Improving Primary Care Response to Youth Suicidality: A Longitudinal Study of a Large-Scale Workforce Training...

Area of Science:

• Public Health
• Mental Health Training
• Primary Care Pediatrics

Background:

• Primary care clinicians (PCCs) play a crucial role in identifying and managing youth suicidal ideation and behavior (SIB).
• There is a need for effective training programs to enhance PCCs' skills in addressing youth SIB.
• Workforce retraining initiatives are essential for improving mental health care delivery in primary settings.

Purpose of the Study:

• To evaluate an intensive, theory-based workforce retraining program for PCCs focused on youth SIB assessment and management.
• To determine if the training improves PCCs' knowledge, self-efficacy, and behavioral intentions regarding youth SIB.
• To assess the sustained impact of the training on PCCs' clinical practices at 6-month follow-up.

Main Methods:

• A longitudinal study involving 3,246 PCCs (pediatricians, family physicians, nurse practitioners) from 2017-2024.
• The training program comprised a 3-day workshop and 6 months of case-based coaching.
• Self-report assessments measured SIB knowledge, self-efficacy, rating scale use, and practice changes at baseline, post-workshop, and 6-month follow-up.

Main Results:

• Significant, sustained increases in SIB knowledge, self-efficacy, and self-reported practice changes were observed from baseline to 6-month follow-up (p <.0029).
• Improvements in knowledge and self-efficacy predicted practice changes at follow-up.
• Training effects were consistent across clinician disciplines, with recent updates yielding even greater gains.

Conclusions:

• An intensive, theory-based retraining program effectively improves and sustains PCCs' preparedness to assess and manage youth SIB.
• Integrating suicidality training within broader pediatric mental health retraining offers a scalable strategy.
• This approach can enhance first-responder capacity to address the critical issue of youth suicide.