Document Type


Publication Date


Date of Final Presentation

Spring 3-13-2019

Committee Chair

Pamela Gehrke EdD, RN

Committee Member

Pamela Strohfus DNP, RN, CNE

Coordinator/ Chair of DNP Program

Pamela Gehrke EdD, RN

Abstract/ Executive Summary

Problem Description

Healthcare workers’ (HCWs) negative stigmas, poor attitudes, and lack of knowledge impact the care delivered to patients with a mental illness or who may be suffering with suicidal thoughts.


Raising HCWs’ awareness, knowledge and skills have been linked to improving the negative stigmas, biases, and attitudes that impede the care required to achieve optimal health outcomes.


Participants attended a 90-minute Question, Persuade, Refer (QPR) gatekeeper training, each participant received six bi-weekly emails about mental health issues, suicide prevention, and community resources. A pre/post survey design using the Mental Illness Clinicians’ Attitude Scale (MICA-4) and the Mental Health Knowledge Schedule (MAKS) was used to measure changes in stigmas, attitudes, and knowledge.


The initial survey was completed by 99 HCWs and post by 72 (73%), QPR was completed by 73 (74%) participants. Groups were established based on the number of emails answered and QPR attendance. The mean percentage and the mean absolute change were calculated for each group, and a two-tailed t-test compared differences between groups. The group who attended QPR and answered 5 or more emails compared to the group who did not attend QPR and answered p value of p=0.01. Pre/post-QPR surveys demonstrated 100% (n=73) self-reported their knowledge level about suicide prevention as either low, medium, or high improved after training and no low reports were given in the post survey. Each participant self-reported their knowledge in 1) how to ask someone about suicide, 2) how to persuade them to get help, and 3) how to refer someone to local resources for immediate assistance.


The project demonstrated a self-reported positive impact on HCWs’ knowledge, skills, and attitudes about mental illness and suicide prevention. QPR training and bi-weekly educational emails should be considered as an option when addressing suicide and mental illness. This work sets the foundation for future developments and larger scale implementation for healthcare organizations. The impact of raising HCWs’ awareness, knowledge, and skills related to mental illness and suicide prevention may increase the early identification and referrals of patients, friends, family members, and community members, leading to better outcomes for all.