Suicide Prevention Gatekeeper Training
Guidance Resource

Gatekeepers are people who can play a role in suicide prevention because of their primary contact with those who may be at risk of suicide. They can include people who are already formally trained to help others, like doctors, psychologists, or social workers. They can even include members of your community, like coaches, teachers, friends or family members.

Gatekeeper training refers to programs that seek to develop individuals' knowledge, attitudes and skills to identify those at risk of suicide and to respond effectively. Gatekeeper training is an important part of a multi-faceted plan for suicide prevention.

There have been many gatekeeper training programs developed to address the specific needs of different populations, so selecting the right option for you can at times seem overwhelming. This resource is intended to be a practical guide and a starting point to assist you in the selection of the best suicide prevention gatekeeper training program for you or your organization.

Key Considerations

Below you will find five key considerations for selecting an effective gatekeeper training program:

1) Ensuring the Program is Part of a Comprehensive Approach

  • No matter what program or approach you are using, any gatekeeper training must be part of a comprehensive approach to suicide prevention to be effective; it should not be used as a stand-alone approach. Suicide prevention requires a combination of efforts that work together to address different aspects of the problem.

2) Ensuring Program Fit with your Community

  • The most researched or most utilized program is not necessarily the best choice for your gatekeeper intervention. In order to determine fit, organizations should have a clear understanding of the cultural context and needs of their target population and compare that with the populations that have been studied, evaluated and researched for each program.

3) Integrating a Program with your Organization's History, Culture and Structure

  • There are a number of important community and organizational considerations that should be made when choosing a program, including whether or not there has been a history of suicide in the community, how well the training program aligns with the organization's values, the organization's time commitments and the organization's level of understanding of mental health and suicide. Consideration should also be given to the availability of the fiscal and human resources needed to train your organization.

4) Assessing a Program's Evidence Base

  • When gatekeeper training programs are referred to as evidence-based, it is important to look closely at what this means to those organizations, what evidence base they are using, what values are reflected and the contexts in which the intervention was studied or evaluated. When considering evidence-based programs, look for programs that have evidence related to the desired outcomes and priority populations in your organization or community.

5) Cultural Safety

  • Many cultural groups will differ in rates of suicidal behaviors, in the context within which suicidal behavior occurs, and in patterns of help seeking. Gatekeeper training programs are more likely to be effective if they are based on the values, needs and strengths of the groups you are trying to reach. Gatekeeper training should be respectful and responsive to the groups' beliefs, practices, and their cultural and linguistic needs and preferences.

Suicide Prevention Gatekeeper Training Program Listing

The following resource provides a summary listing of suicide prevention gatekeeper training programs. In tandem with the considerations above, this resource is intended to simplify the process of selecting the best suicide prevention gatekeeper training program for you, your organization or community.

The listing is organized by the target population that you are intending to help. It provides direct links to program websites and contains key information to help assess the program's suitability for your population and organization.

Please note that the program listing within this table is current as of October, 2018. Changes to these programs may have occurred since this date and additional programs may have been developed that are not included on this list. Please click on the headings below for more information.

Table Legend
  1. Organization and Program Information Link: This lists the program developer and provides a link to their website where information about key components of the program, including purpose, implementation, key learning objectives and outcomes can be found.
  2. Target Population: This identifies both the target audience to be trained, as well as the target audience to be helped.
  3. Adaptations: This identifies any adaptations that have been made to the program to reach a specific audience, including languages or cultural adaptations.
  4. Evaluations/Accreditations: This identifies relevant accreditations or evaluations conducted on, or received by, the program listed.
    • The Suicide Prevention Resource Center (SPRC) is used in this column as a benchmark. It is a well-established inventory and resource for suicide prevention strategies and programs.
    • In this column you will find one of three options for each program:
      • SPRC Program with Evidence of Effectiveness: These are programs that have been evaluated and found to result in at least one positive outcome related to suicide prevention.
      • SPRC Program with Adherence to Standards: These are programs that were listed in the previously SPRC Best Practices Registry (BPR), which served as a source of information on evidence-based programs. These programs were listed under Section III: Adherence to Standards. To be listed as such, program content was reviewed for adherence to standards of accuracy, safety, the likelihood of meeting objectives and program design.
        Note:  Outcome data (e.g., whether the program had evidence of effectiveness) were not a part of the BPR review process.
      • Not Listed in SPRC: These programs were not included in the registry. This may be because the program was never submitted or the program didn’t meet criteria.
    • For further reference and assessment of fit, this column contains links to other evaluations and relevant research.
General Population

Applied Suicide Intervention Skills Training (ASIST)

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

LivingWorks Education

Who is trained: Adults 16+

Who is helped: Youth, adults and older adults

Training is available in 22 countries and it is available in several languages, such as Spanish, Norwegian and French. The program can be culturally adapted.

