Quality improvement project (QIP): evaluating a pilot suicide awareness, screening and signposting training intervention for dental care professionals in a dental teaching hospital and school

Scotland's 2022 suicide prevention strategy recommends building skills and knowledge among healthcare staff who play a role in preventing suicide. A quality improvement project (QIP) in relation to this was initiated because several patients attending dental appointments disclosed suicidal thoughts and/or plans to attempt death by suicide. Dental staff and students involved expressed feeling ill-equipped at how to manage this situation. This initial QIP aimed to establish routine screening, identification and signposting of dental outpatients identified as having an increased risk of suicide during attendance at any dental clinic within the Dental Hospital. Several Plan-Do-Study-Act (PDSA) cycles ensued. First, to understand the problem, a scoping literature search on the role of dental professionals in preventing suicide and the availability of suicide risk awareness training frameworks for non-medical healthcare staff revealed few publications and no identified training frameworks. This was PDSA1. To gain insight into the local culture in relation to the QIP aims, two further cycles were undertaken. These examined whether dental patients were routinely screened for mental health conditions, and dental staff and student attitudes. Screening activity was measured, a new medical history intervention was implemented and a significant improvement in the number of patients being screened was seen (PDSA2). At the time of writing, the newly introduced medical history form is now used routinely to screen all outpatients attending the Dental Hospital, where 60 000 outpatients' appointments are delivered annually. PDSA3 sought dental staff and student views on whether suicide risk awareness is part of their role. This found suicide risk awareness is considered part of the dental professionals' role, but a lack of training, and a desire for training was expressed. With no suitable training frameworks, PDSA4 aimed to design, implement and evaluate a pilot training educational intervention by a clinical psychologist. Sixteen dental care professionals attended the workshop. To measure training effectiveness, participants completed pre-training (baseline) and post-training questionnaires to assess their self-efficacy around suicide awareness. Improvements in self-efficacy following training occurred across all domains, demonstrating a successful intervention which can be upscaled.