Contract grant sponsor: CIHR; contract grant number: #273657; contract grant sponsor: MHRC; contract grant number: #152348.
Prevention and Treatment
GATEKEEPER TRAINING FOR SUICIDE PREVENTION IN FIRST NATIONS COMMUNITY MEMBERS: A RANDOMIZED CONTROLLED TRIAL
Article first published online: 12 JUN 2013
© 2013 Wiley Periodicals, Inc.
Depression and Anxiety
Volume 30, Issue 10, pages 1021–1029, October 2013
How to Cite
Sareen, J., Isaak, C., Bolton, S.-L., Enns, M. W., Elias, B., Deane, F., Munro, G., Stein, M. B., Chateau, D., Gould, M. and Katz, L. Y. (2013), GATEKEEPER TRAINING FOR SUICIDE PREVENTION IN FIRST NATIONS COMMUNITY MEMBERS: A RANDOMIZED CONTROLLED TRIAL. Depress. Anxiety, 30: 1021–1029. doi: 10.1002/da.22141
Clinical Trial Registration Number: NCT01287416.
- Issue published online: 7 OCT 2013
- Article first published online: 12 JUN 2013
- Manuscript Accepted: 10 MAY 2013
- Manuscript Revised: 8 MAY 2013
- Manuscript Received: 24 JAN 2013
- CIHR. Grant Number: #273657
- MHRC. Grant Number: #152348
- suicide/self harm;
- clinical trials;
- life events/stress
Gatekeeper training aims to train people to recognize and identify those who are at risk for suicide and assist them in getting care. Applied Suicide Intervention Skills Training (ASIST), a form of gatekeeper training, has been implemented around the world without a controlled evaluation. We hypothesized that participants in 2 days of ASIST gatekeeper training would have increased knowledge and preparedness to help people with suicidal ideation in comparison to participants who received a 2-day Resilience Retreat that did not focus on suicide awareness and intervention skills (control condition).
First Nations on reserve people in Northwestern Manitoba, aged 16 years and older, were recruited and randomized to two arms of the study. Self-reported measures were collected at three time points—immediately pre-, immediately post-, and 6 months post intervention. The primary outcome was the Suicide Intervention Response Inventory, a validated scale that assesses the capacity for individuals to intervene with suicidal behavior. Secondary outcomes included self-reported preparedness measures and gatekeeper behaviors.
In comparison with the Resilience Retreat (n = 24), ASIST training (n = 31) was not associated with a significant impact on all outcomes of the study based on intention-to-treat analysis. There was a trend toward an increase in suicidal ideation among those who participated in the ASIST in comparison to those who were in the Resilience Retreat.
The lack of efficacy of ASIST in a First Nations on-reserve sample is concerning in the context of widespread policies in Canada on the use of gatekeeper training in suicide prevention.