How Effective are Gatekeepers in Preventing Suicide?

Suicide is a significant public health problem worldwide that requires evidence-based prevention efforts. One approach to prevention is gatekeeper training. Gatekeeper training programs for community members have demonstrated positive changes in knowledge and attitudes about suicide. Changes in gatekeeper skills have not been well established. A paper published in a recent issue of Crisis: The Journal of Crisis Intervention and Suicide Prevention  examine the impact of a brief gatekeeper training program on community members’ observed skills. For the study, fifty participants were randomly selected for skills assessment and videotaped interacting with a standardized actor prior to and following training. Tapes were reliably rated for general and suicide-specific skills. The results showed that gatekeeper skills increased from pre- to post-test: 10% of participants met criteria for acceptable gatekeeper skills before training, while 54% met criteria after training. Pretraining variables did not predict increased skills. Despite this finding, result do not provide firm conclusions about the relationship between observed gatekeeper skills and actual use of those skills in the future. The researchers conclude that gatekeeper training enhances suicide-specific skills for the majority of participants. Other strategies, such as behavioral rehearsal, may be necessary to enhance skills in the remaining participants

For the abstract.

Comments

[Solutions Therapy]

I was surprised to see that gatekeeper skills improved from 10% to 54% post training. I think it is important that we remove the fear of talking about suicidal thoughts and feelings openly. However, it concerns me that rarely is the effect of the client's determination to commit suicide referenced. If a client has seriously made up their mind to commit suicide no amount of gatekeeping will ultimately prevent them from doing so. I think it is important to warn gatekeepers of the potential of clients to commit suicide despite intervention.

I'd love to hear any feedback you might have regarding my post on this at:

http://www.kellevision.com/kellevision/2010/09/the-fallacies-of-suicide-prevention.html

P.S. I'd never heard of EarthWatch and have been looking for something like that. Thanks!

[Romeo Vitelli]

Thanks for commenting. Gatekeepers need to recognize that they are on the front lines as far as preventing suicide is concerned. All too frequently, there are no other resources available to the suicidal patient. The very fact that the suicidal patient is talking about suicidal thoughts at all suggests that a window of opportunity exists for intervention. The truly determined suicides simply go ahead and kill themselves without any warning signs at all.