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J.Kennedy handout

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J.Kennedy handout

  1. 1. © LivingWorks Education www.livingworks.net a suicide-safer community Bendruomenė saugesnė nuo savižudybių
  2. 2. © LivingWorks Education www.livingworks.net John Kennedy - LivingWorks Consulting Trainer Support Person International Quality Assurance Reader Team ASIST Senior Team Leader/ safeTALK Instructor
  3. 3. © LivingWorks Education www.livingworks.net Sveiki atvykę į LivingWorks Education
  4. 4. © LivingWorks Education www.livingworks.net Lithuania Progressing to a national strategy through safeTALK and ASIST
  5. 5. © LivingWorks Education www.livingworks.net Strategy- The Art of Fishtail Movement
  6. 6. © LivingWorks Education www.livingworks.net
  7. 7. © LivingWorks Education www.livingworks.net Key Stakeholders
  8. 8. © LivingWorks Education www.livingworks.net Lithuania and LivingWorks Unite
  9. 9. © LivingWorks Education www.livingworks.net Timeline Date Activity 2004 2006 2011 ASIST workshop conducted in Vilnius, Lithuania by Norwegian VIVAT LivingWorks trainers Dag Willy Tallaksen/Kirsti Silvola Scotland Study Ireland Study May -June 2014 Communication with University of Vilnius – Professor Danute Gailiene and Paulius Skruibis regarding interest in implementing ASIST; Discussions revealed great passion and interest though implementation was not feasible at the time due to funding constraints and lack of infrastructure to support a suicide prevention plan February 2016 Reconnected with Paulius indicating new initiative and Memorandum in Vilnius for suicide prevention addressing infrastructure and funding
  10. 10. © LivingWorks Education www.livingworks.net Norway says ‘HELLO’ again!
  11. 11. © LivingWorks Education www.livingworks.net Timeline Date Activity March – May 2016 Discussions with the Vilnius Municipality Public Health Bureau regarding strategic planning and preparation for implementation of safeTALK and ASIST LivingWorks training programs including application process of potential trainer candidates June 2016 safeTALK and ASIST trainer candidates selected and notified by Public Health Bureau August 2016 safeTALK and ASIST Training for Trainers LivingWorks welcomes 10 new safeTALK and 6 new ASIST trainers Translation process begins in consultation with LivingWorks October 2016 Suicide Prevention Conference Vilnius
  12. 12. © LivingWorks Education www.livingworks.net Introductions before safeTALK
  13. 13. © LivingWorks Education www.livingworks.net Questions after safeTALK
  14. 14. © LivingWorks Education www.livingworks.net Lithuania’s New ASIST Caregivers
  15. 15. © LivingWorks Education www.livingworks.net Lithuania’s First safeTALK and ASIST Trainers
  16. 16. © LivingWorks Education www.livingworks.net 2 Suicide Alert and ASIST helpersBecoming a suicide-safer community
  17. 17. © LivingWorks Education www.livingworks.net Suicide Alertness for Everyone
  18. 18. © LivingWorks Education www.livingworks.net safeTALK: suicide alertness for everyone safeTALK is a half-day training in suicide alertness. It helps participants recognize a person with thoughts of suicide and connect them with resources who can help them to keepsafe. Participants don’t need any formal preparation to attend the training.
  19. 19. © LivingWorks Education www.livingworks.net FOCUS: Suicide alertness training for the community DURATION: 3 hours - 4 hours (half a day) LANGUAGES: English and French (and soon Norwegian and Lithuanian!) PARTICIPANTS: Anyone 15 years or older TRAINERS: 1 Trainer and 1 Community Resource Person for 15-30 participants 12 countries have onsite Trainers with 2,500+ safeTALK Trainers worldwide 273,000+ safeTALK participants trained since 2006 safeTALK is listed in the Suicide Prevention Resource Center Best Practices Registry (USA)
  20. 20. © LivingWorks Education www.livingworks.net Goals and objectives Over the course of their training, safeTALK participants will learn to: •Notice and respond to situations where suicide thoughts may be present •Recognize that invitations for help are often overlooked, •Move beyond the common tendency to miss, dismiss, and avoid suicide •Apply the TALK steps: Tell, Ask, Listen, KeepSafe •Know community resources and how to connect someone with thoughts of suicide to them for further suicide-safer help.
