Abstract
Although the college years prove to be a vulnerable time for students and a critical period for suicide prevention, few school-based prevention strategies have been empirically evaluated. The current study examined the short-term effects of Question, Persuade, and Refer (QPR), a gatekeeper training program that teaches how to recognize warning signs, question suicidal intent, listen to problems, and refer for help. One hundred twenty-two residence advisers (RAs) who were trained in QPR demonstrated significant post-training gains across a variety of domains relevant to suicide and suicide prevention, with 60 who completed the follow-up assessment showing sustained knowledge and appraisals into the following semester. Although these gains were generally more substantial for RAs trained in QPR, 86 controls who completed both baseline and follow-up assessments also demonstrated changes in appraisals relevant to suicide and suicide prevention, despite having not received QPR training. Editors’ Strategic Implications This study provides some promising evidence on gatekeeper training for RAs in terms of suicide prevention knowledge and attitudes. As the authors note, replication, rigorous evaluation, and studies of systemic efforts and behavioral outcomes are needed.
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American College Health Association. (2001). American college health association–national college health assessment: Reference group data report fall 2000. Baltimore: Author.
American College Health Association. (2004). Standards of practice for health promotion in higher education. Baltimore: American College Health Task Force on Health Promotion in Higher Education.
American College Health Association. (2008). American college health association–national college health assessment: Reference group data report fall 2007. Baltimore: Author.
Aseltine, R. H., & DeMartino, R. (2004). An outcome evaluation of the SOS suicide prevention program. American Journal of Public Health, 94, 446–451. doi:10.2105/AJPH.94.3.446.
Barrios, L. C., Everett, S. A., Simon, T. R., & Brener, N. D. (2000). Suicide ideation among U.S. college students: Associations with other injury risk behaviors. Journal of American College Health, 48, 229–233.
Benton, S. A., Robertson, J. M., Tseng, W., Newton, F. B., & Benton, S. L. (2003). Changes in counseling center client problems across 13 years. Professional psychology, research and practice, 34, 66–72. doi:10.1037/0735-7028.34.1.66.
Brener, N., Hassan, S. S., & Barrios, L. C. (1999). Suicidal ideation among college students. Journal of Consulting and Clinical Psychology, 67, 1004–1008. doi:10.1037/0022-006X.67.6.1004.
Brown, C. H., Wyman, P. A., Guo, J., & Pena, J. (2006). Dynamic wait-listed designs for randomized trials: New designs for prevention of youth suicide. Clinical trials, 3, 259–271. doi:10.1191/1740774506cn152oa.
Centers for Disease Control and Prevention. (2005). WISQARS leading causes of death reports, 2004. Retrieved June 20, 2008, from http://webappa.cdc.gov/sasweb/ncipc/leadcaus10.html.
Conner, K. R., & Goldston, D. B. (2007). Rates of suicide among males increase steadily from age 11–21: Developmental framework and outline for prevention. Aggression and violent behavior, 12, 193–207. doi:10.1016/j.avb.2006.07.002.
Cross, W., Matthieu, M. M., Cerel, J., & Knox, K. L. (2007). Proximate outcomes of gatekeeper training for suicide prevention in the workplace. Suicide and Life-threatening Behavior, 37, 659–670. doi:10.1521/suli.2007.37.6.659.
Davis P. (2001, April). QPR gatekeeper training results for different age groups. Poster session presented at the meeting of the American Association of Suicidality, Atlanta, GA.
Eggert, L. L., Randell, B. R., Thompson, E. A., & Johnson, C. L. (1997). Washington State youth suicide prevention program: Report of activities. Seattle, WA: University of Washington.
Francis, P. C. (2003). Developing ethical institutional policies and procedures for working with suicidal students on a college campus. Journal of College Counseling, 6, 114–123.
