Background: Gatekeeper training remains fundamental to broad suicide prevention strategies. In this descriptive study, Question, Persuade, Refer, an evidence-based suicide prevention gatekeeper training program, was implemented community-wide in a state among the highest for suicide in the United States.Objective: To describe and compare cohort pre-post responses to suicide prevention gatekeeper training. Methods:Quantitative and qualitative data were collected from 2013 to 2016 utilizing pre-post training surveys (n=894). Results:Quantitative results were statistically significant (p<0.0001) with little between-cohort variance. Significant differences in pre-post ratings concerned 'how to ask about suicide', 'how to persuade someone to receive help' and 'information about resources'. Post-survey qualitative results revealed a main theme of 'appreciating learning about suicide prevention'. Conclusion:Findings from the ethnically homogenous sample are consistent with other research outcomes, adding to understandings from the few other published community-wide gatekeeper studies. Of note is that gatekeeper training is feasible, beneficial and cost-effective aligning with international and national initiatives. Future research is needed on the sustainability of gatekeeper training outcomes over time and its' impact on suicide rates.
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