  21. 21. © LivingWorks Education www.livingworks.net Why is safeTALK important? Suicide is a community health problem that affects us all. In each community, suicides we hear about are only the tip of the iceberg. There are also... •Unreported suicides (5% to 25% more) •Non-fatal suicide behaviors (40 to 100 times greater than the number of suicides) •People with thoughts of suicide (3% to 5% of the population) •People affected whenever someone dies by suicide
  22. 22. © LivingWorks Education www.livingworks.net LTA K Tell, Ask, Listen and KeepSafe Tell (Pasakyti) Ask (Paklausti) Listen (Klausyti) KeepSafe (Uztikrinti sauguma) safe LTA K
  23. 23. © LivingWorks Education www.livingworks.net 16.1 Connecting with an intervention resource
  24. 24. © LivingWorks Education www.livingworks.net Co-Trainer 2.7.2 and slide 21
  25. 25. © LivingWorks Education www.livingworks.net safeTALK in Vilnius
  26. 26. © LivingWorks Education www.livingworks.net safeTALK in Vilnius
  27. 27. © LivingWorks Education www.livingworks.net Testimonials “As a taxi driver, I speak to a surprising number of people who have thoughts of suicide. safeTALK has given me and other drivers in Kilkenny a way to help them stay safe.” —Derek Devoy, Taxi Driver, Kilkenny, Ireland (Derek also went on to encourage safeTALK training for all the drivers in Kilkenny)
  28. 28. © LivingWorks Education www.livingworks.net 2 Suicide Alert and ASIST helpersBecoming a suicide-safer community
  29. 29. © LivingWorks Education www.livingworks.net Applied Suicide Intervention Skills Training
  30. 30. © LivingWorks Education www.livingworks.net FOCUS: Suicide intervention training DURATION: Two days (15 hours) PARTICIPANTS: Anyone 16 or older TRAINERS: Two registered trainers per 15 – 30 participants LANGUAGES: English, French, Spanish, Inuktitut, and Norwegian (and soon Lithuanian); Large print and Braille also available 11 Updated editions since 1983 for continued growth and improvement 6,300+ ASIST trainers offer workshops in over 30 countries 1,000,000+ people have taken ASIST worldwide
  31. 31. © LivingWorks Education www.livingworks.net • 2-day suicide First aid gatekeeper training workshop • Standardized core curriculum • Pioneered integration of upstream Attitude antecedents with Knowledge and Skills • Facilitates a safety-challenge learning environment • Developed unique suicide intervention model (PAL) • Multiple safeplan options – including safety for now • Common language communication
  32. 32. © LivingWorks Education www.livingworks.net Goals and objectives In the course of the two-day workshop, ASIST participants learn to: •Understand the ways personal and societal attitudes affect views on suicide and interventions •Provide guidance and suicide first-aid to a person at risk in ways that meet their individual safety needs •Identify the key elements of an effective suicide safety plan and the actions required to implement it •Appreciate the value of improving and integrating suicide prevention resources in the community at large •Recognize other important aspects of suicide prevention including life-promotion and self-care
  33. 33. © LivingWorks Education www.livingworks.net 4.3.1 PAL - Bičiulis Pathway for Assisting Life (PAL)
  34. 34. © LivingWorks Education www.livingworks.net 3.10.2 Actions to Confirm Safety Framework (Right now, what will keep you safe?) Workbook Page 16
  35. 35. © LivingWorks Education www.livingworks.net Available ASIST Caregiver Psychological subdivision in the Vilnius County Police Headquarters
  36. 36. © LivingWorks Education www.livingworks.net Common qualities Highly evolved For all types of caregivers Training for Trainers LivingWo rks Programs
  37. 37. © LivingWorks Education www.livingworks.net Country and Number of Evaluations Country ASIST sTALK Australia 4 3 Canada 6 3 Ireland 1 - Norway 4 - Scotland 4 2 USA 16 1 Wales 2 - Totals 37 9 Evaluations range from 1986 to 2015 Include findings on: ✓Satisfaction ✓Utilization ✓Learning ✓Portability ✓Suicide behavior Impact ✓Broader impact ✓Investment Benefit
  38. 38. © LivingWorks Education www.livingworks.net Kirkpatrick-Phillips Model