Furr, S. R., McConnell, G. N., Westefeld, J. S., & Jenkins, J. M. (2001). Suicide and depression among college students: A decade later. Professional psychology, research and practice, 32, 97–100. doi:10.1037/0735-7028.32.1.97.
Gallagher, R. P., Zhang, B., & Taylor, R. (2004). National survey of counseling center directors. Alexandria, VA: International Association of Counseling Services.
Garlow, S. J., Rosenberg, J., Moore, J. D., Haas, A. P., Koestner, B., Hendin, H., et al. (2008). Depression, desperation, and suicidal ideation in college students: Results from the American Foundation for Suicide Prevention college screening project at Emory University. Depression and anxiety, 25, 482–488. doi:10.1002/da.20321.
Gould, M. S., Greenberg, T., Munfakh, J. L., Kleinman, M., & Lubell, K. (2006). Teenagers’ attitudes about seeking help from crisis services (hotlines). Suicide and Life-threatening Behavior, 36, 601–613. doi:10.1521/suli.2006.36.6.601.
Grosz, R. D. (1990). Suicide: Training the resident assistant as an interventionist. Journal of College Student Psychotherapy, 4, 179–194. doi:10.1300/J035v04n03_11.
Haas, A. P., Hendin, H., & Mann, J. J. (2003). Suicide in college students. The American behavioral scientist, 46, 1224–1240. doi:10.1177/0002764202250666.
Institute QPR. (2006). QPR gatekeeper training for suicide prevention: The model, rationale and theory. Retrieved May 17, 2007, from http://www.qprinstitute.com/.
Joffe, P. (2008). An empirically supported program to prevent suicide in a college student population. Suicide and Life-threatening Behavior, 38, 87–103. doi:10.1521/suli.2008.38.1.87.
Kalafat, J., & Elias, M. J. (1995). Suicide prevention in an educational context: Broad and narrow foci. Suicide and Life-threatening Behavior, 25, 123–133.
Kaplan, B., & Reed, M. (2004, Spring). College student mental health: Plan designs, utilization, trends, and costs. Student Health Spectrum, 31–33.
King, K. A., & Smith, J. (2000). Project SOAR: A training program to increase school counselors’ knowledge and confidence regarding suicide prevention and intervention. Journal of School Health, 70, 402–407.
Kisch, J., Leino, F. V., & Silverman, M. M. (2005). Aspects of suicidal behavior, depression, and treatment in college students: Results from the Spring 2000 National College Health Assessment Survey. Suicide and Life-threatening Behavior, 35, 3–13. doi:10.1521/suli.35.1.3.59263.
Kitzrow, M. A. (2003). The mental health needs of today’s college students: Challenges and recommendations. NASPA Journal, 41, 165–179.
Knox, K. L., Litts, D. A., Talcott, G. W., Feig, J. C., & Caine, E. D. (2003). Risk of suicide and related adverse outcomes after exposure to a suicide prevention programme in the U.S. air force: Cohort study. BMJ, 327, 1376–1378. doi:10.1136/bmj.327.7428.1376.
Lawrence, M. T., & Ureda, J. R. (1990). Student recognition of and response to suicidal peers. Suicide and Life-threatening Behavior, 20, 164–176.
Mackesy-Amiti, M. E., Fendrich, M., Libby, S., Goldenberg, D., & Grossman, J. (1996). Assessment of knowledge gains in proactive training for postvention. Suicide and Life-threatening Behavior, 26, 161–174.
Mann, J. J., Apter, A., Bertolote, J., Beautrais, A., Currier, D., Haas, A., et al. (2005). Suicide prevention strategies: A systematic review. JAMA, 294, 2064–2074. doi:10.1001/jama.294.16.2064.
Organizational Research Services. (2002). Youth suicide prevention program. Annual evaluation report 2001-2002: Evaluation of program training workshops. Seattle., WA.: Author. Retrieved January 6, 2006, from http://www.yspp.org/aboutYSPP/reports/2001-2002Report.pdf.
