Skip to main content
Research Trends

Randomized Controlled Trial of an Online Suicide Prevention Gatekeeper Training Program

Impacts on College Student Knowledge, Gatekeeper Skills, and Suicide Stigma

Published Online:https://doi.org/10.1027/0227-5910/a000917

Abstract:Background: Suicide prevention gatekeeper training programs offer a unique opportunity to increase knowledge about suicide prevention, enhance risk identification, and reduce suicide-related stigma. Aims: This study evaluated the efficacy of an online suicide prevention gatekeeper training program in a randomized trial. Method: Participants were US college students (N = 388). Participants (69.3% women) had a mean age of 19.01 years and identified primarily as Hispanic/Latinx (52.1%) and non-Hispanic White (22.4%). Participants completed pre- and posttest surveys and were randomly assigned to either the ASK About Suicide to Save a Life (AS + K?) suicide prevention gatekeeper training program or an information-only comparison intervention. Results: Participants in the AS + K? condition reported significantly greater gatekeeper preparedness and self-efficacy, and lower stigmatized attitudes at posttraining, as compared with those in the comparison condition. There were no significant differences in likelihood of using gatekeeper skills or suicide-related knowledge across groups. Limitations: This short-term study was not able to assess behavioral change resulting in use of gatekeeper skills over time. Conclusions: Completion of gatekeeper training resulted in increases in preparedness and self-efficacy for engaging in gatekeeper behaviors, as well as a reduction in suicide-related stigma. Despite small intervention effects, the online AS + K? training appears to be a promising program.

References

  • Adams, L. M., Nguyen, T., Karen, B. M., & Gumbleton, C. (2018). RU OK: Evaluating the effectiveness of a gatekeeper training program. Journal of College Student Development, 59(5), 614–617. 10.1353/csd.2018.0056 First citation in articleCrossrefGoogle Scholar

  • Albright, G. L., Davidson, J., Goldman, R., Shockley, K. M., & Timmons-Mitchell, J. (2016). Development and validation of the Gatekeeper Behavior scale: A tool to assess gatekeeper training for suicide prevention. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 37(4), 271–280. 10.1027/0227-5910/a000382 First citation in articleLinkGoogle Scholar

  • Burnette, C., Ramchand, R., & Ayer, L. (2015). Gatekeeper training for suicide prevention: A theoretical model and review of the empirical literature. Rand Health Quarterly, 5(1), 1–16. First citation in articleGoogle Scholar

  • Calear, A. L., Batterham, P. J., Trias, A., & Christensen, H. (2021). The literacy of suicide scale. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 43(5), 385–390. 10.1027/0227-5910/a000798 First citation in articleLinkGoogle Scholar

  • Cramer, R. J., Judah, M. R., Badger, N. L., Holley, A. M., Judd, S., Peterson, M., Hager, N., Vandecar-Burdin, T., & Foss, J. J. (2022). Suicide on college campuses: A public health framework and case illustration. Journal of American College Health, 70(1), 1–8. 10.1080/07448481.2020.1739053 First citation in articleCrossref MedlineGoogle Scholar

  • Cross, W. F., Seaburn, D., Gibbs, D., Schmeelk-Cone, K., White, A. M., & Caine, E. D. (2011). Does practice make perfect? A randomized control trial of behavioral rehearsal on suicide prevention gatekeeper skills. The Journal of Primary Prevention, 32(3-4), 195–211. 10.1007/s10935-011-0250-z First citation in articleCrossref MedlineGoogle Scholar

  • Duffy, M. E., Twenge, J. M., & Joiner, T. E. (2019). Trends in mood and anxiety symptoms and suicide-related outcomes among U.S. undergraduates, 2007–2018: Evidence from two national surveys. Journal of Adolescent Health, 65(5), 590–598. 10.1016/j.jadohealth.2019.04.033 First citation in articleCrossref MedlineGoogle Scholar

  • Herron, J., Ticehurst, H., Appleby, L., Perry, A., & Cordingley, L. (2001). Attitudes toward suicide prevention in front-line health staff. Suicide and Life-Threatening Behavior, 31(3), 342–347. 10.1521/suli.31.3.342.24252 First citation in articleCrossref MedlineGoogle Scholar

  • Ho, P. K. H., Ko, T. T., & Xin, M. Q. (2018). School-based gatekeeper training programmes in enhancing gatekeepers’ cognitions and behaviours for adolescent suicide prevention: A systematic review. Child and Adolescent Psychiatry and Mental Health, 12(29), Article 29. 10.1186/s13034-018-0233-4 First citation in articleCrossrefGoogle Scholar

