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Dawn Griesbach, Patricia Russell, Rona Dolev, Clare Lardner (Griesbach and Associates)

ISBN 978 0 7559 7096 4
ISSN 0950 2254

This document is also available in pdf format (1Mb)

CONTENTS

ACKNOWLEDGEMENTS

EXECUTIVE SUMMARY

CHAPTER ONE: INTRODUCTION AND BACKGROUND
Why do this evaluation?
Brief epidemiology and policy context
Aims and objectives
Important things to note
Structure of this report

CHAPTER TWO: WHAT IS ASIST?
Background
Course content
The process of updating the training
Dissemination of training
Training for Trainers (T4T)
International Collaborative Committee ( ICC) agreement
Other suicide prevention training programmes
Similarities and differences between ASIST, STORM, MHFA and SMHFA

CHAPTER THREE: METHODS
Our approach to the evaluation
Summary of study methods
Review of the international literature on ASIST
Review of other suicide prevention training programmes
Analysis of the national ASIST database
National survey of ASIST participants
Interviews with ASIST participants
Interviews and focus groups with ASIST trainers
Interviews with key stakeholders
Local implementation studies

CHAPTER FOUR: IMPLEMENTATION OF ASIST IN SCOTLAND
Implementation at a national level
Implementation at a local level
The views of national and local stakeholders
How could ASIST become sustainable?

CHAPTER FIVE: KIRKPATRICK LEVEL 1 - WHAT DO PEOPLE THINK ABOUT ASIST?
Overall reactions to ASIST
Usefulness and relevance of training
Quality of training
Mixed and negative reactions to ASIST

CHAPTER SIX: KIRKPATRICK LEVEL 2 - WHAT DID PEOPLE LEARN FROM ASIST?
Attitudes
Immediate, post-workshop changes in confidence, knowledge and skills
Maintaining increased skills, knowledge and confidence over time
Whether participants are more likely to intervene
Refresher training
Other training related to suicide prevention prior to, and following, ASIST

CHAPTER SEVEN: KIRKPATRICK LEVEL 3 - WHAT DID PEOPLE DO AS A RESULT OF THE TRAINING?
Intervening with a person at risk
Reports from managers
Other indirect measures of Kirkpatrick level 3 outcomes
Profile of intervener and non-intervener
Intervening with different groups
Female vs. male interveners

CHAPTER EIGHT: KIRKPATRICK LEVEL 4 - WHAT DIFFERENCE HAS ASIST MADE?
Findings from the review of the international literature
Suicide rates
Reducing stigma and raising awareness in organisations and communities
Impacts on service development and planning
Impacts on multi-agency working and information sharing
Impacts on policies and procedures within agencies
Where impacts were limited, unknown, or failed to materialise

CHAPTER NINE: TRAINERS' EXPERIENCES OF ASISTFacts and figures
Recruitment and selection of trainers
Trainers' views on the effectiveness and impact of ASIST - Kirkpatrick levels 1-4
Turnover among trainers
Competence of trainers
Perspectives on ASIST

CHAPTER TEN: THE COST OF ASIST IN SCOTLAND
National costs: payments made to LivingWorks
Other national costs associated with the implementation of ASIST
Introduction of NIST pricing policy
Local costs: venue hire, catering and trainers' fees
Views on the costs of ASIST
How the cost of delivering ASIST can be made cheaper

CHAPTER ELEVEN: DISCUSSION
The implementation of ASIST in Scotland
The effectiveness of ASIST
What has been the impact of ASIST?
The future of ASIST: whether and how it can be made sustainable
Areas for action
Conclusion

REFERENCES

ANNEXES

ANNEX 1: FURTHER DETAILS ABOUT THE HISTORY OF ASIST, THE CONTRACT BETWEEN PROVISIONAL TRAINERS AND LWE, AND THE CRITERIA FOR INTERNATIONAL COLLABORATIVE COMMITTEE MEMBERSHIP, AND LWE'S EXPECTED TRAINER AND CAREGIVER COMPETENCIES

ANNEX 2: LOCAL IMPLEMENTATION STUDIes

LIST OF TABLES
Table 2.1: A comparison of different aspects of ASIST, STORM, MHFA and SMHFA
Table 3.1: Logic model for the Applied Suicide Intervention Skills Training ( ASIST) programme in Scotland
Table 3.2: Description of ASIST survey respondents, by gender
Table 3.3: Comparison of the percentage of ASIST participants in the national database and the survey, by year of course completion
Table 5.1: Percentage of ASIST participants rating elements of ASIST workshop as 'very useful' or 'somewhat useful'
Table 6.1: Reported levels of confidence, knowledge and skills before training, immediately after, and at follow-up among participants who had intervened with a person at risk prior to their ASIST training and participants who had not
Table 6.2: Suicide intervention confidence, knowledge and skills scores for males and females before training, immediately after and at follow-up
Table 7.1: Key characteristics of people who have intervened following ASIST ('intervener'), people who haven't intervened ('non-intervener'), and the overall sample
Table 7.2: Perceived levels of suicide intervention confidence, knowledge and skills before training and at the time of the survey among interveners and non-interveners
Table 7.3: Percentage of male and female participants who have intervened with male and female clients, personal contacts and colleagues following ASIST training
Table 10.1: Payments to LivingWorks Education, 2004-05 to 2007-08, by financial year
Table 10.2: National cost of ASIST, April 2004 - January 2008

LIST OF FIGURES
Figure 1.1: Suicide rates in Scotland, 1996-2006
Figure 4.1: Number of ASIST workshops delivered and number of completed participants in Scotland, 2003-2007, by calendar year
Figure 5.1: Percentage of survey participants who agreed that attending ASIST training had been a good use of their time, by local authority
Figure 6.1: Percentage of participants reporting 'high' or 'very high' levels of confidence, knowledge and skills, before ASIST training, immediately after ASIST training, & at the time of the survey
Figure 7.1: Percentage of males and females who had intervened with a person at risk of suicide before and after ASIST training

The views expressed in this report are those of the researcher and
do not necessarily represent those of the Department or Scottish Ministers.

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