Can web-based training improve management of suicidal patients?

Despite the increasing need, most mental health professionals receive scant training for managing suicidal patients. This is of particular interest to the VHA which employs the greatest number of such providers in the U.S. To improve the preparedness of VA mental health clinicians, we developed an e-learning course covering the same material and learning objectives of a well-known program, the Collaborative Assessment and Management of Suicidality (CAMS). We aimed to test the effectiveness of CAMS e-learning (e-CAMS), when compared to that of CAMS in-person (i-CAMS). Mental health providers were recruited from 5 VHA hospitals and randomly assigned to one of 3 conditions (e-CAMS, i-CAMS, control). Those assigned to e-CAMS were given login information to access the web-based training and given 6.5 hours of non-clinic time to take the course. In i-CAMS clinicians were assigned to a live training session at a local site and given 6.5 hours to attend. Completers of both trainings received 6.5 hours of CMEs. All participants were given a pre-, post-, and 3 month follow-up survey which assessed competence, reactions, beliefs, motivations, and practice. Provider's patient charts were then reviewed for health services use, and the number and duration of high risk episodes.

212 mental health professionals, who were responsible for 285 suicidal patients, enrolled in the study, with 187 (88%) completing. Analysis of the provider data shows that there were only minor differences between the e-CAMSe and i-CAMS clinicians in terms of knowledge, attitudes, and satisfaction. Additional analyses are in process and will be reported.