Innovations in Community Helper Training: How to Improve Your Promotion, Adaptation, and Evaluation of Suicide Awareness Training in Your Community

Body of Abstract: Training Overview
Community Helper (Gatekeeper) training is not a new idea in suicide prevention, and multiple approaches have been described for adapting this training approach with the aim of addressing suicidality across populations. However, the effectiveness of gatekeeper-style trainings is mixed. Recent reviews suggest in many cases trainings have not been evaluated in ways (e.g., not having follow-up assessment of skills or assessing application of learning) that allow for determining their impacts. Suicide prevention trainings designed to promote basic risk identification and helping skills in broad groups of non-mental health professionals (e.g., school staff, military personnel) often document increases in knowledge, but evidence for these changes being sustained over time, and whether there are corresponding behavioral changes or increased identification of suicide risk, is not strong. One approach to strengthening this type of training is to increase the focus of training content on specific community member roles likely to encounter high risk populations. Additionally, training content can be thoughtfully adapted to better fit the targeted populations, in contrast with applying a generic gatekeeper-style training approach. To the extent that trainings address increasing trainees’ self-efficacy to engage individuals and decrease their reluctance to intervene, such trainings are more likely to lead to sustained changes in future suicide prevention behaviors.

In the context of a statewide initiative to expand the suicide prevention readiness and skills of community members functioning as Community Helpers, we worked with partners to identify customizations of an existing Community Helper training, Umatter. These changes were made in order to train specific participant roles and with the aim of benefitting previously identified (through epidemiological analysis) populations at elevated risk for suicide. The proposed session describes the overall strategy for improving and expanding the Community Helper trainings, including specifics on how the different trainees and target populations were identified, how the training model was adapted and delivered, and how the modified approach was promoted and spread across communities. The session will also present evaluation data reflecting the impacts of the training adaptations and describe how the findings were shared with key audiences. The session will conclude with an interactive discussion of the benefits and drawbacks of adapting Community Helper trainings and suggestions for making adaptations in other states and communities.

Background
As part of applying for and then implementing a Comprehensive Suicide Prevention grant from the US CDC, leadership in the state Departments of Mental Health and Health worked with community members, suicide prevention training providers, epidemiologists, evaluators, public health officials and others to identify priority populations for suicide prevention training efforts. In the context of this work, we discontinued using the term Suicide Prevention Gatekeeper Training based on feedback from community partners and Suicide Awareness and Support Training was adopted as a more respectful alternative. More recently we have transitioned to the term Community Helpers. The outcome of the collaborative planning process was a strategy that has been implemented over three years in which we worked with partners to adapt existing training approaches for the identified priority populations, and which will be described during the session.

Trainer Roles
Nick Nichols, MSW, coordinates Vermont’s Comprehensive Suicide Prevention grant and will be the primary presenter about the development and implementation of the Community Helper training strategy. Tom Delaney, PhD, will be the primary presenter describing the evaluation design and findings, and how the findings were communicated.

Key Training Content and Delivery
In the workshop participants will learn effective methods for: 1) promoting community helper training and making the case for expansion of this strategy, 2) adapting the training for different groups and populations, including gun owners, construction workers, farmers, LGBTQIA+. and refugee and immigrant communities, 3) helping community partners sustain knowledge and skills taught by the training, and 4) evaluating training effectiveness and demonstrating that that training helps people at risk get connected to suicide care. In the context of summarizing effective training efforts, the workshop will incorporate active learning techniques including informal polling, a think-pair-share exercise, and facilitated discussion to boost session participants’ engagement with the material. Participants will be encouraged to share their own experiences related to Community Helper training and have the opportunity to learn from other communities’ approaches to broad-based suicide prevention training efforts.

Data will be presented showing that among people trained during the initiative there was a high level of retention of suicide prevention-related knowledge and confidence over the six-month follow-up assessment period. Regarding the application of Community Helper training skills at six-months, 43% of trainees reported using what they learned to start conversations with individuals they were concerned might be at risk for suicide, and 36% reported having helped one or more people get connected to suicide prevention-related services since the training. Among those who reported starting conversations, when asked to estimate how many times they used those skills the answers ranged from once to more than 20 times, with the most frequent answer being twice. These findings and others will be shared, along with essential context about the training adaptations and groups of participants, as part of describing the impact of the training approach we implemented. Barriers related to collecting and interpreting evaluation findings on Community Helper trainings will also be explored. Towards the end of the session, we will briefly focus on strategies for sharing the evaluation findings using different channels to reach key audiences and stakeholders. The main outcome of the training will be that participants will emerge with information they can incorporate into developing or refining their own Community Helper initiatives.

Learning Objectives:

• Describe innovations in Community Helper (Gatekeeper) training approaches.
• Discuss how Community Helper trainings have been adapted for specific audiences.
• Assess the short- and medium-term effectiveness of Community Helper trainings for supporting training participants’ skills.