Ross, C. P. (1980). Mobilizing schools for suicide prevention. Suicide and Life-threatening Behavior, 10, 239–243.
Shaffer, D., Garland, A., & Gould, M. (1988). Preventing teenage suicide: A critical review. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 675–687. doi:10.1097/00004583-198811000-00001.
Silverman, M. M., Meyer, P. M., & Sloane, F. (1997). The big ten student suicide study: A 10-year study of suicides on midwestern university campuses. Suicide and Life-threatening Behavior, 27, 285–303.
Stuart, C., Waalen, J. K., & Haelstromm, E. (2003). Many helping hearts: An evaluation of peer gatekeeper training in suicide risk assessment. Death studies, 27, 321–333. doi:10.1080/07481180302906.
Suicide Prevention Resource Center. (2004). Promoting mental health and preventing suicide in college and university settings. Newton, MA: Education Development Center.
The Jed Foundation. (2006). Framework for developing institutional protocols for the acutely distressed or suicidal college student. New York: Author.
Tierney, R. J. (1994). Suicide intervention training evaluation: A preliminary report. Crisis: The Journal of Crisis Intervention and Suicide, 15, 69–76.
Turley, B., & Tanney, B. (1998). Livingworks Australian field trial evaluation report on suicide intervention field trial Australia (SIFTA). Melbourne: LifeLine Australia.
United States Department of Education, National Center for Education Statistics. (2007). Digest of education statistics (NCES 2008-022). Retrieved July 1, 2008, from http://nces.ed.gov/programs/digest/d07/tables/dt07_182.asp.
United States Public Health Service. (1999). The surgeon general’s call to action to prevent suicide. Retrieved May 5, 2007, from http://mentalhealth.samhsa.gov/suicideprevention/calltoaction.asp.
Voelker, R. (2003). Mounting student depression taxing campus mental health services. JAMA, 286(16), 2055–2056. doi:10.1001/jama.289.16.2055.
Weitzman, E. R. (2004). Poor mental health, depression and associations with alcohol consumption, harm, and abuse in a national sample of young adults in college. Journal of Nervous and Mental Disease, 192, 269–277. doi:10.1097/01.nmd.0000120885.17362.94.
Westefeld, J. S., Button, C., Haley, J. T., Kettman, J. J., MacConnell, J., Sandil, R., et al. (2006). College student suicide: A call to action. Death Studies, 30, 931–956. doi:10.1080/07481180600887130.
Westefeld, J. S., Homaifar, B., Spotts, J., Furr, S., Range, L., & Werth, J. L. (2005). Perceptions concerning college student suicide: Data from four universities. Suicide and Life-threatening Behavior, 35, 640–645. doi:10.1521/suli.2005.35.6.640.
Wyman, P. A., Brown, C. H., Inman, J., Cross, W., Schmeelk-Cone, K., Guo, J., et al. (2008). Randomized trial of a gatekeeper program for suicide prevention: 1-year impact on secondary school staff. Journal of Consulting and Clinical Psychology, 76, 104–115.
Acknowledgments
This research was supported by a student/faculty collaborative research grant from Linfield College. This research was Jody Witt’s honor’s thesis, and a portion of the current study was previously presented at the meeting of the Association for a Psychological Science in May 2007. We gratefully acknowledge Nadia Abraibesh and Jee-Yeon Kim for their assistance with data collection and entry. We also thank Christina Ries and Kristen Michael for providing the QPR training. Finally, we extend our deepest appreciation to the residence life administrators and staff members for their willingness to participate and help us understand the effectiveness of QPR.
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Tompkins, T.L., Witt, J. The Short-Term Effectiveness of a Suicide Prevention Gatekeeper Training Program in a College Setting with Residence Life Advisers. J Primary Prevent 30, 131–149 (2009). https://doi.org/10.1007/s10935-009-0171-2
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DOI: https://doi.org/10.1007/s10935-009-0171-2