SPRC Program with Evidence of Effectiveness

Related Publications:


Connect Suicide Prevention Intervention Training

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

NAMI New Hampshire

Who is trained: Adult community members and service providers

Who is helped: Individuals at risk for suicide

Special Populations: Indigenous peoples

Connect staff welcome collaboration with organizations and Indigenous communities to customize the training to be culturally effective.

SPRC Program with Adherence to Standards


Mental Health First Aid Basic

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Mental Health Commission of Canada

Who is trained: Adults

Who is helped: Adults

Several variations of the training are developed for First Nations, Inuit and Northern populations, youth, older adult and veteran populations.

SPRC Program with Evidence of Effectiveness

The program has been evaluated quite extensively in many different settings and contexts.

The extent to which the program has undergone independent evaluation is unclear.

Related Publications:

 
Psychological First Aid

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

National Child Traumatic Stress Network

Who is trained: Educators and adults

Who is helped: Students, adolescents, children and adults

Some models have been modified for special applications with children, older adults, and special needs survivor populations.

This is not listed in SPRC.

It is endorsed by many international organizations, including the World Health Organization.

Related Publications:

  • www.ncbi.nlm.nih.gov/pmc/articles/PMC5314921/
  • Fox J.H., Burkle, F.M., Bass J, Pia, F.A., Epstein, J.L. & Markenson, D. (2012). The effectiveness of psychological first aid as a disaster intervention tool: research analysis of peer-reviewed literature from 1990-2010. Disaster Medicine and Public Health Preparedness. 6(3), 247-52.

Question. Persuade. Refer. (QPR)

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

QPR Institute

Who is trained:  Adults

Who is helped: Individuals at risk for suicide

The QPR program has been culturally adapted for use with African American and Indigenous groups and for use in Australia and New Zealand.

SPRC Program with Evidence of Effectiveness

Related Publications:


STORM

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

STORM Skills Training

Who is trained: Adults

Who is helped: Individuals at risk of suicide

None are listed.

This is not listed in SPRC.

Related Publications:

  • Robinson J, Green G, Spittal M, Templer K, Bailey E. (2010). Impact and acceptability of delivering skills based training on risk management (STORM) in Australian secondary schools. Health Behaviour and Policy Review. 3(3), 259-268.
  • Gask G., Lever-Green G., & Hays R. (2008). Dissemination and implementation of suicide prevention training in one Scottish region. BMC Health Services Research. 8, 246.
  • Hayes A.J., Shaw, J., Lever-Green, G., Parker, D. & Gask L. (2008). Improvements to suicide prevention training for prison staff in England and Wales. Suicide and Life-Threatening Behavior. 38(6), 708-713.
  • Gask L., Dixon C., Morriss, R., Appleby, L., & Green, G. (2006). Evaluating STORM skills training for managing people at risk of suicide. Journal of Advanced Nursing. 54, 739-750.
  • Appleby, L., Morriss, R., Gask, L., Roland, M., Perry, B., Lewis, A., Battersby, L., Colbert, N., Green, G., Amos, T., Davies, L. & Faragher B. (2000). An educational intervention for front-line health professionals in the assessment and management of suicidal patients (The STORM Project).Psychological Medicine. 30(4), 805-812.
  • Morriss, R., Gask, L., Battersby, L.., Francheschini, A. & Robson M. (1999). Teaching front-line health and voluntary workers to assess and manage suicidal patients. Journal of Affective Disorders. 52, 77-83.
  • Gask, G., Green, G. & Coupe N. Evaluation of a National Dissemination across Scotland: utilising STORM® training as part of a National Suicide Prevention Training Strategy. Submitted.
  • Gask, G., Green, G. & Coupe N. Evaluation of suicide prevention gatekeeper training: utilising STORM® in a British university setting - in process.

