Thank you for your commitment to patient safety and for exploring these pages. As you know, the National Strategy for Suicide Prevention 2001 specifically calls for enhancing clinical knowledge and skill in the prevention of suicide in healthcare settings, as well as improving the policy and procedures that address client safety.

As you also know, preventing patient suicide attempts and completions is a critical patient safety issue in all healthcare organizations. Before selecting one or more training programs to address this often overlooked area of clinical practice and care, we invite you to explore the QPR Institute’s systems approach to suicide risk reduction.

The QPR Institute offers an ecological care model that specifically addresses the challenges of preventing suicidal behavior in clinical settings. This integrated systems approach is now used by more than 1,000 agencies, hospitals, military commands and individual practitioners across the United States.

Screening for Suicide
Before suicide risk can be assessed, it must first be detected. Most busy primary care providers lack the time necessary to conduct a comprehensive suicide risk assessment, but do have an affirmative duty to screen for suicide risk in identified high-risk groups. As part of its systems approach, the QPR Institute provides Gatekeeper training designed to teach primary care staff how to screen for suicide potential.

Suicide Warning Signs Recognition and Referral Training for All Staff
Clinical staff is not always in the best position to recognize when a patient or client is emitting suicide warning signs, e.g., a patient paying his co-pay says to the receptionist, “Tell Dr. Smith he was great and I know he really tried to help, but I won’t need any more appointments.” Failure to recognize this statement as a possible suicide warning sign may be a missed opportunity to avoid an adverse event.

The QPR Institute provides Gatekeeper training designed to teach non-clinical support and administrative staff how to recognize and refer consumers or even other staff who may be sending suicide warning signs. For a description of the QPR Gatekeeper Training for Suicide Prevention program, click here.

Suicide Risk Assessment Training
Once risk has been detected, it must be assessed and managed. To assist professionals responsible for patient safety in this task we provide a standardized, evidence-based suicide risk recognition and assessment skills training program for professionals at all levels of experience. In comparing training programs, here are six key questions to ask.

  1. Is it field tested?
  2. Is it evidence-based?
  3. Has the training been evaluated by objective 3rd parties?
  4. Does the training provide a standardized documentation protocol?
  5. Is there a competency-based credentialing option?
  6. Is the training offered online and for continuing education credits?

The assessment protocol we teach is the QPRT Suicide Risk Management Inventory©, 1999, published by the QPR Institute and available in adult, youth, and inpatient (hospital) versions. This is the most widely-used standardized risk assessment interview protocol in use today. The training is standardized and is designed to establish specific competencies in the detection, assessment, and management of suicide risk in all clinical settings, including medical, behavioral health, and substance abuse treatment facilities.

For a comprehensive description of how the QPR Suicide Risk Reduction Program has been successfully implemented by the largest non-profit provider of mental health services in the United States, we urge you to review a summary description of the Joint Commission’s recent article in Perspectives of Patient Safety describing this project by the Devereux Foundation. Click here.

Pricing
In conjunction with its educational partner, Eastern Washington University, all QPR Institute training programs may be delivered using distance learning technology, resulting in substantial savings in time, travel and staff costs. These learning platforms include blended online training programs (DVD lectures and study guides, online tutorials and quizzes), train-the-trainer programs, and multimedia, interactive, certificate programs for those learning the QPR Gatekeeper Training Program for Suicide Prevention. To estimate the cost of program installation, click here.

Frequently asked questions
Here are frequently asked questions about the QPRT Suicide Risk Management Inventory© as well as linked files for supporting research and additional information about this tool. Please note that some of these files are extensive.

Question: What is the QPRT Suicide Risk Management Inventory©?

Answer: The QPRT Suicide Risk Management Inventory© is a highly-tested, structured clinical interview protocol designed to detect, assess and manage emergent suicide risk in consumers of medical, chemical dependency and behavioral health services. Several versions of the training program are available, including youth, adult, inpatient and outpatient, as well as a program tailored to chemical dependency counselors and college or university counselors. The QPRT does not have psychometric properties, but does produce a shared, documented, safety and monitoring plan to reduce the immediate risk of suicidal behaviors.

Question: Can a clinical provider use the protocol effectively without training?

Answer: No. Our experience in training more than 10,000 healthcare professionals in the United States and abroad shows that the safe and effective use of the QPRT requires a structured 7-8 hour (online or face-to-face) training program taught by experts in the field of suicide risk assessment, management and prevention. This is a core competencies training program and requires passing a nationally standardized 25-item exam to earn a certificate. For an example of pre/post QPRT training scores on this quiz by profession, click here .

Question: When is the QPRT suicide risk assessment interview conducted and documented in the protocol format?

Answer: At initial intake, at all significant transitions in care, at termination and/or when additional risk factors or suicide warning signs are observed. These recommendations are in keeping with guidelines suggested by the Joint Commission on the Accreditation of Healthcare Organizations.

Question: Why not just document a suicide risk assessment in the progress notes?

Answer: Historically, clinical providers have noted their suicide risk findings in progress notes. Unfortunately, this documentation is often sparse and uninformative to other decision-making staff, which may lead to poor communication and contribute to an adverse event. Because suicide is the leading cause of premature death in persons with Axis I disorders and because there is an increasing focus on patient safety as relates to suicidal behavior a thorough assessment and documentation of suicide risk is necessary to a) prevent suicidal behaviors and b) avoid claims of suicide malpractice.

