The impact of the Garrett Lee Smith Youth Suicide Prevention Program

Analysis of evaluation data from Garrett Lee Smith (GLS) Memorial Youth Suicide Prevention Program grantees found that counties with GLS programs “had significantly lower suicide rates among the population aged 10 to 24 years the year after GLS training than similar counties.” The researchers calculated that GLS programs prevented 427 suicides between 2007 and 2010. The impact on suicide rates did not persist after one year. The authors suggest that this may have resulted from staff turnover, the need for refresher gatekeeper training, and the possibility that “adherence and focus on comprehensive programming may fade over time.”

The authors used gatekeeper training as a “time- and region-stable proxy for GLS suicide prevention program implementation” given that gatekeeper training “has been a core part of all GLS programs.” Suicide rates in counties in which GLS programs implemented gatekeeper training for the 10- to 24-year-old age group fell, on average, 1.33 deaths per 100,000. While inconclusive, there was evidence of a stronger effect on the 10- to 18-year-old age group. The reduction in rates increased with the number of gatekeepers trained. No corresponding declines in rates were found for adults.

The primary impact was in smaller and more rural counties. The authors suggest that it may be difficult for programs in larger urban communities to mount an effort commensurate to the number of youth in those areas. They also speculated that gatekeepers “may have been particularly effective in a context in which professional mental health support was less available, accessible, or socially acceptable.”

The authors suggest that, because GLS grantees implement “multifaceted community-based suicide prevention programs,” these findings “support gatekeeper practice guidelines that recommend implementing gatekeeper training sessions as part of a larger portfolio of suicide prevention strategies tailored specifically to reduce youth suicide in a particular community.”

This summary is from: Walrath, C., Garraza, L.G., Reid, H., Goldston, D.B., & McKeon, R. (2015). Impact of the Garrett Lee Smith Youth Suicide Prevention Program on suicide mortality. American Journal of Public Health 105(5), 986-993.

SPRC Commentary

This research provides evidence that supports the use of a comprehensive suicide prevention program as an important context for the success of gatekeeper training. It also demonstrates the importance of actively supporting implementation of prevention efforts (including refresher gatekeeper trainings). More information on a comprehensive approach to suicide prevention and choosing and implementing gatekeeper training programs can be found on the SPRC website.