SafeTALK

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

LivingWorks Education

Who is trained: Youth  ages 16+ and adults

Who is helped: Individuals with thoughts of suicide

Programs are available in various languages.

SPRC Program with Adherence to Standards

SafeTALK has been the subject of evaluation since 2007, including a school-based evaluation throughout Manitoba schools in 2017. This evaluation and others can be found here.

 
suicideTALK

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

LivingWorks Education

Who is trained: Individuals 15 or older

Who is helped: Individuals at risk of suicide

Programs are available in various languages.

This is not listed in SPRC.

 

Children

Assessing for Suicide in Kids (ASK)

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Lifeline Workshops Inc.

Who is trained: Individuals who come into regular contact with children ages 5-14

Who is helped: Children ages 5-14

Special Populations: Children

None are listed.

This is not listed in SPRC.

No evaluations or published research was found.


Little Cub

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Centre for Suicide Prevention

Who is trained: 18+ individuals working with Indigenous children
Who is helped: Indigenous children 12 years of age or younger who are at risk for suicide

None are listed.

This is not listed in SPRC.


Suicide Prevention: A Gatekeeper Training for School Personnel

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Riverside Trauma Center

Who is trained: Elementary and high school teachers, administrators and support staff

Who is helped: Children and youth

None are listed.

SPRC Program with Adherence to Standards


Tattered Teddies

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Centre for Suicide Prevention

Who is trained: Adults 18+

Who is helped: Children 12 and under

Special Populations: Children

No population or culture-specific adaptations of the intervention were identified.

This is not listed in SPRC.

No evaluations or published research was found.

 

Youth and Young Adults

Be a Link!

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Yellow Ribbon Suicide Prevention Program

Who is trained: Adults, community members and service providers

Who is helped: Youth at risk for suicide (10-18 years of age)

None are listed.

SPRC Program with Adherence to Standards

For additional research, see:


Connect Youth Leaders: Partnering with Adults in Youth Suicide Prevention

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

NAMI New Hampshire

Who is trained: Youth and adults

Who is helped: Youth

None are listed

SPRC Program with Adherence to Standards


Gryphon Place Gatekeeper Suicide Prevention Program-A Middle School Curriculum

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Gryphon Place

Who is trained: School administrators, faculty, staff and students

Who is helped: Middle school students

None are listed.

SPRC Program with Adherence to Standards


High School Gatekeeper Training

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Gryphon Place

Who is trained: High school students and teachers

Who is helped: Students at risk for suicide

None are listed.

SPRC Program with Adherence to Standards


Kognito At-Risk for College Students

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Kognito Interactive

Who is trained: College staff and students

Who is helped: Young adults 18 to 25

None are listed.

SPRC Program with Evidence of Effectiveness


Kognito At Risk for Middle School

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Kognito Interactive

Who is trained: Middle school teachers and staff

Who is helped:
Middle school students

Special Populations:
Evidence of effectiveness in Indigenous populations, but not fully adapted

Indigenous populations

SPRC Program with Adherence to Standards

Studies were conducted between 2011 and 2013.

For additional research, see:


Kognito At Risk for High School Educators

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Kognito Interactive

Who is trained: High school educators

Who is helped:
High school students

Special populations: Indigenous peoples

The program has shown promising results in Indigenous populations.

SPRC Program with Evidence of Effectiveness

Studies were reportedly conducted between 2011 and 2013.

For additional research, see:


Kognito: At Risk for Middle School Educators

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Kognito Interactive

Who is trained: Middle school educators and staff

Who is helped: Students at risk for suicide

None are listed.

SPRC Program with Adherence to Standards  


Let’s Talk Gatekeeper Training

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Massachusetts Department of Public Health

Who is trained: Foster parents and adults who care for children

Who is helped:  At-risk youth

Special populations:  Foster children

None are listed.

SPRC Program with Adherence to Standards

The program is endorsed by the State of Massachusetts.

Training content was developed through a review of the literature, key informant interviews, and a review of other suicide prevention trainings. Pilot trainings were conducted to refine the final product.


