Description

Applied Suicide Intervention Skills Training (ASIST) is a 

two-day workshop with a standardized curriculum designed to 

develop “suicide first aid” skills. It teaches participants to 

recognize when someone may have thoughts of suicide, to 

discuss suicide in a direct manner with that person, and how to 

intervene and work with the person to create a plan that

supports their immediate safety. The training is based on a 

person-centered prevention model: Rather than guiding 

people-at-risk through a predetermined pathway to safety, the

model supports the person in developing their own safety plan

using personal and community resources. The training courses 

are available to anyone over the age of 16 concerned with the 

immediate safety of people at risk of suicide; no prior 

experience or education is required. ASIST can also provide 

those in formal helping roles with professional development: 

Continuing Education Units (CEU) are available to workshop 

participants. ASIST has been designated as a “program with 

evidence of effectiveness” by the Suicide Prevention Resource 

Center and adopted by the U.S. Army Suicide Prevention 

Program as the approved intervention training. The 

intervention was also tested in K-12 schools and listed as a 

recommended program in SAMHSA’s toolkit for preventing 

suicide in high schools. 

Is It a Good Fit for My Agency? 

The ASIST model is suitable for any community-based 

caregiving organization wishing to train staff members in 

suicide prevention. Anyone over the age of 16 can be trained 

on the model; no particular educational background or prior 

experience is required. Some community organizations opt to 

provide a few staff members with the ASIST Training for

Trainers, which qualifies them to become registered ASIST 

trainers and to provide consultation and training to local 

agencies, corporations, and community members. Currently, 

there are over 6,000 registered ASIST trainers worldwide.

Cultural Adaptability The training teaches skills in understanding the client’s 

personal and cultural background and the community 

resources available to them so that an individually tailored 

safety plan can be developed. In that sense, the training 

prepares the practitioner to adapt the intervention to multiple 

cultural contexts. The curriculum is available in English, 

French, Spanish, Inuktitut, and Norwegian. Training materials 

are also available in large print and Braille formats. 

How Does It Work?

The ASIST model involves an assessment of suicide risk and 

the development of a “safeplan,” based on present and future 

risk, available resources, and the needs of the person at risk. In 

addition to referrals to formal mental health services, the

safeplan could include connection to and support from friends, 

family members, and other sources in the community. 

ASIST has five components through which trainees gradually 

build an understanding of suicide risk and suicide intervention: 

1) understand attitudes about suicide 

2) provide guidance and suicide first aid to a person at risk

3) identify the key elements of an effective suicide safety 

plan and the actions required to implement it

4) appreciate the value of improving community suicide 

prevention resources

5) recognize important aspects of suicide prevention, 

including life-promotion and self-care

ASIST Training for Trainers is a five-day program. The first 

two days cover the above five components. The remaining 

time is spent learning the trainer role and participating in 

practice sessions. 

Program Materials

The 2-day workshop is interactive and includes audiovisual 

aids, discussions in large and small groups, and skills practice 

and development. Training cannot be offered via webinar. 

How to Learn More

LivingWorks is the central source of information on the 

ASIST program where one may learn more about the program, 

workshops, and training processes; locate upcoming ASIST 

and Training for Trainers (T4T) workshops; order resources; 

and read FAQs, news, and stories.

 ASIST: 

Applied Suicide Intervention Skills Training

September 2021
Training Costs

Tuition for ASIST’s two-day intensive training varies from 

one location to another. A review of currently available 

trainings across the United States revealed a range between 

$175 and $350 per attendee. For an agency planning to train a 

large number of staff members or to offer ASIST to 

community members over an extended period, the ASIST 

Training for Trainers could be a feasible investment. The 

tuition for this 5-day training is approximately $3,000 plus tax 

in certain states; trainees become registered ASIST trainers. 

After completing the training, trainers are required to deliver 

at least three trainings during their first year and at least one 

training annually in subsequent years for their certification to 

remain active. LivingWorks estimates that a registered trainer 

conducts approximately 10 trainings per year with an average 

of 24 participants per training. 

Potential Funding Sources

The two-day trainings provide Continuing Education Units, 

and tuition costs are typically within the staff development 

budgets of most community-based organizations. To invest in 

a Training for Trainers course for staff to become a provider 

of ASIST training in the community, organizations could seek 

grant funding themselves or partner with another organization 

that has a grant. A common source of financial support for 

suicide prevention efforts is the Zero Suicide Grant from 

SAMHSA. State agencies or health systems supported by this 

grant program frequently partner with local caregiving 

organizations to implement evidence-based training and 

prevention activities in their communities. 

Implementation Examples

Centennial Mental Health Center, a community-based 

organization partnering with local healthcare resources to 

provide integrated healthcare to rural communities in 

northeastern Colorado, participated in a 10-community suicide 

prevention initiative funded by The Colorado Trust. As part of 

their participation, they set a goal to train their entire staff in 

ASIST.

Behavioral Health Response, a nonprofit community-based 

mental health organization partnering with other local 

caregiving organizations in St. Louis, Missouri, has registered 

ASIST trainers on staff who have completed the ASIST 

Training for Trainers. Two of their staff members recently 

trained the city’s 911 Diversion team members in ASIST to 

better prepare them to provide emergency first aid to 

individuals at risk of suicidal behavior. 

Benefits of ASIST 

 A randomized control trial that monitored 1,507 calls to 

the National Suicide Prevention Lifeline found that callers

who spoke with ASIST-trained counselors were 31% 

more likely to have reduced level of depression and 74% 

more likely to have reduced suicide risk, compared to 

callers who spoke with a counselor not trained in ASIST. 

 A cost-benefit analysis of California Mental Health 

Services Authority’s investment in ASIST estimated that 

the state’s investment in this initiative averted 3,600 

suicide attempts and 40 deaths per year, saving $1,100 in 

total costs per dollar invested in training. Financial gains 

to the state government alone were estimated to be $50 

per dollar invested in ASIST. 

 Trillium Health Centre in Mississauga, Ontario is a 

facility that consists of a 660-bed general hospital, an 

ambulatory care center, and a range of outpatient and 

community health services. The facility provided ASIST 

for all clinical and administrative staff and psychiatrists in 

its mental health programs. Program evaluation results 

indicate that in the first year of the program, there was a 

14.5% reduction in average length of hospital stay among

patients admitted with suicidal ideation. After four years 

of implementation, identification of suicide risk among 

mental health clients increased from 14% to 21%, and 

hospital admissions among suicidal patients presenting in 

the emergency department decreased from 56% to 42%. 

Implementing and Financing ASIST