Suicide is the tenth leading cause of death in the United States (McIntosh & Drapeau, 2018). Mental illness is prevalent among suicide deaths (Cavanaugh et al., 2003) and psychologists can expect to have clients with increased suicide risk during their training or career (Dexter-Mazza & Freeman, 2003; Kleespies, Penk, & Forsyth, 1993), it is vital that students training to be health service psychologists, including clinical psychology, counseling psychology, and school psychology (APA, 2018), be competent in providing clinical care to individuals with increased suicide risk. Competency incorporates “knowledge, skills, attitudes, and personal qualities” essential to clinical practice (Albanese et al., 2008). Although suicide is an important topic, only two studies have directly examined clinical skill with suicidal clients by graduate students (Mackelprang et al., 2014; Neimeyer & Bonnelle, 1997). There have been many calls to further emphasize clinical preparation related to suicide assessment and management (SAM; Neimeyer, 2000; Rudd et al., 2008; Westefeld et al., 2000), particularly because many students receive little training related to suicide at the internship level or beyond (Schmitz et al., 2012). The current study examined the experience, training, and competency of 140 health service psychology graduate students prior to internship, using a measure of skill (Suicide Intervention Response Inventory [SIRI-2]; Neimeyer & Bonnelle, 1997), attitudes, knowledge (Attitudes Towards Suicide Scale [ATTS]; Salander Renberg & Jacobsson, 2003), and a self-rating of clinical suicide competency (Suicide Competency Assessment Form [SCAF]; Cramer et al., 2013). These measures were compared examining a number of personal qualities identified in previous research as potentially affecting skill, attitudes, or knowledge related to suicide.
Findings indicate nearly all graduate students were providing clinical services to clients with suicidal thoughts or attempts prior to internship. Most students reported receiving instruction and training through their graduate programs with one in five reporting none. More than two thirds indicated they had pursued training outside of their doctoral program. Students, on average, rated themselves as competent on most skills related to SAM and identified several deficiencies. Skill scores indicated the sample achieved an advanced level of skill. Clinical, training, research, and policy recommendations for findings are discussed.