Assessment of a Suicide Prevention Gatekeeper Training Program for Nursing Home Staff

Abstract

Introduction

Older adults have one of the highest age‐specific suicide rates in France, and the risk of suicide is higher for those living in nursing homes. The aim of our study was to assess the effectiveness of gatekeeper training for nursing home staff on the knowledge and stigmas towards suicidal crisis and the impact on suicidal behaviour rates.

Method

A total of 427 nursing or administrative staff from 110 nursing homes received gatekeeper training in the Hauts-de-France French region between September 2016 and June 2018. First, knowledge and stigmas on suicidal crisis were assessed through a pretest and posttest survey. Second, a retrospective survey was conducted to determine suicide behaviour rates before and after training in nursing homes. Then, changes between pre- and posttraining scores and suicide rates were evaluated with a paired samples T test and rate difference calculation (P value of <0.05 was considered statistically significant).

Results

A total of 315 trainees completed the questionnaires on knowledge and stigmas related to suicidal crisis, and we found a significant difference in the total scores (P < 0.01). Moreover, we found a significant decrease in the incidence of suicide attempts (SAs) after training (P = 0.002), but the incidence of deaths by suicide was not significantly different prior to and after the training course (P = 0.46).

Conclusion

We highlighted an improvement in knowledge and stigmas after training and a reduction in the rates of SAs with our gatekeeper suicide prevention program. Future research is needed to improve suicide prevention for nursing home residents.

Keywords

suicide prevention gatekeeper nursing home

Get full access to this article

View all access options for this article.

References

Fazel

Runeson

. Suicide. N Engl J Med. 2020;382(3):266-274. doi:10.1056/NEJMra1902944.

World Health Organization . WHO | National Suicide Prevention Strategies: Progress, Examples and Indicators. WHO; 2019. http://www.who.int/mental_health/suicide-prevention/national_strategies_2019/en/. Accessed February 2, 2020.

Centre for Epidemiology on Medical Causes of Death (CepiDc) . CépiDc; 2018. https://www.cepidc.inserm.fr/. Accessed February 2, 2020.

World Health Organization . WHO | Preventing Suicide: A Global Imperative. http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/. Accessed August 3, 2021.

Shah

Bhat

McKenzie

Koen

. Elderly suicide rates: cross-national comparisons and association with sex and elderly age-bands. Med Sci Law. 2007;47(3):244-252. doi:10.1258/rsmmsl.47.3.244.

Conwell

Duberstein

Caine

. Risk factors for suicide in later life. Biol Psychiatry. 2002;52:193-204. doi:10.1016/s0006-3223(02)01347-1.

Crestani

Masotti

Corradi

Schirripa

Cecchi

. Suicide in the elderly: A 37-years retrospective study. Acta Biomed. 2019;90(1):68-76. doi:10.23750/abm.v90i1.6312.

Fässberg

Cheung

Canetto

, et al. A systematic review of physical illness, functional disability, and suicidal behaviour among older adults. Aging Ment Health. 2016;20(2):166-194. doi:10.1080/13607863.2015.1083945.

Minayo

MC de S

Cavalcante

De Minayo

MCS

Cavalcante

. Suicide attempts among the elderly: A review of the literature (2002/2013). Cien Saude Colet. 2015;20(6):1751-1762. doi:10.1590/1413-81232015206.10962014.

10.

Muller

. 728 000 résidents en établissements d’hébergement pour personnes âgées en 2015 - Ministère des Solidarités et de la Santé; 2017. https://drees.solidarites-sante.gouv.fr/etudes-et-statistiques/publications/etudes-et-resultats/article/728-000-residents-en-etablissements-d-hebergement-pour-personnes-agees-en-2015. Accessed February 2, 2020.

11.

Mezuk

Kalesnikava

Jurgens

. Suicide Among older adults living in or transitioning to residential long-term care, 2003 to 2015. JAMA Netw open. 2019;2(6):e195627. doi:10.1001/jamanetworkopen.2019.5627.

12.

Mezuk

Lohman

Leslie

Powell

. Suicide risk in nursing homes and assisted living facilities: 2003-2011. Am J Public Health. 2015;105(7):1495-1502. doi:10.2105/AJPH.2015.302573.

13.

Murphy

Bugeja

Pilgrim

Ibrahim

. Suicide among nursing home residents in Australia: A national population-based retrospective analysis of medico-legal deah investigation information. Int J Geriatr Psychiatry. 2018;33(5):786-796. doi:10.1002/gps.4862.

14.

Levin

Wei

Akincigil

Lucas

Bilder

Crystal

. Prevalence and treatment of diagnosed depression among elderly nursing home residents in Ohio. J Am Med Dir Assoc. 2007;8(9):585-594. doi:10.1016/j.jamda.2007.07.010.

15.

Murphy

Bugeja

Pilgrim

Ibrahim

. Completed suicide among nursing home residents: a systematic review. Int J Geriatr Psychiatry. 2015;30(8):802-814. doi:10.1002/gps.4299.

16.

Beck

Davis

Frederick

, et al. Classification and nomenclature. In: Suicide Prevention in the Seventies. Resnik

HLP

Hathorne

, ed. 1972. https://www.suicideinfo.ca/resource/siecno-19841424/. Accessed January 25, 2020.

17.

