In recent years, the rising rate of suicides by military personnel has generated concern among policymakers, military leaders, and the public at large. Based on a recommendation from an earlier RAND report on preventing suicide among military personnel, this report reviews the literature on gatekeeper models of suicide prevention to better understand what is known about the effectiveness of gatekeepers and gatekeeper training.

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Gatekeeper Training for Suicide Prevention

A Theoretical Model and Review of the Empirical Literature

by Crystal Burnette, Rajeev Ramchand, Lynsay Ayer

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Research Questions

  1. What literature exists on gatekeeper models of suicide prevention and what is known about the effectiveness of gatekeepers and gatekeeper training?
  2. How might gatekeeper training influence individual knowledge, beliefs, and attitudes that may result in intervention behaviors?

In recent years, the rising rate of suicides by military personnel has generated concern among policymakers, military leaders, and the public at large. Based on a recommendation from an earlier RAND report on preventing suicide among military personnel, this report reviews the literature on gatekeeper models of suicide prevention to better understand what is known about the effectiveness of gatekeepers and gatekeeper training. The report presents a theoretical model describing how gatekeeper training may influence individual knowledge, beliefs, and attitudes that may, in turn, result in intervention behaviors. It then reviews the evidence supporting each of the relationships presented in this model, and concludes with recommendations for advancing research in this field.

Key Findings

  • There is some evidence from the literature that gatekeeper training can improve knowledge about suicide, beliefs and attitudes about suicide prevention, self-efficacy to intervene, and reluctance to intervene.
  • The transfer of knowledge, beliefs, and skills learned in training to actual intervention behavior is largely unstudied.
  • Individual and contextual factors are associated with how effective gatekeeping programs will be.
  • Existing gatekeeping programs are heterogeneous.

Recommendations

  • Continued research is needed as to how knowledge, beliefs, self-efficacy, and reluctance are related to both intervention behavior and changes in suicide rates.
  • Future evaluation studies of gatekeeper training programs should examine the influence of contextual factors, such as support for gatekeeping and competing demands.
  • Research should examine the components and features of gatekeeper trainings that yield the most promising effects.

Research conducted by

The research presented here was sponsored by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury and conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute (NDRI).

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