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Teaching front-line health and voluntary workers to assess and manage suicidal patients.

BACKGROUND: To devise and evaluate the retention of a new brief training package for non-psychiatrically trained multidisciplinary staff to assess suicide risk and manage suicidal patients, including referral of patients at significant risk to psychiatric staff. METHOD: 8 h of interview skills training, using role play with modelling and video feedback, was taught to 33 health and voluntary workers. Evaluation used a controlled before and after training design. Performance of the interview skills was assessed blindly by raters using predetermined criteria from videotaped role played interviews with actors. Self-rated questionnaires (SIRI-2 and visual analogue scales) were used to assess the clinical skills and confidence respectively of the front-line workers. RESULTS: Suicide risk assessment and management skills such as problem solving, future coping and provision of immediate support were significantly improved at 1 month after training. Training did not significantly improve general interview skills, combating hopelessness nor the removal of lethal weapons. Performance on the SIRI-2 and confidence significantly improved after training. The assessment procedure itself did not improve clinical skills nor confidence. LIMITATIONS: Performance among individual health disciplines was not assessed. Design was not a randomised controlled trial with short follow up and no patient outcome data. CONCLUSIONS: A brief training package is available which is effective in teaching suicide risk assessment and clinical management skills.

Adult↗
PubMed1996

Tuberculosis in the community: 2. The perceptions of members of a tuberculosis health team towards a voluntary health worker programme.

SETTING: A voluntary community health worker programme, in the Western Cape, South Africa, utilizing volunteers to administer directly observed therapy to tuberculosis (TB) patients. OBJECTIVE: This study describes the perceptions of health team members regarding the voluntary community health worker project. DESIGN: A qualitative, participatory research study utilizing focus groups. RESULTS: TB was perceived by the health team to be a stigmatized disease causing some patients to be reluctant to be associated with the TB control programme. Despite the project's dedicated approach to case-holding, volunteers expressed the need to develop skills in providing more comprehensive care. The volunteers appear to administer a more personalized service to TB patients and can bridge the gap between TB patients and the health agency. CONCLUSION: Sustained evaluation and support seem to be a vital tool in integrating a volunteer project into a health team approach. Its effectiveness appears to depend to a large degree on the people involved.

Adult↗