Gatekeeper training and access to mental health care at universities and colleges
Open accessAbstract
Purpose Gatekeeper training (GKT) programs are an increasingly popular approach to addressing access to mental health care in adolescent and young adult populations. This study evaluates the effectiveness of a widely used GKT program, Mental Health First Aid, in college student populations.Methods A randomized control trial was conducted on 32 colleges and universities between 2009 and 2011. Campus residence halls were assigned to the intervention (Mental Health First Aid plus pre-existing trainings) or control condition (pre-existing trainings only) using matched pair randomization. The trainings were delivered to resident advisors (RAs). Outcome measures include service utilization, knowledge and attitudes about services, self-efficacy, intervention behaviors, and mental health symptoms. Data come from two sources: (1) surveys completed by the students (resident advisors and residents; N = 2,543), 2-3 months pre- and post-intervention; and (2) utilization records from campus mental health centers, aggregated by residence.Results The training increases trainees' self-perceived knowledge (regression-adjusted effect size [ES] = .38, p < .001), self-perceived ability to identify students in distress (ES = .19, p = .01), and confidence to help (ES = .17, p = .04). There are no apparent effects, however, on utilization of mental health care in the student communities in which the trainees live.Conclusions Although GKT programs are widely used to increase access to mental health care, these programs may require modifications to achieve their objectives.
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There were two outlier studies at 6-month follow-up [44, 45]; removing these only slightly reduced the pooled effect size for confidence to d = 0.43 (95% CI: 0.30, 0.57).
“There were two outlier studies at 6-month follow-up [44, 45]; removing these only slightly reduced the pooled effect size to d = 0.43 (95% CI: 0.30, 0.57).”
From Systematic review and meta-analysis of Mental Health First Aid training: Effects on knowledge, stigma, and helping behaviour (2018) · cites this paper as [44]
The Results (Regression-adjusted intervention effects, primary outcomes; page not provided) report an effect on resident advisors’ confidence to help. But the Methods (Participants; page not provided) place the follow-up survey 2–3 months after training, not at six months. This paper does not establish that it was an outlier; the pooled effect after removing studies is the citing authors’ analysis, not a result attributed to this source. (LLM, conf=0.86)
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- Authors
- Lipson, S. K., Speer, N., Brunwasser, S., Hahn, E., & Eisenberg, D.
- Affiliations
- University of Michigan (US)
- University of Colorado Boulder (US)
- Vanderbilt University (US)
- Harvard University (US)
- Corresponding author
- Eisenberg, Daniel
- Venue
- Journal of Adolescent Health
- Publisher
- Elsevier BV
- Published
- 2014-11
- Volume
- 55
- Issue
- 5
- Pages
- 612-619
- ISSN
- 1054-139X (ISSN-L)
- PMC
- PMC4209329
- OpenAlex
- W2068767952
- Cited by
- 157
- References
- 22
- Citations by year
- 2026: 10 · 2025: 11 · 2024: 5 · 2023: 6 · 2022: 12 · 2021: 51 · 2020: 13 · 2019: 12 · 2018: 13 · 2017: 14 · 2016: 3 · 2015: 5 · 2014: 2
- FWCI
- 11.84
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Adolescent Health (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- AcademyHealth
- National Institutes of Health (5rc1mh089757-02)
- National Institute of Mental Health (1RC1MH089757-01, RC1 MH089757)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Keywords
- gatekeeper training, mental health first aid, university students, access to mental health care, resident advisors, university mental health services, service utilization, self-efficacy, adolescent and young adult mental health
- MeSH terms
- Adolescent, Adult, Mental Disorders, Communication, Counseling, Crisis Intervention, Female, Health Services Accessibility, Humans, Inservice Training, Male, Preventive Health Services, Problem-Based Learning, Gatekeeping, Young Adult
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