APNA Position Statement on Competency-Based Training for PMH Nurse Generalists: Inpatient Intervention and Prevention of Suicide

(The full version of this scholarly paper, as published in the July/August 2013 issue of the Journal of the American Psychiatric Nurses Association, is available here.)


Suicide is the tenth leading cause of death in the United States. Approximately 90,000 psychiatric mental health (PMH) nurse generalists work in hospitals in the United States, mostly on inpatient psychiatric units where the most acutely suicidal patients are hospitalized. Although competencies have been developed for mental health clinicians in assessing and managing suicide risk, there are no standard competencies for PMH nurse generalists. Widely accepted nursing practices do not meet suicide-specific standards of care or evidence-based criteria. Although both the Commission on Collegiate Nursing Education Essentials for Baccalaureate Education and the Quality and Safety Education for Nurses competencies stress the necessity for comprehensive assessment, safe clinical practices, patient-centered care, evidence-based interventions, and interprofessional communication and collaboration, there are no specific requirements for suicide prevention training in educational and clinical programs. The American Psychiatric Nurses Association has an opportunity to provide leadership in developing, implementing, and evaluating competency-based training for nurses and partner with the national effort to increase the competencies in suicide prevention in the behavioral health workforce.


APNA believes that ultimately the individual nurse is responsible to practice competently, based on research and evidence and within his/her scope, to assist persons with mental illness in his/her process of recovery. This is supported by the Institute of Medicine’s (2010) report on the future of nursing, which states that nurses should practice to the full extent of their education and training. Reduction of suicidality is a critical dimension of recovery and essential for quality of life. Thus, APNA supports a sustained commitment for the development of guidelines/competencies/standards of care for PMH nurse generalists who care for persons at risk for suicide. Moreover, we recognize the need to collaborate with other mental health professionals, consumers/clients, families, advocacy groups, and regulatory bodies to ensure that PMH nurse generalists are competent to assess and manage the care of people at risk for suicide.

Therefore, APNA

  • Acknowledges that there are serious gaps in nursing education specifically in the area of suicide risk assessment, prevention, and intervention.

  • Recognizes that despite the development of suicide prevention therapeutic frameworks, core competencies, guidelines, and standards of care for psychiatrists, psychologists, social workers, and advanced practice nurses, none have been developed specifically for inpatient PMH nurse generalists.

  • Identifies that although generalist nurses represent the largest professional workforce in inpatient psychiatric units with 24-hour accountability for the care and safety of the most vulnerable persons with mental illness, they have limited training in the assessment and management of persons at risk for suicide.

  • Recognizes that there are no developed structures and processes for the education and training of generalist nurses who provide care and treatment to people at risk for suicide in psychiatric settings.

Therefore, APNA Board of Directors will convene a task force to address these issues for psychiatric mental health nursing.

View the Full Scholarly Paper


Approved by the APNA Board of Directors on May 14, 2013.

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