Gatekeeper Training and Access to Mental Health Care at Universities and Colleges

Abstract

Purpose Gatekeeper-training programs (GKTs) are an increasingly popular approach to addressing access to mental health care in adolescent and young adult populations. This study evaluates the effectiveness of a widely used GKT program, Mental Health First Aid (MHFA), in college student populations. Methods A randomized control trial was conducted on 32 colleges and universities between 2009 and 2011. Campus residence halls were assigned to the intervention (MHFA plus preexisting trainings) or control condition (pre-existing trainings only) using matched pair randomization. The trainings were delivered to resident advisors (RAs). Outcome measures include service utilization, knowledge and attitudes about services, self-efficacy, intervention behaviors, and mental health symptoms. Data come from two sources: (1) surveys completed by the students (RAs and residents) (N=2,543), 2-3 months pre- and post-intervention; and (2) utilization records from campus mental health centers, aggregated by residence. Results The training increases trainees’ self-perceived knowledge (regression-adjusted effect size (ES)=0.38, p<0.001), self-perceived ability to identify students in distress (ES=0.19, p=0.01), and confidence to help (ES=0.17, p=0.04). There are no apparent effects, however, on utilization of mental health care in the student communities in which the trainees live. Conclusions Although GKTs are widely used to increase access to mental health care, these programs may require modifications in order to achieve their objectives.

Mental health training programmes for non-mental health trained professionals coming into contact with people with mental ill health: a systematic review of effectiveness

“…Other measures used were basic rating scales, for example a categorical measure of the number of residents with whom university resident advisors interacted [21]. None of the included studies undertook an economic evaluation or reported resource use or costs.…”

Under the Radar: The Mental Health of Australian University Students

“…Davies, Beever, & Glazebrook, 2016;Lipson, Speer, Brunwasser, Hahn, & Eisenberg, 2014). However, as Lipson et al (2014) found, effects are not apparent for the translation of these improvements into help-seeking behaviours or mental health service utilisation among students.…”

Impact of Mental Health First Aid on Confidence Related to Mental Health Literacy: A National Study With a Focus on Race-Ethnicity

“…However, most of the research was conducted in Australia, where the training was originally developed (8). There has been very little research on the impact of MHFA on MHL in the United States, with only two studies published thus far (9,10). Although the results of both studies were consistent with previous research, further evidence of the impact of MHFA on the American public in general, and among specific subgroups, is needed.…”