An Evaluation of a Unique Gatekeeper Training for Suicide Prevention of College Students: Demonstrating Effective Partnering within Student Affairs

Abstract

For college students, suicide is the second leading cause of death resulting in over 1,100 student deaths per year (Center for Disease Control, 2009). Researchers from the American College Health Association (2011), assessed over 105,000 students across the United States, and found that almost 10% of students seriously contemplated suicide and 1.5% had made a suicide attempt in the past year. In addition, Hirch and Barton (2011) surveyed 439 college students and found that 46% of students reported past suicidal ideation, 10% reported making a past suicide attempt, and 2% reported that they might attempt suicide in the future (Hirsch & Barton, 2011). Thus, the development of suicide prevention programs on college campuses is an important and urgent task. Researchers have indicated that there are numerous risk factors linked to college student suicidal behavior including previous suicide attempts, history of depression or other mental illness, alcohol or drug use, stress, low self-esteem, academic problems, relationship issues, and loneliness (Center for Disease Control, 2009). Some students enter college with pre-existing mental health conditions, while others may develop risk factors during their time in college. Garlow et al. (2008) found an association between suicidal ideation, a history of suicidal acts, and depressive symptoms in college students. Specifically, individuals with more severe symptoms of depression were more likely to experience suicidal ideation. An association was also found between suicidal ideation and other internal distress such as anxiety, irritability, and rage (Garlow et al., 2008). College is a major transitional period, which may increase the likelihood for depressive symptoms and exposure to drugs and alcohol which are two major risk factors for suicide (Westefeld et al., 2006). Gatekeeper Suicide Prevention The problem of college student suicide has drawn national attention and encourages college mental health professionals to focus on suicide prevention and intervention. One type of prevention effort for at-risk students is the gatekeeper training method. Gatekeepers have primary contact with people at risk for suicide and identify them by recognizing suicidal risk factors. In essence, gatekeepers open the gate to assistance for people at risk for suicide (Gould & Kramer, 2001). Gatekeeper training programs aim to enhance recognition and referral by training staff at colleges and universities to help identify students at risk and refer these students to appropriate supportive services or counseling. Research on gatekeeper training programs for college students is limited. Findings from a recent study on gatekeeper skills of community members after a brief suicide prevention training program, indicated that 10% of participants met criteria for acceptable gatekeeper skills prior to the training compared to 54% of participants after training (Cross, Matthieu, Lezine, & Knox, 2010). According to Aseltine and Demartino (2004), youth who are suicidal may turn to their peers first for help, therefore gatekeeper prevention programs that teach peers how to recognize warning signs of suicide, deal effectively with a student in distress, and make appropriate referrals are important. The benefit of peers helping peers has been supported by research on peer health education programs on college campuses. There is significant support in the literature for the positive effects of peer health educators on college students in regards to making healthy decisions about alcohol and drug use, sex, nutrition and exercise, and mental health issues (Sloane & Zimmer, 1993; White, Park, Israel, & Cordero, 2009). Peer health educators have credibility from students and are therefore more likely to facilitate attitude and behavior changes, as well as, be able to understand the experiences of their fellow classmates (Sloane & Zimmer, 1993). In a systematic review of gatekeeper training programs, Isaac et al. …