Predicting Practitioners' Perceived Competency with Youths at Suicide Risk: Acute versus Chronic
This study of 237 practitioners reveals that while self-efficacy mediates the relationship between workplace support and perceived competence in both acute and chronic youth suicide contexts, the influence of professional experience on competence varies by context, suggesting that training and support strategies should be tailored to the specific nature of the suicide risk.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Every year, suicide remains one of the leading causes of death for young people around the world. In places like Singapore, it is the most common cause of death for those between the ages of ten and twenty-nine. When a young person is in crisis, the first line of defense is often a front-line worker: a social worker, a counselor, or a case manager who meets the youth in schools, hospitals, or community centers. These professionals are tasked with a heavy responsibility: to recognize when a young person is in danger, to assess the severity of that danger, and to intervene effectively. But how confident do these workers feel when they face such high-stakes situations? Do they feel they have the right tools and the right support to do the job?
To understand this, researchers look at two main ideas. The first is self-efficacy, which is simply a person's belief in their own ability to handle a specific task. If a worker believes they can successfully calm a distressed youth or navigate a complex family situation, they are more likely to try harder and stick with the challenge. The second idea is perceived competence, which is how capable a person feels they actually are at performing the professional skills required for the job. While these two concepts are related, they are not the same; one is a feeling of confidence, and the other is a judgment of skill. Previous research has suggested that training, support from supervisors, and years of experience help build these feelings. However, a critical question remained unanswered: does the type of risk a young person faces change how these factors work? Some young people are in immediate, acute danger, requiring rapid action to prevent a suicide attempt in the next few hours. Others face chronic risk, where the danger is a long-term reality involving repeated attempts and ongoing mental health struggles. The demands on a worker in these two scenarios are vastly different, yet most studies have treated all suicide risk as the same.
A team of researchers from SHINE Children and Youth Services and Singapore Management University set out to untangle these differences. They surveyed 237 practitioners across Singapore who had experience intervening with youths at risk of suicide. The group was diverse, including social workers, counselors, and case managers from schools, hospitals, and community organizations. The researchers asked these workers to rate their own feelings about three things: how adequate their training felt, how sufficient the support from their workplace was, and how many years they had spent intervening in these cases. Crucially, the workers answered these questions twice for each scenario: once imagining they were dealing with a youth in acute, immediate crisis, and once imagining they were working with a youth facing chronic, long-term risk. They also rated their own self-efficacy and their perceived competence for both scenarios.
The results revealed a clear picture of how confidence and skill are built, but with a twist depending on the situation. Across both acute and chronic risks, the number of years a worker had spent in the field was a strong predictor of how competent they felt. Experience mattered, and it worked in two ways: it directly boosted their sense of skill, and it also made them feel more confident in their abilities. This suggests that simply being on the job and facing these challenges repeatedly builds a form of practical knowledge that training alone cannot replicate.
Workplace support, such as supervision and peer consultation, played a different role. The study found that support did not directly make workers feel more competent. Instead, it worked by boosting their self-efficacy. When workers felt supported by their colleagues and supervisors, they felt more confident in their ability to handle the situation, and that confidence, in turn, made them feel more competent. This link was true for both types of risk, but it was much stronger for chronic cases. For workers dealing with long-term, complex cases, the support they received from their workplace was a major driver of their sense of capability. In acute situations, while support still helped build confidence, it did not translate into a measurable increase in their overall feeling of competence.
Training showed the starkest difference between the two contexts. For workers facing acute, immediate risks, feeling that their training was adequate was a key factor in building their confidence, which then led to a feeling of competence. Formal instruction seemed to prepare them well for the rapid, high-pressure demands of crisis intervention. However, this chain of events broke down completely for chronic risk. The workers did not feel that their existing training equipped them to handle the long-term, complex needs of youths with chronic suicide risk. The training they received did not seem to boost their confidence or their sense of competence in these ongoing cases.
The study suggests that the current approach to professional development in youth suicide intervention may need to be more nuanced. While training appears effective for preparing workers for sudden crises, it may not be addressing the specific, sustained challenges of chronic risk. Similarly, while workplace support is vital for everyone, it becomes a critical infrastructure for those managing long-term cases, helping them maintain the confidence needed to navigate years of complex care. The researchers noted that their findings are based on the workers' own perceptions and that the cross-sectional nature of the study means they cannot prove cause and effect with absolute certainty. However, the patterns are clear: the path to feeling capable is not a single road. It changes depending on whether the worker is facing a storm that needs to be weathered immediately or a climate that must be navigated over a lifetime.
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