Evaluating Suicide Prevention Gatekeeper Training in a Real-World Setting: Pre- and Post-Training Findings from an Academic Medical Center Implementing the Zero Suicide Framework

Arch Suicide Res. 2026 May 24:1-13. doi: 10.1080/13811118.2026.2675592. Online ahead of print.

ABSTRACT

BACKGROUND: Gatekeeper training is a widely endorsed strategy for suicide prevention education, yet its effectiveness in real-world healthcare settings remains underexplored. Within the Zero Suicide framework, training the healthcare workforce to recognize and respond to suicide risk is a key implementation component.

OBJECTIVE: This evaluation examined whether a suicide prevention gatekeeper training implemented at an academic medical center was associated with differences in self-perceived suicide prevention competencies among healthcare employees.

METHODS: Pre- and post-training questionnaires were administered to employees at University of Utah Health who participated in gatekeeper training between 2023 and mid-2025. A total of 1,658 completed questionnaires were analyzed, assessing self-reported competencies in suicide risk identification, referral knowledge, supportive listening, and comfort initiating conversations about suicide.

RESULTS: Results demonstrated statistically significant differences across all self-reported domains, with medium-to-large effect sizes for referral knowledge and warning sign recognition. Differences were consistent across years and among both patient-facing and non-patient-facing staff.

CONCLUSION: Findings suggest higher self-perceived suicide prevention competencies in post-training responses within a large real-world healthcare system setting. These results support the role of workforce training as a core component of the Zero Suicide framework. Future research should incorporate longitudinal designs and objective behavioral measures to assess sustained impact and inform best practices.

PMID:42177782 | DOI:10.1080/13811118.2026.2675592