  39. 39. © LivingWorks Education www.livingworks.net Did participants like the trainings? Summary of Satisfaction Based on multiple evaluations, satisfaction has generally been high. ASIST Participants: • Good use of their time • High quality • Benefits were long lasting • Better prepared them to address suicide directly safeTALK Participants: • Training enjoyable and worthwhile, relevant to role • Content well received • Acceptable to young people • Appreciated trainer knowledge and preparedness ASIST: Canada (2000, 2007), Norway (2003), Scotland (2005, 2007, 2008) safeTALK: UK (2014) Australia (2015), Scotland (2007),
  40. 40. © LivingWorks Education www.livingworks.net Did participants learn from the trainings? Summary of Learning ASIST Participants: • Greater knowledge about suicide, prevention and intervention • Greater confidence in their ability to intervene • Readiness to intervene increased • Increase in knowledge of intervention skills • Improved ability of medical students to detect suicide vs TAU safeTALK Participants: • More willing to talk openly about suicide and help • More positive attitudes toward suicide and prevention • Better prepared to recognize suicide, ask directly, connect with help • More likely to seek help ASIST: Australia (2000), Canada (1994, 2015), Scotland (2008), Washington (2003) safeTALK: Scotland (2007; 2010), Australia (2015), Canada (2011)
  41. 41. © LivingWorks Education www.livingworks.net Did participants use the trainings? Summary of Utilization Impact ASIST Participants: • Increased Interventions √ 99% applied at least one aspect of intervention model √ More identification (18%) & risk assessment (13%) in medical setting • Use in Garrett Lee Smith Youth Suicide Prevention Grants √ Most used programs by GLS grantees: ASIST (longer), QPR (shorter) √ People in longer programs had proportionately more interventions √ Counties with Gatekeeper trainings had reductions in suicide behaviours compared with counties without training • Use with serious mental illness population √ Reduced suicide by 38% in year 1, increasing to 42% in year 2 safeTALK Participants: • increased case management referrals ASIST: Australia (2000), Canada (2007), Scotland (2008), USA. (2010, 2015) safeTALK: Australia (2011)
  42. 42. © LivingWorks Education www.livingworks.net Did ASIST and safeTALK Impact results? Summary of Results ASIST Impact: • National vehicle √ raising public awareness; building longer term community capacity √ Reducing reliance on specialized professionals; sustainable resource (Scotland 2006) • Intervention changes √ Raised layperson Attitude/Knowledge/ Skills & interventions to level of MH professionals √ Increased networking and sense of community empowerment (Ireland 2011) • Organization managers √ Better able to understand and support staff experiences (Wales 2011) • Common language √ Better inter-agency working relationships (Wales 2011) • Intervention outcomes √ Less suicidal, less overwhelmed, more hopeful (Mattie Gould study 2013) safeTALK Impact • Established preparedness for connections with help • Identified & connected young people at risk who had not come forward before • Safe - no iatrogenic effects for young participants (Australia 2011/2015) ASIST: Canada (2007), Ireland (2011), Scotland (2006, 2008), USA (2013), Wales (2011) safeTALK: Australia (2011, 2015)
  43. 43. © LivingWorks Education www.livingworks.net Did trainings have an investment benefit? Summary of Return on Investment (ROI) ASIST Benefit: • Scotland (Choose Life, 2006) √ Cost saving (direct & indirect costs) benefit: needed 17 fewer suicides (1.9% reduction) on $5.5m annual investment √ Achieved 19.5 % reduction over 10 years against 20% goal • California (Rand, 2015) √ State gain: $50 for each $1 invested in ASIST -averted health care costs; increased income tax revenue. √ Individual-family gain: $1100 for each $1 invested in ASIST – medical care savings; increased lifetime earnings. safeTALK Benefit: • no investment benefit studies to date ASIST: Scotland (2006), USA. (2015) safeTALK:
  44. 44. © LivingWorks Education www.livingworks.net
  45. 45. © LivingWorks Education www.livingworks.net Template
  46. 46. © LivingWorks Education www.livingworks.net National Task Force Guidelines 1998 Reach Out- Suicide Prevention Strategy National Strategy for Action on Suicide Prevention 2005-2014
  47. 47. © LivingWorks Education www.livingworks.net Connecting for Life Strategy 2015-2020
  48. 48. © LivingWorks Education www.livingworks.net Numbers Trained in ASIST and SafeTALK Year SafeTALK Workshops SafeTALK Participant ASIST Workshops ASIST Participants 2004 0 0 30 641 2005 0 0 80 1724 2006 11 200 150 3184 2007 30 473 151 3219 2008 31 443 152 3279 2009 58 915 159 3348 2010 199 3439 158 3461 2011 282 5100 162 3525 2012 326 6921 156 3444 2013 379 6982 154 3406 2014 319 5891 114 2509 2015 343 6353 106 2501 Total 1,978 36,717 1,572 34,241
