily on selective interventions, with less attention on indicated and universal interventions. Most evidence comes from North America and high-income countries. The target of interventions has been: non-fatal suicidal behaviour; confidence and ability of staff/students to intervene in a suicidal crisis; suicide-related knowledge and attitudes; and suicide-related stigma. No studies included suicide deaths as an outcome, evaluated eco-systemic interventions, explored how context influences implementation, used multisite study designs, or focused explicitly on LGBTQ+ youth. Two studies evaluated digital interventions. Quality of the majority of studies was compromised by lack of methodological rigour, small samples, and moderate/high risk of bias. Interventions often assume the existence of an external well-functioning referral pathway, which may not be true in low-resource settings.ConclusionTo advance evidence-based suicide prevention in educational settings we need to: conduct more high-quality clinical and pragmatic trials; promote research in low- and middle-income countries; test targeted interventions for vulnerable populations (like LGBTQ+ youth), evaluate interventions where death by suicide is the primary outcome; include translational studies and use implementation science to promote intervention uptake; evaluate the potential use of digital and eco-systemic interventions; and conduct multisite studies in diverse cultural settings.

Suicide risk assessment training using an online virtual patient simulation.

Improving the identification of and intervention with patients at risk for suicide requires innovative training techniques that safely and effectively teach or enhance practitioners' skills. Virtual patient simulations (VPS) can be particularly effective for this purpose because they allow for repetition in skill building as well as a safe space to practice difficult interactions with patients. The purpose of this study was to assess the feasibility and acceptability of a novel VPS that trains practitioners in suicide risk assessment, as well as to examine pre-post changes in suicide-related knowledge through a pilot of the VPS training. Practitioners (n=20) were recruited from a Federally Qualified Health Center in the northeastern United States to test the feasibility and acceptability of a VPS suicide risk assessment training. A paired samples t-test was conducted to compare mean differences in practitioners' suicide risk assessment knowledge scores from pre- to post-training, on a scale of 0 to 10. The VPS was feasible to implement, with 18 of 20 participants using the VPS for an average of 21 to 95 minutes, and was acceptable to participants, with an average satisfaction rating of 5.82 out of 7. Participants' knowledge scores improved significantly by an average of 1.86 points from pre- to post-training. The VPS was feasible and acceptable to this sample of practitioners and significantly increased knowledge from pre- to post-training. As such, VPS holds promise as a technique to develop skills in suicide risk assessment.

Associations of Tabloid Newspaper Use With Endorsement of Suicide Myths, Suicide-Related Knowledge, and Stigmatizing Attitudes Toward Suicidal Individuals

Educating the public about suicide is an important component of suicide prevention. So far, little is known about whether common misconceptions of suicide are related to individual tabloid newspaper use. This study aimed to investigate associations of time spent reading tabloids with endorsement of suicide myths, suicide-related knowledge, and with stigmatizing attitudes toward suicidal individuals. In this cross-sectional online survey, we assessed suicide-related knowledge and stigmatizing attitudes toward suicidal individuals among 456 study participants in Austria together with their endorsement of five common suicide myths (e.g., "suicidal individuals do not communicate their intent"). Furthermore, we assessed participants' time spent reading tabloids. Multivariate analyses controlling for gender, age, education, and the time spent reading broadsheet newspapers and watching television indicated that participants' time spent reading tabloids was associated with higher endorsement of suicide myths as well as with a lower level of suicide-related knowledge and a higher level of stigmatizing attitudes toward suicidal individuals. Due to the study's cross-sectional design, causality concerning these associations could not be assessed. The present findings confirm that readers of tabloids are an important target group for suicide education efforts.

Gatekeeper Suicide Training's Effectiveness Among Malaysian Hospital Health Professionals: A Control Group Study With a Three-Month Follow-Up.

