A contributing blog post from Victor Schwartz, Clinical Associate Professor of Psychiatry, NYU School of Medicine and Medical Director at The Jed Foundation
There is a real challenge in evaluating programs like gatekeeper training. The first issue is how to define success or impact of the program. The simplest measure would be that the people we are trying to train have learned what we wanted or expected. But let's say the training worked and the gatekeepers learned their lessons. We are then faced with a number of questions: did we train the correct people-the ones who are likely to see or be approached by students in distress? will what they learned translate into action when necessary? will the lessons be sustained over time?
Then another series of challenges: if we are focused on suicide prevention-an event with a fortunately low rate-how do you actually determine and prove successful impact? If you measure suicides on campus, it will take years of tracking to show anything close to statistical significance. If you measure other things, you might be presented with paradoxical responses-if the training worked well, you might hear about more problems and thus it appears the training made matters worse. It is very hard to find proxy measures that are meaningful and measurable.
Then, faced with products that in some case are quite expensive but are very hard to clearly evaluate, how do you determine if they are "worth it"? I believe that much of the data supporting the gatekeeper training products shows that people have learned the lessons intended to be taught. That is not nothing but.....
From a purely common sense point of view, I wonder whether intensive 1-2 day trainings with a strong suicide focus is the most effective way to teach this material. As an old therapist I find myself wondering whether less information, rather than more, and frequent reminders or recharges and reviews, especially in the context of real live events-may not be as or more effective than the intensive frontloaded approach. I used this approach with RA's and many gatekeeper staff for many years-give them the least possible info that would allow them to identify a risk, make sure they knew whom to call when concerned-and frequent refreshers and reviews-all as simple and brief as possible-during the course of the year. Also, my inclination was to downplay the focus on suicide-but instead to focus on how to tell you or your friend is in some kind of difficulty. what are generic signs of emotional trouble or crisis. I actually worry that for the layperson (and for many clinicians) if there is too much focus on suicide risk, the listeners' anxiety levels go up and they cannot hear what is being conveyed. To be clear- I am not suggesting the gatekeepers should not be taught how to ask about suicidality-I am suggesting that if the training is too suicide focused, we will miss many people who are in serious trouble and our trainees may have a harder time learning their lessons.
I have often said in the past that trainings need to evoke enough anxiety to draw the audience’s attention but not so much that they are too anxious to hear what you are saying.