Top

BMC Psychiatry

Published in:

Open Access 01-12-2016 | Research article

Brief gatekeeper training for suicide prevention in an ethnic minority population: a controlled intervention

Authors: Alan R. Teo, Sarah B. Andrea, Rae Sakakibara, Satoko Motohara, Monica M. Matthieu, Michael D. Fetters

Published in: BMC Psychiatry | Issue 1/2016

Abstract

Background

Suicide is a critical public health problem around the globe. Asian populations are characterized by elevated suicide rates and a tendency to seek social support from family and friends over mental health professionals. Gatekeeper training programs have been developed to train frontline individuals in behaviors that assist at-risk individuals in obtaining mental health treatment. The purpose of this study is to assess the efficacy of a brief, multi-component gatekeeper intervention in promoting suicide prevention in a high-risk Asian community in the United States.

Methods

We adapted an evidence-based gatekeeper training into a two-hour, multi-modal and interactive event for Japanese-Americans and related stakeholders. Then we evaluated the intervention compared to an attention control using mixed methods.

Results

A sample of 106 community members participated in the study. Intervention participants (n = 85) showed significant increases in all three types of intended gatekeeper behavior, all four measures of self-efficacy, and both measures of social norms relevant to suicide prevention, while the control group (n = 48) showed no significant improvements. Additional results showed significantly higher satisfaction and no adverse experiences associated with the gatekeeper training. The separate collection of qualitative data, and integration with the quantitative survey constructs confirmed and expanded understanding about the benefits of the intervention.

Conclusions

A brief, multi-modal gatekeeper training is efficacious in promoting positive gatekeeper behaviors and self-efficacy for suicide prevention in an at-risk ethnic minority population of Japanese Americans.

Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3(11):e442.CrossRefPubMedPubMedCentral

Center for Disease Control and Prevention. (n.d.-a). Connectedness as a Strategic Direction for the Prevention of Suicidal Behavior. 2015. Retrieved August 19, 2015, from https://www.cdc.gov/violenceprevention/pdf/suicide_strategic_direction_full_version-a.pdf

Center for Disease Control and Prevention. (n.d.-b). Fatal Injury Reports | WISQARS | Injury Center | CDC. 2015. Retrieved August 19, 2015, from http://www.cdc.gov/injury/wisqars/fatal_injury_reports.html

Chan CH, Caine ED, Chang SS, Lee WJ, Cha ES, Yip PSF. The impact of improving suicide death classification in South Korea: a comparison with Japan and Hong Kong. PLoS One. 2015;10(5):e0125730. http://doi.org/10.1371/journal.pone.0125730.CrossRefPubMedPubMedCentral

Hoeffel et al. 2012. The Asian Population: 2010–2010 Census Briefs. Retrieved January 19, 2016, from http://www.census.gov/prod/cen2010/briefs/c2010br-11.pdf.

Ahmedani BK, Stewart C, Simon GE, Lynch F, Lu CY, Waitzfelder BE, Williams K. Racial/Ethnic differences in health care visits made before suicide attempt across the United States. Med Care. 2015;53(5):430–5. http://doi.org/10.1097/MLR.0000000000000335.CrossRefPubMedPubMedCentral

Vogel DL, Wade NG, Wester SR, Larson L, Hackler AH. Seeking help from a mental health professional: the influence of one’s social network. J Clin Psychol. 2007;63(3):233–45. http://doi.org/10.1002/jclp.20345.CrossRefPubMed

Sakamoto S, Tanaka E, Kameyama A, Takizawa T, Takizawa S, Fujishima S, Ono Y. The effects of suicide prevention measures reported through a psychoeducational video: a practice in Japan. Int J Soc Psychiatry. 2014;60(8):751–8. http://doi.org/10.1177/0020764013518689.CrossRefPubMed

Barton AL, Hirsch JK, Lovejoy MC. Peer response to messages of distress. Crisis. 2013;34(3):183–91. http://doi.org/10.1027/0227-5910/a000169.CrossRefPubMed

10.

Institute of Medicine. (n.d.). Reducing Suicide: A National Imperative. 2002. Retrieved from 2002. http://www.nap.edu/catalog/10398/reducing-suicide-a-national-imperative

11.

Bartlett H, Travers C, Cartwright C. Evaluation of a project to raise community awareness of suicide risk among older men. J Ment Health. 2008;17(4):388–97. http://doi.org/10.1080/09638230701506010.CrossRef

12.

Cross WF, Seaburn D, Gibbs D, Schmeelk-Cone K, White AM, Caine ED. Does practice make perfect? A randomized control trial of behavioral rehearsal on suicide prevention gatekeeper skills. J Prim Prev. 2011;32(3–4):195–211. http://doi.org/10.1007/s10935-011-0250-z.CrossRefPubMedPubMedCentral

13.

Osteen PJ, Frey JJ, Ko J. Advancing Training to Identify, Intervene, and Follow Up with Individuals at Risk for Suicide Through Research. Am J Prev Med. 2014;47:S216–21. http://doi.org/10.1016/j.amepre.2014.05.033.CrossRefPubMed

14.

