GATEKEEPER TRAINING FOR SUICIDE PREVENTION IN FIRST NATIONS COMMUNITY MEMBERS: A RANDOMIZED CONTROLLED TRIAL

Background Gatekeeper training aims to train people to recognize and identify those who are at risk for suicide and assist them in getting care. A pplied S uicide I ntervention S kills T raining ( 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 R esilience R etreat that did not focus on suicide awareness and intervention skills (control condition). Methods First N ations on reserve people in N orthwestern M anitoba, 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 S uicide I ntervention R esponse I nventory, a validated scale that assesses the capacity for individuals to intervene with suicidal behavior. Secondary outcomes included self‐reported preparedness measures and gatekeeper behaviors . Results In comparison with the R esilience R etreat (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 R esilience R etreat . Conclusions The lack of efficacy of ASIST in a F irst N ations on‐reserve sample is concerning in the context of widespread policies in C anada on the use of gatekeeper training in suicide prevention .