Tennessee Lives Count: Statewide gatekeeper training for youth suicide prevention.

Abstract

Youth suicide remains a significant public health problem in the United States. In 2004, the Garrett Lee Smith Memorial Act provided states and tribes with funding to implement and evaluate youth suicide prevention programs. The Tennessee Lives Count project was developed through a collaborative model at the state level and delivers an enhanced version of the Question, Persuade, Refer gatekeeper training program to individuals working with youth across the state. This article describes the development of the project and preliminary outcomes of 416 participants in child welfare, juvenile justice, health, and education systems at pretest, posttest, and 6-month follow-up. The findings suggest the training has an immediate and long-term impact on perceived knowledge of suicide prevention, self-efficacy, and attitudes about the inevitability of suicide. Policy and practice implications are presented.

Putting program evaluation to work: a framework for creating actionable knowledge for suicide prevention practice

“…What follows are descriptions of the key findings and lessons learned from each of these enhanced program evaluations ("enhanced evaluations"), and the actionable knowledge framework used to make these findings relevant and actionable for use by practitioners in the field of suicide prevention. Prior research has shown that immediately after gatekeeper training, participants showed increased knowledge (actual and perceived), improved attitudes about suicide prevention, increased confidence (self-efficacy beliefs), and skills to help at-risk individuals [38][39][40][41][42]. Little research exists, however, on whether increases in gatekeepers' knowledge, attitudes, beliefs, and skills lead to actual gatekeeperhelping behaviors, nor is there much research on the long-term effectiveness of gatekeeper training in preventing suicidal behavior.…”

“…The broad purpose of the TLC-enhanced evaluation was to expand understanding about gatekeeper training among several specific populations. The enhanced evaluation consisted of three studies: (1) a 6-month follow-up to monitor long-term gains after one-time gatekeeper training [39], (2) a study of factors that predict gatekeeper-helping behaviors [43], and (3) a descriptive study of gatekeeper-helping behaviors as they naturally occur in the child welfare system. Initial outcomes from the enhanced evaluation were further explored, and additional lessons learned were gathered in a separate longitudinal study of gatekeeper training for staff of juvenile justice centers.…”

“…Quantitative findings indicated that long-term gains from training are not guaranteed [39], and prior and ongoing training can make a difference [43]. At pretest, participants with prior suicide prevention training had more perceived knowledge about suicide prevention, more self-efficacy for engaging in gatekeeper behavior (identifying and referring atrisk youth), and more favorable attitudes (i.e., that suicide is preventable).…”

A Community's Response to Gatekeeper Training

“…Tennessee Lives Count gatekeeper training targeted social service workers, educators and lay persons [19]. Pre-post surveys (n=416) about attitudes, knowledge and self-efficacy revealed initial improvements but gains were not maintained at six months with authors concluding long-term effects warranted further examination [19].…”

System constraints on efficacious teacher behaviours in school-based suicide prevention initiatives; a qualitative study of teacher views and experiences

“…Existing research has shown that, whilst teacher knowledge and attitudes are improved by gatekeeper training, teacher behaviours are not significantly affected (Keller et al 2009;Reis & Cornell 2008;Wyman, Inman & Guo 2008). For example, Wyman et al (2008) examined teachers' self-reported behaviour with students, such as how often they had asked students about distress or depressed mood since gatekeeper training.…”