Anyone can have thoughts of suicide.
Everyone can learn to help
Results of the Impact Evaluation of the Choose Life
National Training Programme
Erica Stewart-Jones
Choose Life
NHS Health Scotland
 Choose Life strategy launched in 2002
 Target to reduce suicide in Scotland by 20% by
 Training was a key part of the implementation
 Key relevant objectives:
early prevention and intervention
responding to immediate crisis
coping with suicidal behaviour and completed suicide
promoting greater public awareness and encouraging
people to seek help early
choose life: A National Strategy and Action Plan to Prevent Suicide in Scotland (2002), Scottish
Gatekeeper training
Teachers and school staff
School health personnel
Police officers
Correctional personnel
Supervisors in occupational
Natural community helpers
Hospice and nursing home
Primary health care providers
Mental health care and substance abuse treatment providers
Emergency health care personnel
Launch of the Choose Life strategy
Launch of the HEAT
H5 training target
Impact Evaluation Purpose
To improve the understanding of the effectiveness
and impact of rolling out a cascaded programme of
training, involving a suite of training options, as an
intervention to help reduce the incidence of suicide
in Scotland through increasing incidences of
helping behaviour and to reduce the stigma
associated with suicide and suicide-prevention
Impact Evaluation
How has the Choose Life training programme impacted on
practice and behaviour change when dealing with people with
thoughts of suicide at the individual, community, organisational or
systems level across different localities in Scotland?
More specifically, is the Choose Life Training Programme effective
Creating behaviour and/or practice change at the individual,
community, organisational or system levels
Impacting on attitudes in the immediate environment of
participants and impacting on their organisation’s policies and
attitudes towards suicide and people with thoughts of suicide
Contributing to the creation of an environment of reduced
stress and increased confidence in self and others when
helping people with thoughts of suicide
 Review evidence of previous evaluations within Scotland
 Survey of local areas focusing on reach of the
 Survey with past participants of the courses
 Interviews with trainers
 Four in-depth case studies including interviews with
participants, trainers, local co-ordinators, managers and
senior managers.
 Follow-up analysis reviewing findings in light of
international evidence around suicide prevention and the
delivery of large scale training programmes and the
learning gathered by the Choose Life national team
Results: Impact
Reported and observed
 Increased confidence to talk about suicide at
individual and team/organisational levels
 changes in behaviour and practice of individuals
 changes in organisational policies, systems and
 changes in attitudes to talking about suicide at
individual and team/organisational levels
 Increased confidence and reduced stress in dealing
with thoughts of suicide
and completed suicide
The training programme has:
 increased the knowledge, skills and improved
attitudes of participants
 Influenced changes in behaviour and practice
 Influenced changes to organisational
procedures and culture
 Led to a reduction of stigma around discussing
and dealing with suicide
Discussion: Reach
 Targeting professional service provision roles
 GPs and Accident & Emergency
 Gender
Discussion: Administration
 Supporting trained gatekeepers
 Integration
 National Programme Administration
 National centralised team
 Local co-ordination
 Trainers
Transferability of skills
 The range of courses has developed key skills
which are transferable
 For example lecturers at the University of the
West of Scotland saw their students using the
listening and questioning skills learned in ASIST
in other parts of their training.
Discussion: Delivery Methods
Range of courses
Cascaded delivery
Undergraduate courses vs CPD
Multi-agency/disciplinary training
Blended learning
Implications: part 1
 Gatekeepers in a non-professional role
 GPs and A&E: development of additional training options
 Gender: Targeting the training more towards men
 Gatekeeper support:
 refresh skills and information on sources of support.
 sources of support for themselves following an intervention
 organisational and cultural changes needed to support practice
 Transferability of skills from the training
 Continuing the local and national support was considered vital to the
continuing success of the programme.
Implications: part 2
 Trainer skills maintenance
 Training should be delivered in multi-agency or
multi-disciplinary groups as a preference.
 Blended learning
 more TuneUp and suicideTALK courses
 delivering ASIST, safeTALK and STORM is
the most effective approach whenever
Thank you

Anyone can have thoughts of suicide. Everyone can learn …