A Suicide Prevention Approach in an Urban American Indian Community: Gatekeeper Trainings for Community Members and Providers of Service

Background:

American Indian (AI) youth have suicide rates that are 62% above the national average for youth ages 10-25 in the United States. A comprehensive suicide prevention approach to this critical issue is needed. The SAMHSA funded “Manidookewigashkibjigan Sacred Bundle: R.E.S.P.E.C.T. Project,” is a collaboration, since 2011, between American Indian Health and Family Services in Detroit, MI, and the University of Michigan School of Social Work. One aim of the project is the provision of suicide gatekeeper trainings for community members and service providers to improve their ability to identify, manage and treat American Indian/Alaska Native (AI/AN) youth aged 10-24.

Methods: A total of 246 community members and service providers were trained from 2011 to 2014 in Applied Suicide Intervention Skills Training (ASIST) (N = 132); Question, Persuade, and Refer (QPR) (N =75); and Suicide Alertness for Everyone, Tell, Ask, Listen and Keepsafe (SafeTalk) (N = 39). In addition to the training we collected demographic data, job description and job role data. Also, pre and post surveys to assess suicide knowledge were completed. SPSS 24 was used to report on descriptives and frequencies of demographic data, and pre and post-test paired-samples t-tests to assess suicide knowledge.  

Results: We report on select demographic as well as job and role description data on participants. Of the gatekeepers 45 ASIST trainees were community members; of the QPR and ASIST trainees 49 were social workers, and 52 were students and youth. More detailed demographic information will be presented. We then present data on a subset of ASIST participants (n =32) who completed pre and post surveys. Preliminary subset data reveals that of the ASIST participants significant differences were found in the number of correct answers about suicide before (M = 5.37, SD = 1.04) and after the training (M = 6.63, SD = .84); t (26) = -4.46, p < .001; participants’ comfort discussing suicide with others before (M = 3.66, SD = .97) and after training (M = 4.5, SD = .57); t (31) = -5.91, p < .001; and participants’ sense of preparedness for intervening with suicidal youth before (M = 2.69, SD = 1.0) and after training (M = 4.375, SD = .71); t (31) = -9.27, p <.001. Results of all pre and post gatekeeper trainings will be presented.

Conclusions and Implications: Suicide gatekeeper trainings with both community members and providers of service for AI/AN populations do have an impact on the participants’ sense of comfort level when discussing suicide with others, and participants report feeling better prepared to intervene with at risk youth. Since 2014 additional SAMHSA funds have been awarded to provide additional gatekeeper trainings for both urban and tribal communities in Michigan as a prevention measure to reduce the rates of AI/AN suicide. This project was funded by the Substance Abuse and Mental Health Services Administration (Grant # 5U79SM060395-03), the Garrett Lee Smith State and Tribal Youth Suicide Prevention Grant.