Aseltine RH, James A, Schilling EA, Glanovsky J. Evaluating the SOS suicide prevention program: a replication and extension. BMC Public Health. 2007;7:161. http://doi.org/10.1186/1471-2458-7-161.CrossRefPubMedPubMedCentral

15.

Gould MS, Cross W, Pisani AR, Munfakh JL, Kleinman M. Impact of Applied Suicide Intervention Skills Training on the National Suicide Prevention Lifeline. Suicide Life Threat Behav. 2013;43(6):676–91. http://doi.org/10.1111/sltb.12049.CrossRefPubMed

16.

Kitchener BA, Jorm AF. Mental health first aid training for the public: evaluation of effects on knowledge, attitudes and helping behavior. BMC Psychiatry. 2002;2:10.CrossRefPubMedPubMedCentral

17.

Wyman PA, Brown CH, Inman J, Cross W, Schmeelk-Cone K, Guo J, Pena JB. Randomized Trial of a Gatekeeper Program for Suicide Prevention: 1-year Impact on Secondary School Staff. J Consult Clin Psychol. 2008;76(1):104–15. http://doi.org/10.1037/0022-006X.76.1.104.CrossRefPubMedPubMedCentral

18.

Intervention Summary - QPR Gatekeeper Training for Suicide Prevention. (n.d.). 2012. Retrieved July 5, 2016, from http://legacy.nreppadmin.net/ViewIntervention.aspx?id=299

19.

Matthieu MM, Cross W, Batres AR, Flora CM, Knox KL. Evaluation of gatekeeper training for suicide prevention in veterans. Arch Suicide Res. 2008;12(2):148–54. http://doi.org/10.1080/13811110701857491.CrossRefPubMed

20.

Cross W, Matthieu MM, Cerel J, Knox KL. Proximate Outcomes of Gatekeeper Training for Suicide Prevention in the Workplace. Suicide Life Threat Behav. 2007;37(6):659–70. http://doi.org/10.1521/suli.2007.37.6.659.CrossRefPubMed

21.

Cross W, Matthieu MM, Lezine D, Knox KL. Does a brief suicide prevention gatekeeper training program enhance observed skills? Crisis. 2010;31(3):149–59. http://doi.org/10.1027/0227-5910/a000014.CrossRefPubMedPubMedCentral

22.

Klimes-Dougan B, Yuan C, Lee S, Houri AK. Suicide prevention with adolescents: considering potential benefits and untoward effects of public service announcements. Crisis. 2009;30(3):128–35. http://doi.org/10.1027/0227-5910.30.3.128.CrossRefPubMed

23.

Sargent JD, Beach ML, Dalton MA, Ernstoff LT, Gibson JJ, Tickle JJ, Heatherton TF. Effect of parental R-rated movie restriction on adolescent smoking initiation: a prospective study. Pediatrics. 2004;114(1):149–56.CrossRefPubMed

24.

Teo AR, Stufflebam KW, Lu F, Fetters MD. Use of a public film event to promote understanding and help seeking for social withdrawal. Asia-Pacific Psychiatry: Official Journal of the Pacific Rim College of Psychiatrists. 2015;7(2):157–63. http://doi.org/10.1111/appy.12166.CrossRef

25.

Boomachine. (2013). SAVING 10,000 - Winning a War on Suicide in Japan - 自殺者1万人を救う戦い - Japanese Documentary. Retrieved from https://www.youtube.com/watch?v=oo0SHLxc2d0

26.

Intervention Summary - Mental Health First Aid. (n.d.) 2012. Retrieved July 5, 2016, from http://legacy.nreppadmin.net/ViewIntervention.aspx?id=321

27.

Lawrence MT, Ureda JR. Student recognition of and response to suicidal peers. Suicide Life Threat Behav. 1990;20(2):164–76.PubMed

28.

Lapinski MK, Rimal RN. An Explication of Social Norms. Commun Theory. 2005;15(2):127–47. http://doi.org/10.1111/j.1468-2885.2005.tb00329.x.CrossRef

29.

Yun D, Silk KJ. Social norms, self-identity, and attention to social comparison information in the context of exercise and healthy diet behavior. Health Commun. 2011;26(3):275–85. http://doi.org/10.1080/10410236.2010.549814.CrossRefPubMed

30.

Fetters MD, Freshwater D. The 1 + 1 = 3 Integration Challenge. J Mixed Methods Res. 2015;9(2):115–7. http://doi.org/10.1177/1558689815581222.CrossRef

31.

Guetterman TC, Fetters MD, Creswell JW. Integrating Quantitative and Qualitative Results in Health Science Mixed Methods Research Through Joint Displays. Ann Fam Med. 2015;13(6):554–61. http://doi.org/10.1370/afm.1865.CrossRefPubMedPubMedCentral

32.

