Evaluating the Effectiveness of Suicide Prevention Gatekeeper Trainings as Part of an American Indian/Alaska Native Youth Suicide Prevention Program

Abstract

According to the Centers for Disease Control suicide rates in 2022 for American Indian/Alaska Native youth are 2.5 times higher than the national average. An Urban Indian Health Organization’s response to this crisis was to provide community and State-wide Gatekeeper trainings between 2012 and 2019 to teach trainees (N = 810) to respond appropriately to youth at-risk of suicide. We report data on pre-, post-, and six-month follow-up surveys with trainees. Data were analyzed using generalized linear models repeated measures to test within-subject, and between-subject mean score changes on suicide prevention-related measures “knowledge,” “ask directly,” “respond,” “comfort,” and “preparedness.” Results indicated improved capacity to be prepared to address suicide in the short term and that having a graduate degree enhanced baseline suicide prevention knowledge. Over time those with less education benefited the most and better retained content. Future Trainings should engage young people and those with less education to realize the largest benefit.

Expanding the Question–Persuade–Refer (QPR) Evidence Base: Youth Suicide Prevention among the Mississippi Band of Choctaw Indians

“…Therefore, our current study analyzed the effectiveness of QPR gatekeeper training in Mississippi tribal educational and youth-oriented settings. Only one other study has analyzed QPR gatekeeper training efforts in a Native American setting, with similar results [29]. Overall, the analysis of the pre-training and post-training surveys resulted in uniform and statistically significant increases in the knowledge of suicide factors and suicide prevention tools and techniques.…”

“…In the context of our study, effectiveness refers to the increase in knowledge among trainees and not to a reduction in suicides among the population. Prior to analysis, tailoring the training material to Native American culture and available suicide-related data may encourage training implementation in tribe-supported institutions and completion by tribal and affiliated members [12,29]. Additionally, introducing evidence-based gatekeeper trainings to both faculty and students of secondary or higher-learning education would close the gap between youth at risk of suicide and adults who may encounter and guide these youth.…”

“…Similarly, trainee education levels have been identified as influential factors in relation to training outcomes. A study of Native American and Alaska Native adults who interact with youth in Michigan used a comparative analysis of ASIST and SafeTALK, two evidence-based forms of gatekeeper training [29]. Trainees with a lower education level (high school or two years of college) benefitted the most from training materials and better retained the training content over a longer period of time.…”