Gatekeeper Training for Suicide Prevention in First Nations Community Members: A Randomized Controlled Trial

Sareen, Jitender; Isaak, Corinne; Bolton, Shay-Lee; Enns, Murray W.; Elias, Brenda; Deane, Frank P.; Munro, Garry; Stein, M.P.H. Murray B.; Château, Dan; Gould, Madelyn S.; Katz, Laurence Y.

doi:10.1002/da.22141

Cited by 49 publications

(59 citation statements)

References 23 publications

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“…The primary outcome would be assessed using The Suicide Intervention Response Inventory-2 (SIRI-2) [39] at baseline, post-intervention and 6 months follow up. Secondary outcomes would include self-reported preparedness measures [40], GPs attitudes (Attitudes Towards Suicide [41] and confidence (using the 5-item STORM confidence in the assessment and management of suicidal people scale) [22]; service user satisfaction using qualitative interviews; and, cost-effectiveness. If the effectiveness and cost-effectiveness of the e-CDSS is established, then this research could lead to improved assessment and management of suicidality in primary care and better patient experience of primary care mental health services.…”

Section: Discussionmentioning

confidence: 99%

An Electronic Clinical Decision Support System for the Assessment and Management of Suicidality in Primary Care: Protocol for a Mixed-Methods Study (Preprint)

Horrocks¹,

Michail²,

Aubeeluck³

et al. 2018

Preprint

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1Background: Suicide is a global public health concern, but it is preventable. Increased contact with primary care before the suicide or attempted suicide raises opportunities for intervention and prevention. However, suicide assessment and management is an area that many General Practitioners (GPs) find particularly challenging. Previous research has indicated significant variability in how GPs understand, operationalise and assess suicide risk which subsequently has an impact on clinical decision making. Clinical Decision Support systems (CDSS) have been widely implemented across different healthcare settings, including primary care to support practitioners in clinical decision making. CDSS may reduce inconsistencies in the identification, assessment and management of suicide risk by GPs by guiding them through the consultation and generating a risk assessment plan that can be shared with a service user or with specialised mental health services.

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Section: Discussionmentioning

confidence: 99%

An Electronic Clinical Decision Support System for the Assessment and Management of Suicidality in Primary Care: Protocol for a Mixed-Methods Study (Preprint)

Horrocks¹,

Michail²,

Aubeeluck³

et al. 2018

Preprint

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“…The suggestion that gatekeeper training is not a 'one size fits all' may have relevance to minority groups. Lower levels of satisfaction and poorer outcomes, including a concerning increase in suicidal ideation among First Nations tribal community members in Canada, raises concern about appropriateness of standardized training for minority groups [22]. The issue of culture was raised by other researchers [23,31].…”

Section: Discussionmentioning

confidence: 99%

“…In Manitoba, Canada, a randomized-controlled study of gatekeeper training found increased suicidal ideation occurred among First Nations tribal community members [22]. One group (n=31) received two days of Applied Suicide Intervention Skills Training (ASIST) and another group (n=24) attended a Resilience Retreat without focus on suicide awareness.…”

Section: Communitiesmentioning

confidence: 99%

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A Community's Response to Gatekeeper Training

Pullen¹,

Gilje²,

Loftsgaarden³

et al. 2017

J Comm Pub Health Nurs

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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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“…Our satisfaction and outcome variables were also subjective (e.g., attitudes) and we do not know to what extent they would correlate with more-objective assessments of training outcomes (e.g., intervention skill) or client outcomes. Also, while prior studies report the validity of retrospective surveys [14][15][16][17][18], a "true" baseline survey was not administered prior to the training. Finally, we only trained two coders to monitor fidelity and adherence.…”

Section: Limitationsmentioning

confidence: 99%

Implementing Evidence-Based Suicide Prevention Training in Communities: Implications for Quality Improvement

KC¹,

Ramchand²

2015

J Community Med Health Educ

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Suicide prevention trainings are implemented to equip the public's ability to intervene with those who are at-risk, but their implementation is not often monitored for quality. In this study, we propose a quality improvement model to improve trainer skill, demonstrate evidence of knowledge uptake, and document the quality of training workshop implementation. We collected participant data (N=2006) from over 127 Applied Suicide Intervention Skills Training (ASIST) training workshops that evaluated workshop satisfaction, confidence to intervene, and likelihood to intervene and refer immediately post-training. We also collected trainer data by measuring fidelity and adherence to the ASIST protocol at five live ASIST workshops. Training participants reported improved confidence and likelihood to intervene and refer after the workshop. Participants also reported high satisfaction. In three of the five workshops, newly trained trainers covered 75% or more of the fidelity items demonstrating thorough review of the training. Trainers generally adhered to one of four competencies specific to ASIST and five of the 11 general competencies relating to group management. Trainers may need to improve their efforts to tailor content to specific audiences, promote cultural competence, and manage time.

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Gatekeeper Training for Suicide Prevention in First Nations Community Members: A Randomized Controlled Trial

Abstract: The lack of efficacy of ASIST in a First Nations on-reserve sample is concerning in the context of widespread policies in Canada on the use of gatekeeper training in suicide prevention.

Cited by 49 publications

References 23 publications

An Electronic Clinical Decision Support System for the Assessment and Management of Suicidality in Primary Care: Protocol for a Mixed-Methods Study (Preprint)

An Electronic Clinical Decision Support System for the Assessment and Management of Suicidality in Primary Care: Protocol for a Mixed-Methods Study (Preprint)

A Community's Response to Gatekeeper Training

Implementing Evidence-Based Suicide Prevention Training in Communities: Implications for Quality Improvement

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