Question: Is this documentation system helpful in avoiding claims of suicide malpractice?

Answer: In 1998 the QPRT Suicide Risk Management Inventory© and associated risk reduction practices won the J.J. Negley Associates, Inc. Presidents Award for Avoiding Suicide Malpractice. This $15,000 award was given to Spokane Mental Health (where the program originated) by the National Council for Behavioral Health Care Organizations at their annual convention in Chicago, Illinois.

Question: Is the QPRT a stand-alone tool?

Answer: In many settings, a QPRT assessment is sufficient to set up a patient care and safety plan. However, the QPRT is a key part of a larger institutional suicide risk reduction program which mandates training at all staff levels in a healthcare organization to help ensure patient and staff safety.

Question: How can my staff get QPRT training?

Answer: Online QPRT training is available through the School of Social Work and Department of Educational Outreach at Eastern Washington University. For a description of this option, click here. QPRT training is also available in a classroom setting hosted by your organization, for your staff and/or others in your community. Highly experienced licensed trainers are available nationally.

Question: How much does QPRT training cost?

Answer: Onsite training for up to 25 persons is $2,500 per day, plus travel expenses and inclusive of study guides and materials. For each person over 25, $149 is charged. Online QPRT training, through Eastern Washington University, is $149 per person, inclusive of mailed study guide, DVD lectures, user’s manual and continuing education credits ($239.00 for college credit). Volume discounts are available for 10 or more staff.

Question: Are continuing education or college credits available?

Answer: Yes, National Board of Certified Counselor credits are available for all face-to-face classes and continuing education credits are available for all online courses, including 6.5 hours of CE from the American Psychological Association. The QPR Institute will assist your organization with the necessary goals and objectives to meet local continuing education requirements should you schedule a face-to-face training.

Question: Do you have a train-the-trainer option?

Answer: Yes. The QPR Institute offers a train-the-trainer option for teaching the QPRT. To become a licensed instructor requires approximately 36 hours of self-study, online training, reading, and quizzes. For successful QPRT applicants who become licensed to teach QPRT, faculty appointments to the QPR Institute and opportunities to travel and train others may be available. For more information on this option please contact the QPR Institute.

Question: Are there ongoing costs associated with using the QPRT protocol?

Answer: Yes. The QPRT protocol is a copyrighted assessment tool and may not be replicated without permission. However, the QPR Institute sells hard copy protocols from its website or they can be ordered by phone. Another option is our site license to replicate and distribute the protocol in unlimited quantities based on a simple, anticipated utilization formula. The assessment inventory can also be added to your electronic medical records system at the same annual fee.

Question: Who developed the QPRT and what is its history?

Answer: The QPRT training program/protocol was developed by an experienced multidisciplinary team of mental health, substance abuse treatment professionals, and suicide prevention specialists. For a complete developmental history of the QPRT, click here .

Question: What evaluations of the training have been conducted?

Answer: Every QPRT course is evaluated by participants and, where possible, by independent, third party evaluators. For a formal and comprehensive evaluation of the training by the University of Georgia, click here .

Question: Can training staff in the use of the QPRT lead to quality-improvement projects?

Answer: The QPR Institute provides two turn-key CQI programs that may be completed using training data collected from QPRT training. These are free to purchasers on request.

Question: Have consumers of service ever evaluated their experience in being assessed for suicide risk with the QPRT?

Answer: Yes. Consumers of mental health services were surveyed for their reactions to the QPRT interview. For a narrative description of this study, click here .

Question: Given the move to evidence-based practice and the demonstration of competencies, is there a credentialing process to assure that those trained in using QPRT in clinical practice are doing it correctly?

Answer: Yes. The QPR Institute provides a four-step credentialing process to determine staff competency to conduct a suicide risk assessment and management/monitoring plan in clinical settings. We also provide annual review standards, quality of documentation standards, and quality-assurance guidelines. These are free to purchasers on request.

Question: Who is using QPR Institute programs now?

Answer: QPR programs are currently in use by a wide variety of healthcare organizations, universities, military units, schools and tribes. The derivative program, (QPR Suicide Triage Training for 1st responders) is used by dozens of police departments and the US Army, among others.

A Final Note
Before adopting any suicide risk reduction training program, we ask that leadership consider the following:

  • Suicide prevention funding often follows tragedy or, in the clinical care setting, an adverse event. While a bad outcome may stimulate a call for training, one-time training fails to address the ongoing need for maintaining safety practices and necessary staff competencies to address these issues over time.
  • Suicide is a public health problem that impacts not only consumers of our services, but our staff, their family members, and the communities we all serve. According to the Centers for Disease Control, most suicide deaths in America occur in between the ages of 25 and 55. This is our work force and it is your work force. Please consider that to reduce suicidal behaviors in all areas of concern requires that leadership participate in and help build institutional and community support for suicide prevention activities throughout the communities that sustain us.
  • To help organizations address the issue of program implementation and sustainability we invite you to explore a series of self-study questions. Click here

We also invite you to explore the QPR Institute’s web site , call us at 509-536-5100 or email us at qinstitute@qwestoffice.net with your questions.

Thank you for your time.