Is Gatekeeper Training Enough for Suicide Prevention?

  • Natasha Robinson-Link
  • Sharon Hoover
  • Larraine Bernstein
  • Nancy Lever
  • Kenneth MatonEmail author
  • Holly Wilcox
Original Paper


While schools have the capacity to reach youth at-risk for suicide, there remains a gap between the number of youth with mental health issues and those who receive services. Accordingly, gatekeeper training programs, which teach community members signs of psychological distress and strategies to refer youth to mental health support, are often one component of suicide prevention. Nevertheless, there is a dearth of research about the efficacy of online gatekeeper training, which may provide the flexibility and accessibility needed for overburdened schools. This study sought to investigate whether Kognito, an online and easily accessible gatekeeper training, was related to changes in teachers’ suicide prevention beliefs, behavioral intentions, and behaviors (proportion of students approached and referred over time). Teachers significantly increased their beliefs (i.e., preparedness and self-efficacy) and behavioral intention (i.e., likelihood) to intervene with at-risk students. However, teachers did not change suicide intervention behaviors. Natural gatekeeper status (i.e., teachers approaching students at baseline) impacted number of referrals over time (in the opposite direction we predicted); however, natural gatekeeper status did not have an impact on proportion of students approached. Self-efficacy change, however, preceded change in proportion of students approached, but not referred. The findings, taken as a whole, indicate gatekeeper training alone appears insufficient to change suicide prevention behaviors, and accordingly, suicide prevention needs to employ a comprehensive approach.


Gatekeeper training Suicide prevention Teachers Schools 



This paper was developed, in part, under grant number 1U79SM061751-01 from the Substance Abuse and Mental Health Services Administration (SAMHSA), US Department of Health and Human Services (HHS). The views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Maryland Baltimore institutional committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.University of Maryland Baltimore, School of MedicineBaltimoreUSA
  2. 2.Department of PsychologyUniversity of Maryland Baltimore CountyCatonsvilleUSA
  3. 3.Johns Hopkins University, School of MedicineBaltimoreUSA

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