Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2008 Feb;76(1):104-15.
doi: 10.1037/0022-006X.76.1.104.

Randomized trial of a gatekeeper program for suicide prevention: 1-year impact on secondary school staff

Peter A Wyman  1 , C Hendricks Brown, Jeff Inman, Wendi Cross, Karen Schmeelk-Cone, Jing Guo, Juan B Pena
Affiliations
Randomized Controlled Trial

Randomized trial of a gatekeeper program for suicide prevention: 1-year impact on secondary school staff

Peter A Wyman et al. J Consult Clin Psychol. 2008 Feb.

Abstract

Gatekeeper-training programs, designed to increase identification and referral of suicidal individuals, are widespread but largely untested. A group-based randomized trial with 32 schools examined impact of Question, Persuade, Refer (QPR) training on a stratified random sample of 249 staff with 1-year average follow-up. To test QPR impact, the authors introduced and contrasted 2 models of gatekeeper-training effects in a population: gatekeeper surveillance and gatekeeper communication. Intent-to-treat analyses showed that training increased self-reported knowledge (effect size [ES] = 0.41), appraisals of efficacy (ES = 1.22), and service access (ES = 1.07). Training effects varied dramatically. Appraisals increased most for staff with lowest baseline appraisals, and suicide identification behaviors increased most for staff already communicating with students about suicide and distress. Consistent with the communication model, increased knowledge and appraisals were not sufficient to increase suicide identification behaviors. Also consistent with the communication model were results from 2,059 8th and 10th graders surveyed showing that fewer students with prior suicide attempts endorsed talking to adults about distress. Skill training for staff serving as "natural gatekeepers" plus interventions that modify students' help-seeking behaviors are recommended to supplement universal gatekeeper training.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flowchart of schools and participants in the trial.
Figure 2
Figure 2
Training Impact on Self-Evaluation of Suicide Prevention Knowledge at Time 2 as a Function of Baseline Self-Evaluation.
See this image and copyright information in PMC

References

    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV. 4th Ed. Washington: American Psychiatric Association; 1994.
    1. Asarnow JR, Carlson GA, Guthrie D. Coping strategies, self-perceptions, hopelessness, and perceived family environments in depressed and suicidal children. Journal of Consulting & Clinical Psychology. 1987;55(3):361–366. - PubMed
    1. Aseltine RH, Jr, DeMartino R. An outcome evaluation of the SOS Suicide Prevention Program. American Journal of Public Health. 2004;94(3):446–451. - PMC - PubMed
    1. Brown CH. Design principles and their application in preventive field trials. In: Bukoski WJ, Sloboda Z, editors. Handbook of Drug Abuse Prevention: Theory, Science, and Practice. New York: Plenum Press; 2002. pp. 523–540.
    1. Brown CH, Wyman PA, Guo J, Pena J. Dynamic wait-listed designs for randomized trials: new designs for prevention of youth suicide. Clinical Trials. 2006;3(3):259–271. - PubMed

Publication types