There is a lack of suicide-related training in the nonpsychiatric health professional's basic education. We suggest that a continuing education through a brief gatekeeper suicide training program could be a suitable platform to improve suicide-related knowledge, self-efficacy, and attitudes. This study aimed at examining the effectiveness of the Question, Persuade, Refer gatekeeper program on improving the knowledge, self-efficacy in suicide prevention, and understanding of/willingness to help suicidal patients of Malaysian hospital health professionals. The Question, Persuade, Refer program materials were translated and adapted for implementation in the hospital setting for nonpsychiatric health professionals. There were 159 (mean age = 35.75 years; SD = 12.26) participants in this study. Most participants were female (84.9%), staff/community nurses (52.2%), who worked in the general medical department (30.2%) and had no experience managing suicidal patients (64.2%). Intervention participants (n = 53) completed a survey questionnaire at pretraining, immediately after training, and after three months. Control participants (n = 106) were not exposed to the training program and completed the same questionnaire at baseline and three months later. Significant improvement occurred among intervention participants in terms of perceived knowledge, self-efficacy, and understanding of/willingness to help suicidal patients immediately after training and when compared with the control participants 3 months later. Improvements in declarative knowledge were not maintained at the 3-month follow-up. This study confirmed the short-term effectiveness of the gatekeeper training program. Gatekeeper suicide training is recommended for implementation for nonpsychiatric health professionals nationwide.

Effects of Awareness Material on Suicide-Related Knowledge and the Intention to Provide Adequate Help to Suicidal Individuals.

Little is known about the impact of educative media reports on the intention to provide help to suicidal individuals and on suicide-related knowledge. To test whether material debunking widely shared myths influences knowledge and the intention to provide adequate help to others, and if such information reduces reading enjoyment. A randomized controlled trial was utilized. Participants allocated to the intervention group were exposed to awareness material explicitly addressing suicide myths. Analyses show that exposure to printed awareness material increased knowledge, which in turn positively influenced intentions to provide help. The inclusion of information regarding suicide myths did not reduce reading enjoyment. The awareness material used in this study only addressed two suicide myths that were considered to be especially important. Information debunking suicide myths in suicide-related media reports is therefore both feasible and potentially helpful.

Development, Implementation, and Evaluation of a Comprehensive Course on Suicide in a Master’s of Social Work Program

ABSTRACTMost master of social work (MSW) programs provide minimal education or training on suicide prevention, intervention, and postvention despite that the majority of social workers encounter suicidal clients during their professional careers. This study describes the development, implementation, and evaluation of a course on suicide in an MSW program. Changes in student suicide-related knowledge, confidence, and preparedness were evaluated using a pre/post design. We found statistically significant increases in knowledge (t [df = 21] = 4.79; p < .001), confidence (t [df = 17] = 8.55; p < .001), and preparedness (t [df = 20] = 7.28; p < .001) from pretest to posttest. Knowledge, confidence, and preparedness were significantly positively correlated, indicating that confidence and preparedness did not increase without a corresponding increase in knowledge. Given the prevalence of suicide and the frequency with which social workers serve populations affected by suicide, it is critical that MSW programs provide effective training on understanding suicide.

Assessment of suicide-related knowledge and skills in a sample of health professionals and students

ObjectiveAssessment of suicide risk is of paramount importance for proper prevention.AimsTo examine the association between gatekeeper training and suicide-related knowledge among a diverse set of health care workers (psychiatrists, nurses, psychologists, and educators) and students enrolled in medical and psychological schools who took part in the world suicide prevention day 2015 conference.MethodAmong 223 participants who completed the assessment, 204 provided complete data for analyses. Participants were administered the applied suicide intervention skills training (ASIST), a 13-item survey questionnaire to assess participants’ knowledge about suicidal behavior and comfort dealing with suicidal clients. There were 62 psychiatrists; 23 nurses, 51 psychologists, 11 educators, and 57 university students.ResultsAmong participants, 57.1% of the sample had experiences of suicide a patient (students were excluded from these analyses). Those who reported a suicide among patients (compared with others) less frequently answered that suicide risk is more alarming in older adults than youths. They also less frequently disagreed with questions asking if they had the training to deal with suicidal patients. Students more frequently answered correctly on the association between depression and suicide risk, and less frequently chose the correct answer on the seriousness of suicide intent in borderline personality disorder. Students also more frequently disagreed with questions asking on their suicide assessment skill.ConclusionsOur study highlights that differences exist when it comes to knowledge and skills related to suicide risk assessment both among health professionals and students. Our results also indicate that suicide awareness among these groups should be promoted.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Student Evaluation of the Yellow Ribbon Suicide Prevention Program in Midwest Schools.

