A mass media campaign intended to help prevent suicides in California is reaching a majority of the state's adults and appears to be increasing their confidence about how to intervene with those at risk of suicide, according to new RAND Corporation research.

In addition, an assessment of a companion suicide prevention program finds that for each year the program is operated, the long-term impact could be the prevention of at least 140 deaths and 3,600 suicide attempts over the next three decades.

The analysis also estimates that for every $1 the state invests in the suicide prevention program, the people of California will receive an estimated $1,100 in economic benefits such as reduced spending on emergency care and increased earnings. Economic benefits to the state government alone are estimated to be $50 for every $1 invested in the effort.

"California's pioneering suicide prevention effort is showing early signs of making progress," said Rajeev Ramchand, co-author of two new studies about the suicide prevention programs and a behavioral scientist at RAND, a nonprofit research group. "We found evidence that the mass media campaign is making California adults more confident in their ability to intervene with someone who is at risk for suicide."

The RAND reports assess two suicide prevention strategies being pursued by the California Mental Health Services Administration (CalMHSA) as a part of statewide mental illness prevention and early intervention activities undertaken as a result of Proposition 63. The initiative, approved in 2004, imposed a tax on high-income California residents to expand mental health services.

"CalMHSA is meeting the voter mandate to save lives and dollars through Proposition. 63, according to this rigorous analysis from RAND," said Wayne Clark, executive director of CalMHSA. "CalMHSA is proud to work on behalf of counties to deliver these truly transformational services."

The statewide mass media campaign uses advertising on television, online and elsewhere to encourage the public to "Know the Signs" about suicide and directs individuals to visit an educational website to learn more.

Analyzing a survey of a representative sample of 2,568 California adults, researchers estimate that more than half of California adults have been exposed to the Know the Signs campaign.

Using the survey results, researchers estimate that those people who have been newly exposed to the mass media campaign report being more confident about knowing how to intervene with someone who is at risk for suicide.

The second RAND study estimates the benefits of a series of trainings sponsored by CalMHSA for community leaders from 2011 to 2013.

The intensive Applied Suicide Intervention Skills Trainings (ASIST) provided clergy, first responders, teachers and other gatekeepers with information about how to recognize suicide risk factors, how to intervene to improve immediate safety and how to link at-risk individuals to appropriate resources.

RAND researchers used earlier research about the benefits of ASIST and similar programs to estimate the impact of the California training on suicides and related costs.

"We demonstrate how investments in preventing suicide can actually benefit the state's economy," said, J. Scott Ashwood, lead author of the ASIST evaluation.

The public education and early intervention efforts supported by CalMHSA are intended to reduce stigma and discrimination surrounding mental illness, prevent suicides, and improve the mental health of students in K-12 schools and colleges across the state. These statewide interventions are being evaluated by RAND.

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The two new studies were sponsored by CalMHSA and conducted independently by RAND. The reports, "Adults Newly Exposed to 'Know the Signs' Report Greater Gains in Their Confidence to Intervene with Those Who Might Be At Risk for Suicide" and "Analysis of the Benefits and Costs of CalMHSA's Investment in Applied Suicide Intervention Skills Training (ASIST)," can be found at http://www. rand. org . Other RAND reports about the California mental health prevention and early intervention program are available at http://www. rand. org/ health/ projects/ calmhsa. html .

Other authors of the reports are, Brian Briscombe, Elizabeth May, M. Audrey Burnam, Elizabeth Roth, Joie D. Acosta and Nicole K. Eberhart.

RAND Health is the nation's largest independent health policy research program, with a broad research portfolio that focuses on health care costs, quality and public health preparedness, among other topics.