We found that a brief online role-play simulation was an effective strategy for improving teacher attitudes and behaviors needed to perform a positive mental health gatekeeper role in schools.
The purpose of this study is to examine the impact of an online virtual human role-play simulation in teaching high school educators and staff to identify, talk to, and if necessary, refer students in psychological distress to support services. High school educators (N = 31,144) from 43 US states and 5 American territories completed a baseline survey and then randomly assigned to a wait-list control or treatment group. Participants in the treatment group completed the training simulation which included active learning strategies to teach evidenced-based communication strategies such as motivational interviewing to build skills and shift attitudes. Immediately after the training, treatment group participants completed a post-survey and then a 3-month follow-up survey. Baseline and post-surveys included the validated gatekeeper behavior scale measures which assess attitudinal constructs that predict helping behaviors. Self-reported helping behaviors were collected at baseline from both groups and at the 3-month follow-up for the treatment group. The treatment group participants’ post and follow-up data were compared to the control group’s baseline measures. The treatment group post-training scores were significantly higher (p < .001) than the control group’s baseline scores for all gatekeeper behavior scale attitudinal constructs of preparedness, likelihood, and self-efficacy to engage in helping behaviors. A teacher subsample reported significant increases (p < .001) in the number of students referred to mental health support services when compared to baseline measures of the control group. Role-play simulations hold promise in teaching educators to become the “eyes and ears” of student mental health by empowering them to identify students in psychological distress, engage them in effective conversations about their concerns, and if necessary, make a referral to behavioral health support services. Future studies need to implement measures that document students entering counseling as a result of self-reported referrals and examine the impact of the training on the overall mental health culture within schools. Such studies could lead to simulations being widely adopted to support public health initiatives that address student mental health and wellness.
Objectives: In this study, we examined the impact of a virtual training program, Kognito At-Risk role-play simulation, on the mental health and suicide prevention gatekeeping skills of middle school educators. Methods: The validated Gatekeeper Behavior Scale was administered
to 33,703 participants at baseline, post-training and follow-up. Helping behaviors were measured at baseline and follow-up. We also assessed preparedness, likelihood, and self-efficacy concerning leading conversations with youth about bullying and suicide. Results: Participants showed
positive change from pre-test to 3-month follow-up on variables of interest. Hotelling's T2 test indicated that, as a set, gatekeeper attitudes of preparedness, likelihood, and self-efficacy differed between pre-test and post-test, F (3, 33,512) = 16,283, p < .001, η2
partial = .59. Number of students about whom gatekeepers were concerned (p < .05), number of students approached to discuss concerns (p < .001), and number of students referred to support services (p <.001) increased significantly with training. Conclusions: The
At-Risk simulation shows promise in detecting and referring students in psychological distress, including risk of suicide. Fidelity is maintained because the program cannot be altered. At-Risk can be an effective and affordable way to provide suicide prevention training for those working in
schools.
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