  49. 49. © LivingWorks Education www.livingworks.net Template
  50. 50. © LivingWorks Education www.livingworks.net ASIST/SafeTALK Lithuania
  51. 51. SN1777 © 03/2008 LivingWorks Education www.livingworks.net 2 Suicide Alert and ASIST helpers Becoming a suicide-safer community
  52. 52. © LivingWorks Education www.livingworks.net Suicide Safer Lithuania Vilnius Lithuania August 26th 2016 First safeTALK and ASIST Trainers along with Translators, Municipality, Public Health, University of Lithuania, Suicide Prevention Bureau, local Politicians and LivingWorks Team
  53. 53. © LivingWorks Education www.livingworks.net Lithuania Progressing to a national strategy through safeTALK and ASIST
  54. 54. © LivingWorks Education www.livingworks.net a suicide-safer community Bendruomenė saugesnė nuo savižudybių www.livingworks.net
  55. 55. © LivingWorks Education www.livingworks.net ASIST References (Partial) Australian Institute for Suicide Research and Prevention (2012). A review of the Operation Life suicide awareness workshops: Report to the Department of Veterans' Affairs. Brisbane, QLD: Author. Bolton S-L, (2015). Evaluation of a gatekeeper training program as suicide intervention training for medical students: A randomized controlled trial. Retrieved from University of Manitoba DSpace, http://hdl.handle.net/1993/30725 Gould MS, Cross W, Pisani AR, Munfakh JL, Kleinman M (2013). Impact of Applied Suicide Intervention Skills Training (ASIST) on National Suicide Prevention Lifeline counselor interventions and suicidal caller outcomes. Suicide and Life-Threatening Behavior, 43(6), 676-691. Griesbach and Associates (2008). The use and impact of Applied Suicide Intervention Skills Training (ASIST) in Scotland: An evaluation. Edinburgh, Scotland: The Scottish Government, Health and Community Care. Høifødt TS, Talseth A-G, Olstad R (2007). A qualitative study of the learning processes in young physicians treating suicidal patients: from insecurity to personal pattern knowledge and self-confidence. BMC Medical Education, 7:21 doi:10.1186/1472-6920-7-21 McAuliffe N, Perry L (2007). Making it safer: A health centre’s strategy for suicide prevention. Psychiatric Quarterly, 78, 295-307. Public Health Agency (2011). All Island evaluation of Applied Suicide Intervention Skills Training (ASIST): Summary report. Belfast, Northern Ireland: Author. Evans RE, Price S (2013). Exploring organisational influences on the implementation of gatekeeper training: A qualitative study of the Applied Suicide Intervention Skills Training (ASIST) programme in Wales. Critical Public Health, 23(2), 213-224.
  56. 56. © LivingWorks Education www.livingworks.net safeTALK References Eynan R (2011). Preventing suicides in the Toronto Subway System: A program evaluation. [Thesis – University of Toronto, Toronto, Ontario]. Forward for Life & Common Unity (2014). Suicide prevention training in Hertfordshire: An overview of delivery of the combined approach for suicide prevention implemented on behalf of Hertfordshire County Council Public Health Service 2014. Gullestrup J, Lequertier B, Martin G (2011). MATES in construction: Impact of a multimodal, community-based program for suicide prevention in the construction industry. International Journal of Environmental Research and Public Health, 8, 4180-4196. McLean J, Schinkel M, et al (2007). Evaluation of the Scottish safeTALK pilot. Edinburgh, Scotland: Scottish Development Centre for Mental Health. Mellanby R, Hudson NPH, et al (2010). Evaluation of suicide awareness programmes delivered to veterinary undergraduates and academic staff. Veterinary Record, 167, 730-734. Robinson J Evaluation of the safeTALK program in the Northern Territory. Poster session presented at: American Association of Suicidology Annual Conference; 2016 Mar 30–Apr 2; Chicago, IL. Martin G, Swannell S, Milner A, Gullestrup (2016). Mates in Construction Suicide Prevention Program: A Five Year Review. J Community Med Health Educ 6:465. doi:10.4172/2161-0711.1000465
  57. 57. © LivingWorks Education www.livingworks.net Questions? If you have further questions Please contact: Richard Ramsay (President LivingWorks) richard.ramsay@livingworks.net Heather Stokes (Vice President Strategic Development) heather.stokes@livingworks.net