Training School Staff to Prevent Suicide and Promote Mental Health: Outcomes from Virtual PC CARES at School Intervention.

Suicide is a persistent health inequity for rural Alaska Native (AN) youth. School staff in rural AN communities need training and support to prevent suicide and promote mental wellbeing among AN students. This study presents learning and behavior outcomes from Promoting Community Conversations About Research to End Suicide (PC CARES), done virtually in seven monthly, 2 h sessions with school staff. PC CARES brings people together for a series of interactive workshops to gain skills to prevent suicide across the prevention spectrum. Baseline and 1 month follow-up surveys track adult participants' proximal suicide prevention outcomes of self-efficacy, "community of practice" and behavior outcomes: working together to prevent suicide and promote health; interpersonal support; lethal means reduction and postvention. Mixed effects models tested for pre/post changes for outcomes across participants with complete data (n = 128-140). Moderator analyses tested differential outcomes by number of sessions, cohort, participant role, and school policies. There were 172 PC CARES participants from 21 rural schools and communities in northwestern Alaska in 2020-21 and 2021-22, with average attendance between 4 and 5 sessions. Participants reported significant beneficial changes across all outcomes. Greatest changes occurred for participants with less mental health training (i.e., teachers increased more than school counselors). Greater gains happened in schools where participants reported fewer suicide prevention policies. In rural Alaskan community schools with a high prevalence of suicide, PC CARES At School increased participants' understanding, collaborations, and actions for supporting AN student mental wellbeing and decreasing suicide risk in culturally responsive ways.