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Cited by 127Suicide and Self-Harm StudiesGrief, Bereavement, and Mental HealthSchool Health and Nursing Education

Preventing adolescent suicide: A systematic review of the effectiveness and change mechanisms of suicide prevention gatekeeping training programs for teachers and parents

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Torok, M., Calear, A.L., Smart, A., Nicolopoulos, A., Wong, Q.·2019·Journal of Adolescence
DOI 10.1016/j.adolescence.2019.04.005
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Abstract

Introduction: Suicide is a leading cause of death in young people, which may in part be because young people are notoriously poor help‐seekers. Improving the identification of at‐risk young people and connecting them to appropriate help is needed to prevent suicide in adolescents. The aim of this study is to examine the effectiveness of suicide prevention gatekeeper programs for parents and teachers, which are designed to improve their ability to recognise and respond to risks so that they may intervene before crisis occurs. Methods: Academic databases and reference lists were searched for gatekeeper training programs involving teachers and parents, and which aimed to prevent youth suicide, between journal inception and May 2018. Information directly reporting on suicide literacy (knowledge, confidence, attitudes) and/or gatekeeper behaviours (identification, referral) was extracted and a qualitative synthesis was conducted. Results: Thirteen studies fulfilled inclusion criteria. Significant moderate‐to‐large intervention effects were reported for suicide literacy outcomes among teachers and parents, with the largest gains among those with lowest baseline scores. No improvements in identification and referral behaviors among gatekeepers were noted. A need to improve evaluation research designs and outcome measurements was evident. Conclusions: While gatekeeper programs lead to increased suicide literacy, there is little evidence for behavioural change. There is need to increase the reach and uptake of gatekeeper training by offering digital versions, which may lead to improved behavioural outcomes, and to employ targeted strategies to engage parents in this training as one of the most trusted sources of support for vulnerable youth.

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  • Gatekeeper training programs for parents and teachers show improvements in knowledge of gatekeepers but may not lead to behavior change that results in identification or referral of suicidal young people to further services.

    “Gatekeeper training programs for parents and teachers show improvements in knowledge of gatekeepers but may not lead to behavior change that results in identification or referral of suicidal young people to further services.158”

    From Suicide in young people: screening, risk assessment, and intervention (2023) · cites this paper as [158]

  • There is little evidence that Gatekeeper Training delivered to teachers and parents changes behaviour.

    “A systematic review of Gatekeeper Training delivered to teachers and parents showed that these interventions do improve suicide literacy but with little evidence of behaviour change (Torok 2019).”

    From Prevention of self-harm and suicide in young people up to the age of 25 in education settings (2024) · cites this paper as Torok 2019

  • Gatekeeper Training delivered to teachers and parents improves suicide literacy.

    “A systematic review of Gatekeeper Training delivered to teachers and parents showed that these interventions do improve suicide literacy but with little evidence of behaviour change (Torok 2019).”

    From Prevention of self-harm and suicide in young people up to the age of 25 in education settings (2024) · cites this paper as Torok 2019

  • For teachers, Torok and colleagues found no included studies reporting specific effects on attitudes towards suicide, but one study found parental attitudes improved between first and second assessment (d=0.21), though this was not maintained 2 months later.

    “For teachers, Torok and colleagues 126 found that none of the included studies reported specific effects for measures of attitudes towards suicide, but one study found that parental attitudes improved between the first and the second assessment (d=0•21), although the effect was not maintained 2 months later.”

    From The Lancet Commission on ending stigma and discrimination in mental health (2022) · cites this paper as [126]

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Authors
Torok, M., Calear, A. L., Smart, A., Nicolopoulos, A., & Wong, Q.
Affiliations
  • Black Dog Institute (AU)
  • Australian National University (AU)
Corresponding author
Torok, M.
ORCID
Venue
Journal of Adolescence
Publisher
Wiley
Published
2019-05
Volume
73
Issue
1
Pages
100-112
ISSN
  • 0140-1971 (ISSN-L)
  • 1095-9254
DOI
10.1016/j.adolescence.2019.04.005
OpenAlex
W2942755022
Cited by
127
References
42
Citations by year
2026: 22 · 2025: 27 · 2024: 20 · 2023: 20 · 2022: 17 · 2021: 15 · 2020: 6
FWCI
1.50
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Adolescence (publishedVersion)
  • PubMed (publishedVersion)
  • UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
Keywords
adolescent suicide prevention, suicide literacy, teachers, parents, help-seeking, suicide risk identification, referral behavior, digital interventions
MeSH terms
School Teachers, Suicide Prevention, Adolescent, Psychology, Adolescent, Female, Humans, Parents, Program Evaluation

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