Lifelines Intervention: Helping Students At Risk for Suicide

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Hazelden Publishing

Who is trained: School resource staff

Who is helped: Middle and high school students at risk for suicide

Priority populations: Studies included predominately Caucasian individuals (95 per cent).

None are listed.

This is not listed in SPRC.


Making Educators Partners in Youth Suicide Prevention (ACT on FACTS)

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Society for the Prevention of Teen Suicide

Who is trained: School personnel

Who is helped: Youth

Priority populations: contain specific information on LGBT2SQ populations

None are listed.

SPRC Program with Adherence to Standards

Related Publications:


Mental Health First Aid for Adults who Interact with Youth

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Mental Health Commission of Canada

Who is trained: Adults

Who is helped: Youth

Several variations of the training are developed for First Nations, Inuit and Northern populations, youth, older adult and veteran populations.

This is not listed in SPRC.

Related Publications:

  • Clark J.C. (2009). A Quasi-Experimental Study of Mental Health First Aid Training -- Manitoba Community & Youth Corrections. Winnipeg, MB: Manitoba Youth Centre
  • Jorm A.F., Kitchener B.A., Sawyer, M.G., Scales
    H. & Cvetkovski, S. (2010). Mental health first aid training for high school teachers: A cluster randomized trial. BMC Psychiatry.10, 51.
  • Kelly C.M., Mithen J.M., Fischer, J.A., Kitchener
    B.A., Jorm A.F., Lowe, A. & Scanlan C. (2011). Youth mental first aid: A description of the program and an initial evaluation. International Journal of Mental
    Health Systems.5, 4

SOS Signs of Suicide Prevention Program

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Screening for Mental Health, Inc.

Who is trained: Middle and high school staff members

Who is helped: Middle and high school students

None are listed.

SPRC Program with Adherence to Standards

Screening for Mental Health® (SMH) developed the SOS Program in 2001. To create the online course, SMH staff worked with the Tufts University School of Medicine’s Health Care Institute.


Response

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

ColumbiaCare

Who is trained: High school staff, students and parents

Who is helped: Students at risk for suicide

The program has been customized for several states and can provide customized editions.

SPRC Program with Adherence to Standards

The program is the subject of Program Evaluation by Regional Research Institute at Portland State University.


Sources of Strength

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Sources of Strength

Who is trained: Youth and adults

Who is helped: Youth in schools or colleges, faith, cultural, and community-based settings, as well as for rural communities.

The program has been used in Indigenous communities and adapted for community agencies working with youth.

SPRC Program with Evidence of Effectiveness

Related Publications:

Wyman, P. A., Brown, C. H., LoMurray, M., Schmeelk-Cone, K., Petrova, M., Yu, Q., & Wang, W. (2010). An Outcome Evaluation of the Sources of Strength Suicide Prevention Program Delivered by Adolescent Peer Leaders in High Schools. American Journal of Public Health. 100, 1653-1661.

In 2010, Sources of Strength and the University of Rochester began a six-year randomized trial, using Sources of Strength with more than 40 high schools to measure the impact of 1,500 peer leaders on approximately 15,000 adolescents. This ongoing study is being funded by the National Institute of Mental Health (NIMH), as part of the National Peer Leadership Study.

Sources of Strength has engaged in additional research and evaluation efforts with Stanford University, Johns Hopkins University, University of Manitoba, and The Black Dog Institute in Australia. Over the past decade, Sources of Strength has become one of the most rigorously evaluated and researched programs in the world.


Suicide Prevention: A Gatekeeper Training for School Personnel

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Riverside Trauma Center

Who is trained: Elementary to high school teachers, administrators and support staff

Who is helped: Children and youth

None are listed.

SPRC Program with Adherence to Standards


Straight Talk

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Centre for Suicide Prevention

Who is trained: Individuals working with youth 12-18

Who is Helped: Youth 12-18

None are listed.

This is not listed in SPRC.


The Lifelines Curriculum

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Hazelden Publishing

Who is trained: School educators and staff

Who is helped: Middle and high school students

None are listed.

SPRC Program with Evidence of Effectiveness


Umatter for Schools Suicide Prevention

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Center for Health and Learning

Who is trained: School staff and educators

Who is helped: Middle school and high school students

None are listed.

