Associate Professor Salem State University Salem, Massachusetts, United States
Abstract : Research Aims College is a high-risk time for suicide (Cramer et al., 2020; Mortier et al., 2017) and suicide rates have risen among college students in recent years (Cramer et al., 2020; Duffy et al., 2019). Issues that contribute to the high risk of suicide among college students include isolation, lack of faculty and staff training, and lack of knowledge about university resources and supports (Cramer et al., 2020). Leadership on college and university campuses have become increasingly concerned about the risk of suicide to their students and motivated to address this risk with new suicide prevention efforts (Allie et al., 2023; Cramer et al., 2020; Rompalo et al., 2021). College is an essential time for screening and connecting at-risk individuals to services (Hom et al., 2017), but stigma and lack of knowledge can hamper help-seeking behaviors (Cramer et al., 2020). Suicide prevention programs on college campuses can address these issues, increasing knowledge and skills about suicide, and lowering rates of suicidal thoughts and behaviors (Wolitzky-Taylor et al., 2019). Gatekeeper programs are a popular approach to do this work and have demonstrated effectiveness (Hill & McCray; 2024; Ross et al., 2023).
This project describes the evaluation of a new virtual gatekeeper course: SOS for Higher Education, based on the established SOS Signs of Suicide program (Aseltine et al., 2007; Schilling et al., 2016) designed for 6th-12th graders. This interactive course teaches students, faculty, and staff to recognize signs of psychological distress, connect with friends/peers in distress, and support their help-seeking efforts. This project explored the impact of the training, specifically examining preparation and self-efficacy to recognize, talk with, and support in help-seeking students experiencing psychological distress, including thoughts of suicide.
Methods SOS for Higher Education was initially offered as a virtual training on college and university campuses in August 2024. IRB approval was obtained for this research project. Participants complete a voluntary pretest and posttest immediately before and after the training, using a validated measure, the Gatekeeper Behavior Scale, which has high levels of internal consistency (Albright et al., 2016). This measure has three subscales: preparedness, likelihood, and self-efficacy.
Currently, 196 training participants have participated in this research project, but data is continually being collected and we will be able to report on a larger sample at AAS. The current sample consists of students (n=158) and faculty and staff (n=37). Participants were predominantly female (53.6%), with 15.3% male, and 2.6% nonbinary. Half were White (52.6%), with 9.7% Black, 5.6% Asian, 4.1% multiracial, and 1.0% Indigenous. Many preferred not to disclose gender (28.5%) or race (27.0%).
Results Before the training, most participants felt at least moderately prepared and confident to engage with a student in distress and support their help-seeking. However, there was a small group of participants who felt they were not well prepared to talk with a student in psychological distress (14.8%), did not feel confident that they knew where to refer a student for mental health support (11.5%), and didn’t feel confident in their ability to support a student’s help-seeking (13.5%). After the training, all these participants felt at least moderately prepared and confident to do this work. Compared to the pretest, more participants reported they were very likely to intervene with a student exhibiting psychological distress (29.6% vs. 61.2%, respectively) and recommend mental health support services to students in distress (56.1% vs. 70.6%, respectively). Three paired t-tests demonstrated significant increases in preparedness from pretest (mean = 19.14, SD=3.14) to posttest (mean = 22.88, SD=2.58) (t(136)=15.579, p< 001). Additionally, there was a significant increase in self-efficacy scores from pretest (mean =13.28, SD=2.19) to posttest (mean=14.80, SD=1.64) (t(152)=9.356, p<.001). Finally, there was a significant increase in likelihood scores from pretest (mean=671, SD=1.04) to posttest (mean = 7.43, SD=0.88) (t(161) = 9.872, p< 001).
Participant satisfaction with the training was high. Most of the participants reported the content was very (28.1%) or extremely (44.4%) helpful to them and the majority said they were very likely (27.0%) or extremely likely (48.0%) to use the content of the training to reach out to a student in distress. Open-ended responses supported these quantitative findings, with participants offering statements such as “very helpful,” “very informative,” “lovely examples of how to talk with students to show care and take action,” and “a great initiative.”
Conclusion In conclusion, these initial findings suggest high levels of acceptability for the training from students, faculty, and staff. Additionally, the training increases in preparation, confidence, and likelihood to intervene with a student experiencing psychological distress. Data collection will continue this academic year to increase the sample size and confirm the findings, but this initial data suggests that this training can be an important component of a public health approach to suicide prevention on college and university campuses (Cramer et al., 2020).
