title: Reducing patients' suicide ideation through training mental health teams in the application of the Dutch multidisciplinary practice guideline on assessment and treatment of suicidal behavior: study protocol of a randomized controlled trial.
abstract: BACKGROUND
  To strengthen suicide prevention skills in mental health care in The Netherlands, multidisciplinary teams throughout the country are trained in the application of the new Dutch guideline on the assessment and treatment of suicidal behavior. Previous studies have shown beneficial effects of additional efforts for guideline implementation on professionals' attitude, knowledge, and skills. However, the effects on patients are equally important, but are rarely measured. The main objective of this study is to examine whether patients of multidisciplinary teams who are trained in guideline application show greater recovery from suicide ideation than patients of untrained teams.
  
  
  METHODS
  This is a multicentre cluster randomized controlled trial (RCT), in which multidisciplinary teams from mental health care institutions are matched in pairs, and randomly allocated to either the experimental or control condition. In the experimental condition, next to the usual dissemination of the guideline (internet, newsletter, books, publications, and congresses), teams will be trained in the application of the guideline via a 1-day small interactive group training program supported by e-learning modules. In the control condition, no additional actions next to usual dissemination of the guideline will be undertaken.Assessments at patient level will start when the experimental teams are trained. Assessments will take place upon admission and after 3 months, or earlier if the patient is discharged. The primary outcome is suicide ideation. Secondary outcomes are non-fatal suicide attempts, level of treatment satisfaction, and societal costs. Both a cost-effectiveness and cost-utility analysis will be performed. The effects of the intervention will be examined in multilevel models.
  
  
  CONCLUSIONS
  The strengths of this study are the size of the study, RCT design, training of complete multidisciplinary teams, and the willingness of both management and staff to participate.
  
  
  BACKGROUND
  Netherlands trial register: NTR3092.
authors.affiliation: Department of Clinical Psychology, VU University, Amsterdam, The Netherlands. dp.de.beurs@vu.nl.
authors.forename: Derek P
authors.initials: DP
authors.lastname: de Beurs
authors.forename: Marieke H
authors.initials: MH
authors.lastname: de Groot
authors.forename: Judith E
authors.initials: JE
authors.lastname: Bosmans
authors.forename: Jos
authors.initials: J
authors.lastname: de Keijser
authors.forename: Jan
authors.initials: J
authors.lastname: Mokkenstorm
authors.forename: Bas
authors.initials: B
authors.lastname: Verwey
authors.forename: Erik
authors.initials: E
authors.lastname: van Duijn
authors.forename: Remco F P
authors.initials: RF
authors.lastname: de Winter
authors.forename: Ad J F M
authors.initials: AJ
authors.lastname: Kerkhof
mesh_terms: D001291:Attitude of Health Personnel; D003194:Computer-Assisted Instruction; D003362:Cost-Benefit Analysis; D004496:Education, Continuing; D019983:Guideline Adherence; D017048:Health Care Costs; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000191:economics / Q000193:education* / Q000523:psychology / Q000592:standards*; D006801:Humans; D007318:Inservice Training / Q000191:economics / Q000592:standards*; D008605:Mental Health Services / Q000191:economics / Q000592:standards*; D009426:Netherlands; D010348:Patient Care Team / Q000191:economics / Q000592:standards*; D017410:Practice Guidelines as Topic; D011569:Psychiatric Status Rating Scales; D012107:Research Design; D059020:Suicidal Ideation; D013405:Suicide / Q000191:economics / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D000092864:Suicide Prevention