Best Practices Registry (BPR) For Suicide Prevention

Section I of the BPR lists evidence-based programs: interventions that have undergone rigorous evaluation and demonstrated positive outcomes, as opposed to Section III programs, whose content is reviewed. It is accurate to say these programs are effective, although their effectiveness may not hold true for all audiences or settings (see “NREPP Description” and “Guidance for NREPP Users” below for more details).

Section I of the BPR combines programs from two sources:

• National Registry of Evidence-Based Programs and Practices (NREPP)
  NREPP is SAMHSA's online registry of interventions that have demonstrated effectiveness in the prevention or treatment of mental health and substance use disorders, including some interventions that address suicide. While NREPP operates independently of the BPR, all suicide-related interventions listed by NREPP are also included in Section I of the BPR.

• SPRC/AFSP Evidence-Based Practices Project (EBPP)
  The EBPP was a previous effort to identify evidence-based suicide prevention practices that stopped conducting reviews in 2005, when NREPP began reviewing suicide-related interventions. Based on expert review, the EBPP identified 12 programs as evidence-based and classified them as either effective or promising. These 12 programs continue to be included in Section I of the BPR (most are now also NREPP-listed.) For more information about the EBPP, see the EBPP Project Description (PDF) and a List of Programs Identified by the EBPP (PDF).

Because NREPP is the primary source for BPR Section I programs, the remainder of this page focuses on NREPP.

NREPP Description

NREPP is a searchable online registry to assist practitioners in learning about mental health and substance abuse interventions that have been scientifically tested and can be readily disseminated to the field. It includes preventive interventions and psychosocial treatments that have been reviewed and rated by independent reviewers. NREPP is funded and managed by the Substance and Mental Health Services Administration (SAMHSA).

While the NREPP review and dissemination process operates independently of the BPR, all suicide-related interventions listed by NREPP also are included in Section I of the BPR.

Important Note: NREPP is an information source designed to increase the field’s access to research findings, rather than a list of interventions that meet a certain standard of research quality. NREPP recommends that users carefully review each intervention’s ratings to understand the research results for each outcome. See “Guidance for NREPP Users” below for more suggestions on using NREPP effectively.

NREPP Eligibility and Review Criteria

This section provides a brief overview of SAMHSA's eligibility and review criteria for NREPP interventions. Detailed information can be found at the NREPP web site.

Eligibility Criteria: To be eligible for NREPP review, an intervention must

1. demonstrate one or more positive outcomes (p≤.05) in mental health and/or substance use behavior obtained using an experimental or quasi-experimental study design;
2. have results published in a peer-reviewed article or comprehensive evaluation report; and
3. have documentation describing the program and its proper implementation.

Note that SAMHSA may include additional criteria for a specific submission period.

Review Criteria: Interventions are scored in two general areas:

1. Quality of Research ratings summarize the strength of the evidence supporting the reported results or outcomes of the intervention. Each outcome is scored separately since interventions may target multiple outcomes (e.g., hopelessness, alcohol use, behavior problems in school). Quality of Research is rated on six criteria: reliability, validity, intervention fidelity, missing data and attrition, potential confounding variables, and appropriateness of analysis.
2. Readiness for Dissemination ratings summarize the amount and quality of the resources available to support the use of the intervention. The Readiness for Dissemination of the overall program is rated on three criteria: availability of implementation materials, training and support resources, and quality assurance procedures.

Intervention Summary: NREPP provides a detailed summary for each listed intervention including descriptive information; Quality of Research ratings for each outcome; Readiness for Dissemination ratings for the overall program; strengths and weaknesses; target populations included in the studies; a list of studies and materials that were reviewed; and contact information.

Guidance for NREPP Users

The NREPP web site includes important guidance designed to help users understand and use its listings appropriately. In particular, the site emphasizes the following key points:

• As noted above, NREPP is an information source for accessing research findings, not a list of interventions that meet specific research quality standards. The current NREPP system no longer categorizes interventions into categories such as Model, Effective, or Promising based on the strength of their evidence. Users of NREPP must use the Quality of Research findings to guide their own judgments of an intervention’s effectiveness. See the March 14, 2006 Federal Register for information about changes to NREPP that were implemented in 2007.
• Being listed on NREPP does not mean that an intervention is equally effective for every outcome and for all populations and settings. NREPP ratings summarize information about the quality of the research so potential users can understand each intervention’s scientific evidence base. The section on using NREPP recommends that users carefully read each intervention’s Key Findings for each outcome. The summary also lists the target populations that participated in the research studies.
• NREPP users are encouraged to consider which interventions match their needs and to engage in direct conversations with program developers before selecting an intervention. NREPP provides a list of potential questions to ask developers (PDF) to facilitate these conversations. NREPP also offers an online course to guide users through the process of selecting and implementing evidence-based programs. Also see Advice on Using the BPR for information about using NREPP listings as part of a systematic planning process.
• NREPP is not a complete list of evidence-based interventions. Because it is a voluntary, self-nominating system, some developers do not submit their programs to NREPP. Also, not all submitted programs are accepted for review.

To Apply to Section I

To be listed as an evidence-based program in Section I of the BPR, program developers must apply directly to NREPP following its submission and review processes. Submissions must be made during an open submission period, which typically begins in October and last 3 or 4 months. Open submission periods are announced on the NREPP site and in the Federal Register. Please see How to Apply to Section I for more information about applying to NREPP.

SPRC/AFSP Technical Assistance for NREPP Submissions

Although NREPP is operated independently by SAMHSA, SPRC/AFSP staff members are available to provide technical assistance for program developers wishing to submit their suicide prevention programs for NREPP review. Program developers are encouraged to contact Philip Rodgers for assistance.

Section I Listings: Evidence-Based Programs

The list below includes suicide-related interventions currently listed on NREPP and those previously identified by the EBPP. (Several programs are listed on both registries.) NREPP-listed programs are linked to the program description on the NREPP website. EBPP program information is provided in a program fact sheet (PDF format).