QPR Gatekeeper Training for Suicide Prevention

QPR (Question, Persuade, and Refer) Gatekeeper Training for Suicide Prevention is a 1-2 hour educational program designed to teach lay and professional “gatekeepers” the warning signs of a suicide crisis and how to respond. Gatekeepers can include anyone who is strategically positioned to recognize and refer someone at risk of suicide (e.g., parents, friends, neighbors, teachers, coaches, caseworkers, police officers). The process follows three steps: (1) Question the individual’s desire or intent regarding suicide, (2) Persuade the person to seek and accept help, and (3) Refer the person to appropriate resources. Trainees receive a QPR booklet and wallet card as a review and resource tool that includes local referral resources.

The training is delivered in person by certified QPR gatekeeper instructors or online. Although the foundation for the QPR Gatekeeper Training for Suicide Prevention is the same for all audiences, the training can be customized for use with specific audiences in collaboration with the QPR Institute. Extended learning modules on specific topics are available to complement the basic 1-2 hour course.

Specialized modules exist for various frontline practitioners (e.g. law enforcement, first responders, medical professionals, corrections, individuals who work with veterans, and others). These courses are taught in classroom, online, or blended training formats and range from approximately 3-8 hours in length. Training hours, certificates, and CEs vary with each course. See the QPR website for details.

Designation as a “Program with Evidence of Effectiveness”

SPRC designated this intervention as a “program with evidence of effectiveness” based on its inclusion in SAMHSA’s National Registry of Evidence-Based Programs and Practices (NREPP).

Outcomes Reviewed (Overall Quality of Research Rating-scale of 0 to 4)*

1: Knowledge about suicide (2.6)

2: Gatekeeper self-efficacy (2.6)

3: Knowledge of suicide prevention resources (2.9)

4: Gatekeeper skills (2.8)

5: Diffusion of gatekeeper training information (2.5)

In the three studies reviewed by NREPP, the training was delivered to school staff; parents; and clinical providers and nonclinical staff from the U.S. Department of Veterans Affairs. Outcomes 1 and 2 were measured in all three studies reviewed, while outcomes 3, 4, and 5 were each measured in one study. 

Read more about this program’s ratings.

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* NREPP changed its review criteria in 2015. This program is a “legacy program,” meaning that it was reviewed under the pre-2015 criteria. The evidence for each outcome was reviewed and scored on a scale of 0-4, with 4 indicating the highest quality of evidence and 0 indicating very poor quality of evidence. The overall rating was based on ratings of six criteria: 1) reliability of measures, 2) validity of measures, 3) intervention fidelity, 4) missing data and attrition, 5) potential confounding variables, and 6) appropriateness of analysis. When considering programs, we recommend (a) assessing whether the specific outcomes achieved by the program are a fit for your needs; and (b) examining the strength of evidence for each outcome. 

Program Objectives

After minimum training, QPR participants should be able to:

1. Recognize someone at risk for suicide,
2. Intervene with those at risk; and,
3. Refer them to an appropriate resource.

After expanded training for various professions, additional objectives are included in each course. See the program website for details.

Implementation Essentials

• Training must be conducted by a certified QPR instructor or online by the QPR Institute.
• Training must include standardized PowerPoint slides, and distribution of the QPR Booklet and wallet card in hard copy or electronically.

2012 NSSP Objectives Addressed: 

Objective 7.1: Provide training on suicide prevention to community groups that have a role in the prevention of suicide and related behaviors.