Assessing suicide management skills of emergency medical services providers before and after suicide intervention/prevention training with Lithuanian version of suicide intervention response inventory

Background: Effective suicide management skills of emergency medical services (EMS) providers are crucially important in Lithuania, which has the highest suicide rates in Europe. Methods: Respondents were 268 EMS providers, doctors (n=78) and nurses (n=190), who agreed to participate in suicide prevention/intervention training and completed the survey twice. Study was conducted in five steps: adaptation of Lithuanian version of Suicide Intervention Response Inventory (SI RI-LT); initial assessment of suicide counseling skills of the EMS providers using SI RI-LT; suicide prevention/intervention training; second assessment of suicide counseling skills using SIRI-LT 6 months after training; data analysis evaluating the skills and effectiveness of the training among different groups of EMS providers (doctors vs nurses, age groups). Results: SI RI-LT showed good internal consistency: Cronbach's alpha score of 0.85 (pretest) and 0.73 (posttest). The value of Kaiser-Meyer-Olkin measure of sampling adequacy was 0.849. A four-factor solution was forced and accounted for 40.8% of the variance. The SIRI-LT mean total scores before suicide prevention/intervention training were significantly higher for doctors than for nurses (13.01 +/- 5.24 vs 11.36 +/- 5.14, respectively; P=0.031). Younger respondents with a shorter period of employment and heavier workload were significantly more effective at suicide management than older respondents with a longer period of employment and lower workload. After suicide prevention/intervention training, SI RI-LT mean total scores decreased for doctors (13.0 +/- 5.24 vs 11.02 +/- 4.76; P=0.031) and significantly increased in older (55 age) respondents (11.85 +/- 3.82 vs 9.28 +/- 4.44; P=0.022). Conclusion: SIRI-LT has good internal consistency and can be considered a good instrument for assessing suicide management skills of EMS providers. Our results suggest that ability to find appropriate responses to suicide situations may be multidimensional, related to cultural setting and influenced by age, education, motivation, engagement, and emotional distraction. Particular attention should be paid to active listening and empathic communication skills when developing suicide prevention/intervention training for EMS providers.