Yellow Ribbon is a gatekeeper-type suicide prevention program that is widely used in public schools. However, data on its effectiveness are limited. The purpose of our study was to evaluate self-reported changes in knowledge and comfort level communicating about suicide following Yellow Ribbon training for a large, representative sample of students from a public school system in the midwestern United States. The program was administered to students within the same school district during 2006 through 2009. A pre-post survey using a 4-point Likert scale was administered to rate students' knowledge of risk factors and available resources, comfort level communicating about suicide, estimate of friends at risk for suicide, and behavioral intent toward help-seeking. Aggregate responses from 3,257 students, aged 11 to 18 years, were collected by the schools; 51% were female, 33% were Hispanic, and 30% were white. Suicide-related knowledge of risk factors, where to go for help, and resources, along with comfort level in asking for help, all significantly improved following program participation (Cramer's V = 0.243 to 0.376, P < .001). Responses were associated with age and gender, indicating that younger males may benefit more than older males. Implementation of the Yellow Ribbon school-based suicide prevention program appears to be beneficial for students in the midwestern United States. We observed significant improvement in knowledge, comfort level, and behavioral intent for help-seeking if suicidal thoughts occur. Findings also suggested that Yellow Ribbon training administered during middle school may be especially helpful for males.

Suicide-Related Knowledge and Confidence Among Behavioral Health Care Staff in Seven States.

Death by suicide is a serious and growing public health concern in the United States. This noncontrolled, naturalistic study examined professionals' knowledge about suicide and confidence in working with suicidal individuals, comparing those who had received either of two gatekeeper trainings-Question, Persuade, and Refer (QPR) or Applied Suicide Intervention Skills Training (ASIST)-or other suicide-relevant training or no training. Participants (N=16,693) were individuals in various professional roles in the field of behavioral health care in Indiana, Kentucky, New York, Pennsylvania, Tennessee, Texas, and Utah. Participants completed a survey assessing suicide knowledge and skills confidence. Most participants (52.9%) reported no previous suicide prevention or assessment training. Individuals with suicide-relevant training demonstrated greater suicide knowledge and confidence than those with no such training. Among those who had received any training, no differences were found in suicide knowledge; however, individuals who had received ASIST reported greater confidence in working with suicidal individuals, compared with those who had received other training. Professional role and prior experience with a client who had died by suicide had significant positive relationships with suicide knowledge and confidence. Regional differences emerged between states and are examined within the context of statewide suicide prevention initiatives. Increasing access to and incentives for participating in suicide-relevant training among behavioral health care staff may foster a more knowledgeable and confident group of gatekeepers. Future research should examine whether increases in knowledge and confidence among staff translate into actual changes in practice that help protect and serve at-risk individuals.

An assessment of suicide-related knowledge and skills among health professionals.

The present studies sought to examine the association between gatekeeper training and suicide knowledge among a diverse set of health care workers (case managers, clinicians, administrators, nurses, physicians, support staff). An additional aim of the current studies was to investigate knowledge about suicide among health care workers as well as their confidence in their training and skills. A naturalistic and uncontrolled group comparison study of two large groups (n = 1,336 and 1,507) of community health workers was conducted by having participants complete a brief online survey that assessed suicide-related knowledge, as well as confidence in training, skills, and support. In Study 1, participants with Applied Suicide Intervention Skills Training (ASIST) outperformed those without ASIST training in terms of their knowledge about suicidal behavior and their confidence in their skills. In Study 2, participants with Question, Persuade, and Refer (QPR) training outperformed those with Essential Learning's Suicide Prevention (Online) training and those with No Training on suicide knowledge items; both QPR and Online trained workers reported greater confidence in their skills than workers with No Training. Across both studies, physicians and clinicians tended to score the highest on suicide knowledge and skills items. Overall, health care workers appear to be knowledgeable about suicidal behavior, but there are some specific gaps in their knowledge, such as the rates of suicide in special populations. Participants with ASIST and QPR training demonstrated greater knowledge and skills related to suicidal behavior as compared with participants without gatekeeper training.

Outcomes of a Suicide Prevention Gatekeeper Training on a University Campus

A university-wide suicide prevention program was implemented to provide students, faculty, and staff tools to identify, assist, and refer distressed and suicidal individuals. The study examined participant self-reports of suicide-related knowledge and prevention skills, group differences in suicide prevention knowledge and skills, group differences in confidence and comfort levels, and changes in participants’ beliefs that the interventions they conducted were effective. Participants completed a questionnaire at three time points. Results showed significant increases in self-rated knowledge about suicide, suicide prevention, awareness of resources and belief in the appropriateness and likelihood they would ask someone about suicide. Implications for campus suicide prevention and education programs are discussed.