Is Gatekeeper Training Enough for Suicide Prevention?
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ORIGINAL PAPER
Is Gatekeeper Training Enough for Suicide Prevention? Natasha Robinson‑Link1,2 · Sharon Hoover1 · Larraine Bernstein1 · Nancy Lever1 · Kenneth Maton2 · Holly Wilcox3
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract While schools have the capacity to reach youth at-risk for suicide, there remains a gap between the number of youth with mental health issues and those who receive services. Accordingly, gatekeeper training programs, which teach community members signs of psychological distress and strategies to refer youth to mental health support, are often one component of suicide prevention. Nevertheless, there is a dearth of research about the efficacy of online gatekeeper training, which may provide the flexibility and accessibility needed for overburdened schools. This study sought to investigate whether Kognito, an online and easily accessible gatekeeper training, was related to changes in teachers’ suicide prevention beliefs, behavioral intentions, and behaviors (proportion of students approached and referred over time). Teachers significantly increased their beliefs (i.e., preparedness and self-efficacy) and behavioral intention (i.e., likelihood) to intervene with at-risk students. However, teachers did not change suicide intervention behaviors. Natural gatekeeper status (i.e., teachers approaching students at baseline) impacted number of referrals over time (in the opposite direction we predicted); however, natural gatekeeper status did not have an impact on proportion of students approached. Self-efficacy change, however, preceded change in proportion of students approached, but not referred. The findings, taken as a whole, indicate gatekeeper training alone appears insufficient to change suicide prevention behaviors, and accordingly, suicide prevention needs to employ a comprehensive approach. Keywords Gatekeeper training · Suicide prevention · Teachers · Schools Addressing youth suicide in the USA is a public health imperative: suicide is the second leading cause of death * Kenneth Maton [email protected] Natasha Robinson‑Link [email protected] Sharon Hoover [email protected] Larraine Bernstein [email protected] Nancy Lever [email protected] Holly Wilcox [email protected] 1
University of Maryland Baltimore, School of Medicine, 737 W. Lombard St., Baltimore, MD 21201, USA
2
Department of Psychology, University of Maryland Baltimore County, 1000 Hilltop Circle, Catonsville, MD 21250, USA
3
Johns Hopkins University, School of Medicine, 624 N. Broadway, Baltimore, MD 21205, USA
among young adults 10–34 years old (Centers for Disease Control [CDC], 2016). Further, 17.2% of high school students seriously considered attempting suicide and 7.4% attempted suicide (CDC, 2017). Accordingly, prevention of youth suicide through the mitigation of risk factors, enhancement of emotional and behavioral regulation skills, early identification of at-risk youth, dissemination and development of evidence-based approaches, and development of new
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