JMIR Publications

ABSTRACT

Background:

Gatekeeper training teaches community members to identify individuals at-risk of suicide and assist them with help-seeking. A new online program (Recognise and Respond; R&R) was created to address the need for a program specific to the Australian context, in consultation with clinicians, researchers, and people with a lived experience of suicide.

Objective:

The primary objective was to examine the short- and medium-term impacts of the R&R gatekeeper training program on gatekeeper confidence to identify and support an individual experiencing thoughts of suicide. Secondary objectives were to examine the short-and medium-term impacts of the R&R program on gatekeeper attitudes towards suicide prevention and knowledge of appropriate responses to signs of suicide.

Methods:

A non-inferiority randomised controlled trial compared R&R with the ‘Question, Persuade, Refer’ (QPR) online program. 524 participants completed baseline and were randomised to receive access to either the R&R (n = 263) or QPR (n = 261) online programs. All outcomes were measured at baseline, post-intervention, and three-month follow-up via online surveys. The trial was conducted entirely online, with no face-to-face contact with participants. Data were analysed using mixed effects linear models.

Results:

Participants in both groups reported significant improvements in confidence across time indicating non-inferiority of the R&R program. Both groups showed significant improvements on attitudes and knowledge scores at post-intervention and follow-up, relative to baseline. Improvement in attitude scores between baseline and post-test were greater for the QPR group compared to the R&R group but not at follow-up. Gains at post-intervention were maintained at follow-up for both groups on all outcomes. There were no other between-group differences.

Conclusions:

The findings demonstrate that R&R is as effective as QPR online in improving gatekeeper confidence to identify and support someone having thoughts of suicide. Clinical Trial: This trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620000489998p).