Gatekeeper training for suicidal behaviors: A systematic review.

Area of Science:

• Psychiatry
• Public Health
• Mental Health Interventions

Background:

• Gatekeeper training (GKT) is a widely used intervention strategy aimed at preventing suicidal behavior.
• Existing evidence on GKT's effectiveness requires updated investigation.
• Various GKT programs exist, necessitating a review of their diversity and impact.

Purpose of the Study:

• To systematically review updated evidence on the effectiveness of Gatekeeper training (GKT) in suicide prevention.
• To identify and describe the variations present in current GKT programs.
• To assess the impact of GKT on knowledge, appraisals, and self-efficacy.

Main Methods:

• A systematic literature review was conducted using multiple databases (PubMed, PsycINFO, CINAHL, Cochrane).
• Included studies were randomized controlled trials (RCTs) and intervention studies with prospective or quasi-experimental designs.
• A total of 343 articles were initially identified, with 10 RCTs and 6 intervention studies meeting eligibility criteria.

Main Results:

• Multiple GKT variations were identified, including Question, Persuade, and Refer (QPR), Applied Suicide Intervention Skills Training (ASIST), OSPI, and Youth Aware of Mental Health (YAM).
• For RCTs, GKT's effects on knowledge, appraisals, and self-efficacy remained unclear, though uncontrolled studies showed some support.
• The overall quality of included RCTs was rated as low or unclear.

Conclusions:

• The effectiveness of Gatekeeper training (GKT) for suicide prevention is currently unclear.
• Significant variations exist in GKT programs, and replication studies in target populations are needed.
• Future research should focus on high-quality RCTs evaluating standardized GKT programs with appropriate control groups and pre-specified outcomes.