Background The outcomes of calling 911 for suicide crises remain largely unexplored. Aims To investigate how characteristics of individuals in a suicidal crisis (e.g., age, gender identity, help-seeking source, means, disclosure of historical suicidality, or self-harm) may differentiate outcomes when contacting 911. Method The authors analyzed 1,073 Washington State Police 911 call logs, coding for characteristics and outcome (unknown, monitoring, intervention, adverse outcome). Descriptive and inferential statistics, including multinomial logistic regressions, were used to explore associations. Results When individuals experiencing a suicidal crisis were referred by bystander or associates' observations, there was a greater likelihood of adverse outcome. Self-referral led to a greater likelihood of intervention. Referral from the suicidal individual contacting a known associate led to a greater likelihood of monitoring. Any disclosure of means led to a greater likelihood of intervention or adverse outcomes. Positive disclosure of historical suicidality or self-harm was more likely to result in monitoring. Limitations The dataset was intended for operational use in acute suicidality triage rather than research purposes. Conclusion This study highlights the importance of supporting first responders with research to enhance their triage of people experiencing suicidal crises.

Background: Suicide prevention gatekeeper training programs offer a unique opportunity to increase knowledge about suicide prevention, enhance risk identification, and reduce suicide-related stigma. Aims: This study evaluated the efficacy of an online suicide prevention gatekeeper training program in a randomized trial. Method: Participants were US college students (N = 388). Participants (69.3% women) had a mean age of 19.01 years and identified primarily as Hispanic/Latinx (52.1%) and non-Hispanic White (22.4%). Participants completed pre- and posttest surveys and were randomly assigned to either the ASK About Suicide to Save a Life (AS + K?) suicide prevention gatekeeper training program or an information-only comparison intervention. Results: Participants in the AS + K? condition reported significantly greater gatekeeper preparedness and self-efficacy, and lower stigmatized attitudes at posttraining, as compared with those in the comparison condition. There were no significant differences in likelihood of using gatekeeper skills or suicide-related knowledge across groups. Limitations: This short-term study was not able to assess behavioral change resulting in use of gatekeeper skills over time. Conclusions: Completion of gatekeeper training resulted in increases in preparedness and self-efficacy for engaging in gatekeeper behaviors, as well as a reduction in suicide-related stigma. Despite small intervention effects, the online AS + K? training appears to be a promising program.

Background: Linking college students with mental health services is critical, especially now, as many students report increased mental health concerns and suicidal ideation in the wake of COVID-19. The Suicide Prevention for College Student (SPCS) Gatekeepers Program provides student education and training to help link those in need with appropriate services. Aims: This study aimed to replicate and extend pilot study results by examining the effects of the training program across a larger, more diverse sample of students. Method: As part of three SAMHSA Mental Health and Training Grants, the program was implemented across three college campuses over three years. Results: At posttest, those who participated in the program demonstrated increased knowledge, suicide prevention self-efficacy, and decreased stigma towards suicide. A follow-up questionnaire revealed that students continued to demonstrate program gains 12 weeks after participating, but there was a slight decline in knowledge and self-efficacy between posttest and follow-up. Limitations: Attrition at follow-up should be addressed in future research, and reliability and validity of measures should be further assessed. Conclusion: This study provides support for the efficacy and generalizability of the SPCS Gatekeepers training program.