  • Indelicato, N. A., Mirsu-Paun, A., & Griffin, W. D. (2011). Outcomes of a suicide prevention gatekeeper training on a university campus. Journal of College Student Development, 52(3), 350–361. 10.1353/csd.2011.0036 First citation in articleCrossrefGoogle Scholar

  • Kuhlman, S. T. W., Smith, P. N., Marie, L., Fadoir, N. A., & Hudson, K. (2021). A pilot randomized controlled trial of the Alliance Project gatekeeper training for suicide prevention. Archives of Suicide Research, 25(4), 845–861. 10.1080/13811118.2020.1767246 First citation in articleCrossref MedlineGoogle Scholar

  • Lipson, S. K., Speer, N., Brunwasser, S., Hahn, E., & Eisenberg, D. (2014). Gatekeeper training and access to mental health care at universities and colleges. Journal of Adolescent Health, 55(5), 612–619. 10.1016/j.jadohealth.2014.05.009 First citation in articleCrossref MedlineGoogle Scholar

  • Morton, M., Wang, S., Tse, K., Chung, C., Bergmans, Y., Ceniti, A., Flam, S., Johannes, R., Schade, K., Terah, F., & Rizvi, S. (2021). Gatekeeper training for friends and family of individuals at risk of suicide: A systematic review. Journal of Community Psychology, 49(6), 1838–1871. 10.1002/jcop.22624 First citation in articleCrossref MedlineGoogle Scholar

  • Quinnett, P. (2007). QPR gatekeeper training for suicide prevention: The model, rationale, and theory. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.528.7944&rep=rep1&type=pdf First citation in articleGoogle Scholar

  • Rausch, J. R., Maxwell, S. E., & Kelley, K. (2003). Analytic methods for questions pertaining to a randomized pretest, posttest, follow-up design. Journal of Clinical Child and Adolescent Psychology, 32(3), 467–486. 10.1207/S15374424JCCP3203_15 First citation in articleCrossref MedlineGoogle Scholar

  • Rein, B. A., McNeil, D. W., Hayes, A. R., Hawkins, T. A., Ng, H. M., & Yura, C. A. (2018). Evaluation of an avatar-based training program to promote suicide prevention awareness in a college setting. Journal of American College Health, 66(5), 401–411. 10.1080/07448481.2018.1432626 First citation in articleCrossref MedlineGoogle Scholar

  • Sareen, J., Isaak, C., Bolton, S.-L., Enns, M. W., Elias, B., Deane, F., Munro, G., Stein, M. B., Chateau, D., Gould, M., & Katz, L. Y. (2013). Gatekeeper training for suicide prevention in first nations community members: A randomized controlled trial. Depression and Anxiety, 30(10), 1021–1029. 10.1002/da.22141 First citation in articleCrossref MedlineGoogle Scholar

  • Teo, A. R., Andrea, S. B., Sakakibara, R., Motohara, S., Matthieu, M. M., & Fetters, M. D. (2016). Brief gatekeeper training for suicide prevention in an ethnic minority population: A controlled intervention. BMC Psychiatry, 16(211), 1–9. 10.1186/s12888-016-0924-4 First citation in articleCrossref MedlineGoogle Scholar

  • Texas Suicide Prevention Collaborative (2022). AS+K? Basic gatekeeper training. https://texassuicideprevention.org/training/ask-basic-gatekeeper/ First citation in articleGoogle Scholar

  • Torok, M., Calear, A. L., Smart, A., Nicolopoulos, A., & Wong, Q. (2019). Preventing adolescent suicide: A systematic review of the effectiveness and change mechanisms of suicide prevention gatekeeper training programs for teachers and parents. Journal of Adolescence, 73(1), 100–112. 10.1016/j.adolescence.2019.04.005 First citation in articleCrossref MedlineGoogle Scholar

  • Wexler, L., White, J., & Trainor, B. (2015). Why an alternative to suicide prevention gatekeeper training is needed for rural Indigenous communities: Presenting an empowering community storytelling approach. Critical Public Health, 25(2), 205–217. 10.1080/09581596.2014.904039 First citation in articleCrossrefGoogle Scholar

  • Williams, L. B., & Reetz, D. R. (2020, July 31). How to prepare for the coming flood of student mental-health needs. The Chronicle of Higher Education. https://www.chronicle.com/article/how-to-prepare-for-the-coming-flood-of-student-mental-health-needs First citation in articleGoogle Scholar

  • Yonemoto, N., Kawashima, Y., Endo, K., & Yamada, M. (2019). Gatekeeper training for suicidal behaviors: A systematic review. Journal of Affective Disorder, 246, 506–514. 10.1016/j.jad.2018.12.052 First citation in articleCrossref MedlineGoogle Scholar