Fetters MD, Curry LA, Creswell JW. Achieving Integration in Mixed Methods Designs—Principles and Practices. Health Serv Res. 2013;48(6 pt2):2134–56. http://doi.org/10.1111/1475-6773.12117.CrossRefPubMedPubMedCentral

33.

Riekert KA, Ockene JK, Pbert L, editors. The Handbook of Health Behavior Change. 4th ed. New York, NY: Springer Publishing Company; 2013.

34.

Shrank WH, Patrick AR, Brookhart MA. Healthy user and related biases in observational studies of preventive interventions: a primer for physicians. J Gen Intern Med. 2011;26(5):546–50. http://doi.org/10.1007/s11606-010-1609-1.CrossRefPubMedPubMedCentral

35.

Clifford AC, Doran CM, Tsey K. A systematic review of suicide prevention interventions targeting indigenous peoples in Australia, United States, Canada and New Zealand. BMC Public Health. 2013;13(1):1–11. http://doi.org/10.1186/1471-2458-13-463.CrossRef

36.

Sareen J, Isaak C, Bolton S-L, Enns MW, Elias B, Deane F, Katz LY. Gatekeeper Training for Suicide Prevention in First Nations Community Members: A Randomized Controlled Trial. Depress Anxiety. 2013;30(10):1021–9. http://doi.org/10.1002/da.22141.PubMed

37.

Pisani AR, Cross WF, Watts A, Conner K. Evaluation of the Commitment to Living (CTL) curriculum: a 3-hour training for mental health professionals to address suicide risk. Crisis. 2012;33(1):30–8. http://doi.org/10.1027/0227-5910/a000099.CrossRefPubMedPubMedCentral

38.

Walsh E, Hooven C, Kronick B. School-Wide Staff and Faculty Training in Suicide Risk Awareness: Successes and Challenges. J Child Adolesc Psychiatr Nurs. 2013;26(1):53–61. http://doi.org/10.1111/jcap.12011.CrossRefPubMed

39.

Alexander M, Lenahan P, Pavlov A. Cinemeducation: A Comprehensive Guide to Using Film in Medical Education. Radcliffe Publishing; 2005

40.

Bird L, Marti J. Red carpet reception for inaugural IEPA Short Film Festival. Early Interv Psychiatry. 2009;3(1):3–4. http://doi.org/10.1111/j.1751-7893.2009.00110.x.CrossRefPubMed

41.

Kalra G. Talking about stigma towards mental health professionals with psychiatry trainees: A movie club approach. Asian J Psychiatry. 2012;5(3):266–8. http://doi.org/10.1016/j.ajp.2012.06.005.CrossRef

42.

Kerby J, Calton T, DiMambro B, Flood C, Glazebrook C. Anti-stigma films and medical students’ attitudes towards mental illness and psychiatry: Randomised controlled trial. Psychiatr Bull. 2008;32(9):345–9. http://doi.org/10.1192/pb.bp.107.017152.CrossRef

43.

Masters JC. Hollywood in the classroom: using feature films to teach. Nurse Educ. 2005;30(3):113–6.CrossRefPubMed

44.

Rosenstock J. Beyond A Beautiful Mind: Film Choices for Teaching Schizophrenia. Acad Psychiatry. 2003;27(2):117–22. http://doi.org/10.1176/appi.ap.27.2.117.CrossRefPubMed

45.

Nichols AL, Maner JK. The good-subject effect: investigating participant demand characteristics. J Gen Psychol. 2008;135(2):151–65. http://doi.org/10.3200/GENP.135.2.151-166.CrossRefPubMed

46.

Till B, Tran US, Voracek M, Sonneck G, Niederkrotenthaler T. Associations between film preferences and risk factors for suicide: an online survey. PLoS One. 2014;9(7):e102293. http://doi.org/10.1371/journal.pone.0102293.CrossRefPubMedPubMedCentral

Title: Brief gatekeeper training for suicide prevention in an ethnic minority population: a controlled intervention
Authors: Alan R. Teo
Sarah B. Andrea
Rae Sakakibara
Satoko Motohara
Monica M. Matthieu
Michael D. Fetters
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Psychiatry / Issue 1/2016
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-016-0924-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Brief gatekeeper training for suicide prevention in an ethnic minority population: a controlled intervention

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2016

Internet-based treatment for Romanian adults with panic disorder: protocol of a randomized controlled trial comparing a Skype-guided with an unguided self-help intervention (the PAXPD study)

A pragmatic randomized control trial and realist evaluation on the implementation and effectiveness of an internet application to support self-management among individuals seeking specialized mental health care: a study protocol

Implementation of recommended type 2 diabetes care for people with severe mental illness – a qualitative exploration with healthcare professionals

Impact of the UN convention on the rights of persons with disabilities (UN-CRPD) on mental health care research - a systematic review

Is adjustment for reporting heterogeneity necessary in sleep disorders? results from the Japanese World Health Survey

Psychopathological Functioning Levels (PFLs) and their possible relevance in psychiatric treatments: a qualitative research project