Lapierre

Erlangsen

Waern

, et al. A systematic review of elderly suicide prevention programs. Crisis. 2011;32(2):88-98. doi: 10.1027/0227-5910/a000076.

18.

Mann

Apter

Bertolote

, et al. Suicide prevention strategies: a systematic review. JAMA. 2005;294(16):2064-2074. doi:10.1001/jama.294.16.2064.

19.

Zalsman

Hawton

Wasserman

, et al. Suicide prevention strategies revisited: 10-year systematic review. Lancet Psych. 2016;3(7):646-659. doi:10.1016/S2215-0366(16)30030-X.

20.

Chauliac

Leaune

Gardette

Poulet

Duclos

. Suicide prevention interventions for older people in nursing homes and long-term care facilities: A systematic review. J Geriatr Psychiatry Neurol. 2019;33(6):307-315. doi:10.1177/0891988719892343.

21.

Holmes

Clacy

Hermens

Lagopoulos

. The long-term efficacy of suicide prevention gatekeeper training: A systematic review. Arch Suicide Res. 2019;25(2):177-207. doi:10.1080/13811118.2019.1690608.

22.

Séguin

Terra

J-L

. Formation à l’intervention de crise suicidaire: manuel du formateur. Paris: Ministère de la santé et de la protection sociale; 2004.

23.

Notredame

CEE

Porte

Pauwels

Danel

Walter

Vaiva

. Le Questionnaire d’évaluation des connaissances sur le suicide (QECS). Eur Psychiatry. 2015;30(8):S139. doi:10.1016/j.eurpsy.2015.09.274.

24.

Batterham

Calear

Christensen

. The stigma of suicide scale. psychometric properties and correlates of the stigma of suicide. Crisis. 2013;34(1):13-21. doi:10.1027/0227-5910/a000156.

25.

Van Buuren

Groothuis-oudshoorn

. mice: Multivariate imputation by chained. J Stat Softw. 2011;45(3):1-67. doi:10.18637/jss.v045.i03.

26.

Ratedifference: Calculate incidence rate difference and its confidence in fmsb: Functions for Medical Statistics Book with some Demographic Data; 2022. https://rdrr.io/cran/fmsb/man/ratedifference.html. Accessed November 3, 2022.

27.

Public health code - Research involving Humans (Articles L1121-1 to L1128-12) - Légifrance. https://www.legifrance.gouv.fr/codes/section_lc/LEGITEXT000006072665/LEGISCTA000006154978/. Accessed November 3, 2022.

28.

Chauliac

Brochard

Payet

, et al. How does gatekeeper training improve suicide prevention for elderly people in nursing homes? A controlled study in 24 centres. Eur Psychiatry. 2016;37:56-62. doi:10.1016/j.eurpsy.2016.05.011.

29.

Ziervogel

Pfeiffer

Hegerl

. How effective is advanced training concerning depression and suicidality among the elderly? Results of a pilot study. Arch Suicide Res. 2005;9(1):11-17. doi:10.1080/13811110590512822.

30.

Matthieu

Swensen

. Suicide prevention training program for gatekeepers working in community hospice settings. J Soc Work End-of-Life Palliat Care. 2014;10(1):95-105. doi:10.1080/15524256.2013.877865.

31.

Litteken

Sale

. Long-term effectiveness of the question, persuade, refer (QPR) suicide prevention gatekeeper training program: Lessons from Missouri. Community Ment Health J. 2018;54(3):282-292. doi:10.1007/s10597-017-0158-z.

32.

Wyman

Brown

Inman

, et al. Randomized trial of a gatekeeper program for suicide prevention: 1-year impact on secondary school staff. J Consult Clin Psychol. 2008;76(1):104-115. doi:10.1037/0022-006X.76.1.104.

33.

Isaac

Elias

Katz

, et al. Gatekeeper training as a preventative intervention for suicide: a systematic review. Can J Psychiatry. 2009;54(4):260-268. doi: 10.1177/070674370905400407.

34.

Matthieu

Cross

Batres

Flora

Knox

. Evaluation of gatekeeper training for suicide prevention in veterans. Arch Suicide Res. 2008;12(2):148-154. doi:10.1080/13811110701857491.

35.

Cross

Seaburn

Gibbs

Schmeelk-Cone

White

Caine

. Does practice make perfect? A randomized control trial of behavioral rehearsal on suicide prevention gatekeeper skills. J Prim Prev. 2011;32(3-4):195-211. doi:10.1007/S10935-011-0250-Z.

36.

Cross

Matthieu

Cerel

Knox

. Proximate outcomes of gatekeeper training for suicide prevention in the workplace. Suicide Life Threat Behav. 2007;37(6):659-670. doi:10.1521/SULI.2007.37.6.659.

37.

Burnette

Ramchand

Ayer

. Gatekeeper training for suicide prevention: A theoretical model and review of the empirical literature. Rand Heal Q. 2015;5(1):16. http://www.ncbi.nlm.nih.gov/pubmed/28083369. Accessed June 2, 2021.

38.

Aseltine

DeMartino

. An outcome evaluation of the SOS suicide prevention program. Am J Public Health. 2004;94(3):446-451. doi:10.2105/AJPH.94.3.446.

39.

Gordana

Milivoje

. Suicide prevention program in the army of Serbia and Montenegro. Mil Med. 2007;172(5):551-555. doi:10.7205/MILMED.172.5.551.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.33 MB