Skills Training on Risk Management

The STORM Background Mid 1990’s STORM ® began as a research project at the University of Manchester in response to the need for skills-based self-harm risk assessment and management training underpinned by Adult Learning Theory. The STORM ® model of training has been tested in research studies at the University of Manchester. Findings show the model increases skills, improves attitudes to self-harm mitigation, and confidence in assessing risk and safety planning. The training is highly rated as useful and relevant 'The STORM ® Project', a research group was created to widely disseminate the training to service providers, healthcare, social care, education and criminal justice services. There are currently over 500 trained Facilitators, delivering training in organizations and partnerships across the UK, Republic of Ireland, and Malta. We are also engaged in social impact work providing STORM ® training to mental health workers in Russia, Pakistan, and Bangladesh, where training is difficult to fund. Our mission is to increase this work and reach out to communities here in the UK and internationally. In 2012, STORM ® Skills Training CIC, social enterprise, was created to build on this work. As a community interest company all profits will fund our social impact work and the research undertaken by The STORM ® Project at the University of Manchester.

PCH and STORM Objective 1 (1.2) of the National Suicide Prevention Strategy and it’s Annual Report on Progress 2005 ‘…..to reduce risk in key high risk groups.’ ‘A risk assessment training package will be made available by NIMHE (CSIP) to frontline clinical staff, the Prison Service, primary care, substance misuse services and college counselling services.’

What have we got? STORM training objectives: To develop/enhance skills and confidence in suicide prevention. To provide a forum for discussion on related practice issues. To provide a common language around suicide assessment and management. To provide networking opportunities with other professionals/agencies. 635 Mental Health and other staff trained (including GP’s) since 2007

The STORM package There are four modules covering: Assessment Crisis Management Problem Solving and Crisis Prevention –Short lectures specific to skills being taught. –Videotaped excerpts are shown to demonstrate skills to be learned. – –Role-rehearsal enables participants to practice skills with the benefit of self-reflection and feedback. –Videotaped rehearsal compliments the learning process offering the opportunity to observe performance and benefit from self- reflection and feedback.

Module 3: Problem Solving Problem Solving is a basic technique that can help a person take control of their problems. –Rehearsal focuses on teaching this basic problem solving technique Module 4: Crisis Prevention Crisis Prevention is an extension of Crisis Management. It draws on the techniques of keeping –a person safe and develops a strategy/discharge plan for the future. –Rehearsal focuses on identifying signs & triggers, building a network of support and recognizing self help strategies

Content of Training Module 1: Assessment Assessment is concerned with the skills needed to assess suicidal risk. –interview skills –suicidal ideation and degree of seriousness, –risk factors and levels of risk. –Practice focuses on identifying suicidal intent and degree of seriousness Module 2: Crisis Management Crisis Management forms part of Assessment, it is taught as a separate module. It concentrates on the skills needed to keep –the person safe after suicidal intent and risk is established. –Rehearsal focuses on removing/restricting means of lethality and building a network of support

Research History STORM is evidence based and has undergone three stages of evaluation since its introduction in STORM has been successful in developing and formalising the skills needed to assess and manage suicidal risk and improved participant’s confidence and attitude towards suicide prevention

STAGE 1 Evaluation of Package (Morris et al, 1999) Evaluated the content and the teaching format of STORM package STAGE 2 Translation into Practice comprised of two studies Study 1 Geographical Feasibility (Appleby et al, 2000) Evaluated the impact of training across 3 health care settings within a geographical area (South Lancashire) Study 2 Clinical Practice (Gask et al, in process) Evaluated the maintenance of skills and changes in clinical practice (mental health professionals)

STAGE 3 Intervention & Translation Nationally and Internationally Exploration of the dissemination of a health improvement training package (STORM) across complex organizations

Where does STORM fit in? Supports other risk assessment and management training (ASIST, HRC20) with a structured system for clinical recording. Supports Person Centred Approaches (WRAP ELP etc.) and person centred risk evaluation. Supports positive risk taking. Supports Appreciative Inquiry, CBT, Solution Focussed methods and approaches. It is adaptable to many settings. It represents good practice.