Evaluation of suicide intervention effectiveness.

Considering the prevalence of suicide and other forms of self-injurious behavior, it is ironic that relatively little attention has been paid to the training of mental health workers in suicide intervention. Still less effort has been spent in evaluating the effectiveness of such workers or the agencies in which they serve. We review the evaluation strategies that have been used to assess the process and outcome of suicide intervention, ranging from macroanalyses of the impact of crisis services on suicide rates in the community to microanalyses of the competence of individual suicide interventionists. Particular attention is paid to the Suicide Intervention Response Inventory, a self-administered test of suicide counseling skills whose validity, reliability, and practical utility suggest the benefit of its use in a broader range of research and applied settings. The advantages and disadvantages of each evaluation strategy are discussed, and guidelines are offered for the sophistication of future research and program evaluation efforts.