SPRC Program with Adherence to Standards

 

LGBT2SQ

Community Gatekeeper Training: Lesbian, Gay, Bisexual Transgender (LGBT2SQ) Older Adults & Suicide Prevention

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Crisis Support Services of Alameda County

Who is trained: Caregivers and service providers for LGBT2SQ older adults and community members

Who is helped: LGBT2SQ older adults

None are listed.

SPRC Program with Adherence to Standards


Kognito LGBTQ on Campus for Faculty and Staff

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Kognito Interactive

Who is trained: School staff and faculty

Who is helped: Students on campus

Special Populations: LGBT2SQ

None are listed.

SPRC Program with Adherence to Standards


Kognito Step In, Speak Up!

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Kognito Interactive

Who is trained: Teachers and staff

Who is helped: LGBT2SQ students

Special Populations: LGBT2SQ

None are listed.

SPRC Program with Evidence of Effectiveness


Suicide Prevention among LGBT Youth: A Workshop for Professionals who Serve Youth

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Suicide Prevention Resource Center

Who is trained: Adults and professionals who work with youth

Who is helped: LGBT2SQ  youth

None are listed.

SPRC Program with Adherence to Standards


Connect, Accept , Respond, Empower (CARE): How to Support LGBTQ Youth

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

The Trevor Project

Who is trained:     
• K-12 school staff and educators
• Higher education staff and faculty
• Health professionals

Who is helped: LGBT2SQ+* youth and young adults

LGBT2SQ populations

This is not listed in SPRC.

No published studies were found.

 

Veterans

Mental Health First Aid Veteran Community

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Mental Health Commission of Canada

Who is trained: Veterans, former Royal Canadian Mounted Police members, health care providers, service providers of veteran services, family members and concerned community members

Who is helped: Veterans and their primary supports

Several variations of the training are developed for First Nations, Inuit and Northern populations, youth, older adult and veteran populations.

This is not listed in SPRC.

Mohatt N.V., Boeckmann R., Winkel N., Mohatt, D.F. & Shore, J. (2017) Military mental health first aid: Development and preliminary efficacy of a community training for improving knowledge, attitudes, and helping behaviors. Military medicine. 18.

 

Older Adults

Mental Health First Aid Seniors

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Mental Health Commission of Canada

Who is trained: Adults

Who is helped: Older adults

Several variations of the training are developed for First Nations, Inuit and Northern populations, youth, and older adult and veteran populations.

This is not listed in SPRC.

No published studies were found.

 

Indigenous Peoples

Kognito At Risk for Middle School

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Kognito Interactive

Who is trained: Middle school teachers and staff

Who is helped:
Middle school students

Special Populations:
Evidence of effectiveness in Indigenous populations, but not fully adapted

Indigenous populations

SPRC Program with Adherence to Standards

Studies were conducted between 2011 and 2013.

For additional research, see:


Kognito At Risk for High School Educators

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Kognito Interactive

Who is trained: High school educators

Who is helped:
High school students

Special populations: Indigenous peoples

The program has shown promising results in Indigenous populations.

SPRC Program with Evidence of Effectiveness

Studies were reportedly conducted between 2011 and 2013.

For additional research, see:


Mental Health First Aid Inuit

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Mental Health Commission of Canada

Who is trained: Inuit adults or adults who work with Inuit

Who is helped: Inuit peoples

Several variations of the training are developed for First Nations, Inuit and Northern populations, youth, and older adult and veteran populations.

This is not listed in SPRC.

No published studies were found.


Mental Health First Aid First Nations

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Mental Health Commission of Canada

Who is trained: Adults in First Nations communities

Who is helped: First Nations individuals

Several variations of the training are developed for First Nations, Inuit and Northern populations, youth, and older adult and veteran populations.

This is not listed in SPRC.

No published studies were found.


Mental Health First Aid Northern Peoples

Organization and Program Information Link

Target Population

Adaptations

Evaluations and Accreditations

Mental Health Commission of Canada

Who is trained: Adults

Who is helped: Adults residing in Northern communities

Several variations of the training are developed for First Nations, Inuit and Northern populations, youth, and older adult and veteran populations.

This is not listed in SPRC.

No published studies were found.