How does gatekeeper training improve suicide prevention for elderly people in nursing homes? A controlled study in 24 centres

Abstract

Having trained gatekeepers has an impact not only for the trained individuals but also for the whole institution where they work, both in terms of managing suicidal residents and routine suicide prevention measures.

Suicide prevention gatekeeper training in the Netherlands improves gatekeepers’ knowledge of suicide prevention and their confidence to discuss suicidality, an observational study

“…Six weeks after the gatekeeper training, all participants benefitted significantly from the training on these topics. These outcomes are consistent with other studies on gatekeeper training effects, showing primarily increased knowledge and self-confidence [ 16 , 24 – 32 ].…”

“…Given the limitations, our findings show that the gatekeeper training is effective in improving knowledge and skills-confidence for a wide range of professions and thus positively supports gatekeepers’ willingness to address suicidality. Moreover, dissemination of the training program could contribute to reducing the taboo on addressing suicide and suicidal thoughts in the immediate vicinity of trainees and even encourage prevention policy within institutions where staff is trained [ 24 , 53 ]. Based on these considerations and the results of our study, we conclude that increasing the number of gatekeeper training programs in all sectors is recommended.…”

“…In most studies, knowledge improvement is a convincing outcome of the gatekeeper training [ 16 , 24 – 29 ] as well as improved self-efficacy [ 25 , 28 , 30 , 31 ] and confidence to act when in contact with a suicidal person [ 16 , 24 , 27 , 32 ]. Furthermore, gatekeeper training seems beneficial in referring youth to appropriate services, especially within school-based settings [ 33 , 34 ].…”

“…Furthermore, gatekeeper training seems beneficial in referring youth to appropriate services, especially within school-based settings [ 33 , 34 ]. The improved self-efficacy found in Chauliacs controlled study resulted in significantly more referrals to psychologists [ 24 ]. On the other hand, four uncontrolled studies found that participants with higher pre-training intentions to help, were more likely to actually reach out to a person in a suicidal crisis and showed a decline in referral behaviour [ 26 ].…”

A Community's Response to Gatekeeper Training

“…In France, a study compared outcomes of gatekeeper training implemented in 12 longterm care facilities to a control group of 12 similar settings without training [34]. It was found training increased interactions among staff with those residents at-risk, improving patient care [34].…”