Training in the assessment and management of suicide risk can be delivered to approximately half the targeted staff in primary care, accident and emergency departments and mental health services. The current training package can improve skills and is well accepted. If it were to produce a modest fall in the suicide rate, such training would be cost-effective. However, a future training programme should develop a broader training package to reach those who will not attend.

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There is a shortage of health staff available in primary care who can assess and manage anxiety disorders using effective evidence-based psychological methods. Previous training packages have largely failed to evaluate skill acquisition. We devised a brief training package for practice nurses to learn how to treat anxiety disorders. Fourteen practice nurses acted as their own controls in a before and one month after training design to determine retention of assessment and management skills. Both were rated 'blind' in videotaped role-played interviews with an actor. With training, there were significant improvements in specific history-taking, explaining anxiety disorders, all aspects of anxiety management (breathing exercise, distraction, exposure), follow-up of patients and overall performance. Overall, 11 practice nurses (79%) were judged to be clinically effective after training compared to none before. After training, all nurses reported that they had used the training package in clinical practice. The findings are discussed in the light of the published literature, and possible future directions for research are suggested.