Preventing adolescent suicide: A systematic review of the effectiveness and change mechanisms of suicide prevention gatekeeping training programs for teachers and parents

Abstract

Introduction: Suicide is a leading cause of death in young people, which may in part be because young people are notoriously poor help-seekers. Improving the identiication of at-risk young people and connecting them to appropriate help is needed to prevent suicide in adolescents. The aim of this study is to examine the efectiveness of suicide prevention gatekeeper programs for parents and teachers, which are designed to improve their ability to recognise and respond to risks so that they may intervene before crisis occurs. Methods: Academic databases and reference lists were searched for gatekeeper training programs involving teachers and parents, and which aimed to prevent youth suicide, between journal inception and May 2018. Information directly reporting on suicide literacy (knowledge, conidence, attitudes) and/or gatekeeper behaviours (identiication, referral) was extracted and a qualitative synthesis was conducted. Results: Thirteen studies fulilled inclusion criteria. Signiicant moderate-to-large intervention efects were reported for suicide literacy outcomes among teachers and parents, with the largest gains among those with lowest baseline scores. No improvements in identiication and referral behaviors among gatekeepers were noted. A need to improve evaluation research designs and outcome measurements was evident. Conclusions: While gatekeeper programs lead to increased suicide literacy, there is little evidence for behavioural change. There is need to increase the reach and uptake of gatekeeper training by ofering digital versions, which may lead to improved behavioural outcomes, and to employ targeted strategies to engage parents in this training as one of the most trusted sources of support for vulnerable youth.

Taking Youth Suicide Prevention to the Schools: Pilot Evaluation of School-Based Clinician Outcomes and Perspectives of a Multi-Modal Program Including Post-Training Online Consultations for Management of Ongoing Suicide Risk

“…Encouragingly, effect size estimates for changes from baseline to post-workshop and post-consultation were both large. These results build upon findings from previous gate-keeper trainings that report shortto moderate-term improvements in confidence and competence across a range of health professionals, community groups, and school staff [14,15,[44][45][46].…”

Exposure to Suicidal Behavior and Social Support Among Sexual- and Gender-Minority Youth

“…Gatekeeper training has gained considerable attention in suicide prevention. [70][71][72] Such suicide prevention programs focus on training peers and key adults as active bystanders, a model based in social support. 70,71,[73][74][75] Gatekeeper training education is a strategy used within school settings to help staff identify at-risk youth and help them get the help they need.…”

Empirische Arbeit: Gatekeeper in Schulen: Ergebnisse eines Suizidpräventionsprogramms

“…Forschung zur Wirksamkeit von Gatekeeper-Programmen in Europa und den USA konnte zeigen, dass die Teilnehmer*innen nach einem gezielten Training über ein größeres Wissen zu Suizidalität sowie zu Risiko-und Warnsignalen verfügten (Brown, Straub, Bohn acker & Plener, 2018;Groschwitz, Munz, Straub, Bohnacker & Plener, 2017;Reis & Cornell, 2008;Robinson et al, 2013;Scouller & Smith, 2002;Taub et al, 2013;Torok, Calear, Smart, Nicolipoulos, & Wong, 2019;Wyman et al, 2008), die eigene Fähigkeit, mit Jugendlichen in einer Krise zu interagieren, besser einschätzten (Fischer, Göbelbecker & Schneider, 2011) und ihre Kommunikationsfähigkeiten in Krisen verbesserten (Taub et al, 2013). Das Vertrauen in die eigenen Fähigkeiten, mit gefährdeten Schüler*innen mit selbstverletzendem Verhalten oder Suizidalität umzugehen bzw.…”