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How does gatekeeper training improve suicide prevention for elderly people in nursing homes? A controlled study in 24 centres

Published online by Cambridge University Press:  23 March 2020

N. Chauliac ,
N. Brochard ,
C. Payet ,
Y. Margue ,
P. Bordin ,
P. Depraz ,
A. Dumont ,
E. Kroupa ,
M. Pacaut-Troncin  and
P. Polo
...Show all authors
N. Chauliac*
Affiliation:
Centre de Prévention du Suicide, Centre hospitalier le VinatierBron69500, France Université de Lyon, Health Services and Performance Research Lab (HESPER) EA 7425Lyon69003, France
N. Brochard
Affiliation:
Centre de Prévention du Suicide, Centre hospitalier le VinatierBron69500, France
C. Payet
Affiliation:
Université de Lyon, Health Services and Performance Research Lab (HESPER) EA 7425Lyon69003, France Hospices Civils de Lyon, Pôle Information Médicale Evaluation RechercheLyon69003, France
Y. Margue
Affiliation:
Agence Régionale de Santé, Lyon, France
P. Bordin
Affiliation:
Centre de Prévention du Suicide, Centre hospitalier le VinatierBron69500, France
P. Depraz
Affiliation:
Centre de Prévention du Suicide, Centre hospitalier le VinatierBron69500, France
A. Dumont
Affiliation:
Centre de Prévention du Suicide, Centre hospitalier le VinatierBron69500, France
E. Kroupa
Affiliation:
Centre de Prévention du Suicide, Centre hospitalier le VinatierBron69500, France
M. Pacaut-Troncin
Affiliation:
Centre de Prévention du Suicide, Centre hospitalier le VinatierBron69500, France
P. Polo
Affiliation:
Centre de Prévention du Suicide, Centre hospitalier le VinatierBron69500, France
S. Straub
Affiliation:
Centre de Prévention du Suicide, Centre hospitalier le VinatierBron69500, France
J. Boissin
Affiliation:
Centre hospitalier, Belleville-sur-Saône, France
C. Burtin
Affiliation:
Centre hospitalier, Belleville-sur-Saône, France
G. Montoya
Affiliation:
EHPAD La Salette, Bully, France
A. Rivière
Affiliation:
EHPAD Les Landiers, Bron, France
C. Didier
Affiliation:
EHPAD Les Landiers, Bron, France
C. Fournel
Affiliation:
EHPAD Les Verts Monts, Charly, France
C. Durand
Affiliation:
EHPAD Les Verts Monts, Charly, France
M. Barrellon
Affiliation:
EHPAD Le Vernon, Condrieu, France
O. Amigues
Affiliation:
EHPAD Saint Vincent, Givors, France
A. Brosson
Affiliation:
EHPAD Saint Vincent, Givors, France
E. Mahé
Affiliation:
EHPAD Château du Loup, Gleizé, France
O. Haxaire
Affiliation:
EHPAD Château du Loup, Gleizé, France
C. Bonnot
Affiliation:
Hôpital intercommunal, Grandris, France
M. Defaux
Affiliation:
EHPAD Saint Laurent, Lentilly, France
D. Rougier
Affiliation:
EHPAD Saint Laurent, Lentilly, France
A. Gaultier
Affiliation:
EHPAD Etoile du jour, Lyon, France
A. Gutierrez
Affiliation:
EHPAD Etoile du jour, Lyon, France
M. Pozo
Affiliation:
EHPAD Les Cristallines, France
V. Lefèvre
Affiliation:
EHPAD Les Cristallines, France
A. Nier
Affiliation:
EHPAD Madeleine Caille, France
S. Bolzan
Affiliation:
EHPAD Madeleine Caille, France
M. Liautaud
Affiliation:
EHPAD Saint Camille, France
S. Barbosa
Affiliation:
EHPAD public, Mornant, France
S. Garcia
Affiliation:
EHPAD public, Mornant, France
A. Anfreville
Affiliation:
EHPAD Claude Bernard, Oullins, France
S. Mazille
Affiliation:
EHPAD Claude Bernard, Oullins, France
C. Durantet
Affiliation:
EHPAD La Boissière, Saint-Igny-de-Vers, France
M. Morlon
Affiliation:
EHPAD Arc en ciel, Saint-Martin-en-Haut, France
C. Gaboriau
Affiliation:
Hôpital Local, Saint-Symphorien-sur-Coise, France
C. Halbert
Affiliation:
EHPAD Les Acanthes, Vaulx-en-Velin, France
M. Cholvy
Affiliation:
EHPAD Les Acanthes, Vaulx-en-Velin, France
P. Milinkovich
Affiliation:
EHPAD Saint François, Vernaison, France
L. Martin
Affiliation:
EHPAD Joseph Forest, Villefranche-sur-Saône, France
L. Maury-Abello
Affiliation:
EHPAD Joseph Forest, Villefranche-sur-Saône, France
B. Toulier
Affiliation:
EHPAD Château Gaillard, Villeurbanne, France
V. Kerleguer
Affiliation:
EHPAD Château Gaillard, Villeurbanne, France
S. Gabriel
Affiliation:
EHPAD Eloise, France
A. Duclos
Affiliation:
Université de Lyon, Health Services and Performance Research Lab (HESPER) EA 7425Lyon69003, France Hospices Civils de Lyon, Pôle Information Médicale Evaluation RechercheLyon69003, France
J.-L. Terra
Affiliation:
Centre de Prévention du Suicide, Centre hospitalier le VinatierBron69500, France Université Claude Bernard Lyon 1, Equipe d’Accueil 4129 Laboratoire P2S Parcours Santé SystémiqueLyon69003, France
*
* Corresponding author. Service hospitalo-universitaire du pôle Ouest, CH le Vinatier, BP 30039, 69678 Bron cedex, France. Tel.: +33 43791 5120/+33 43791 5586; fax: +33 43791 5122. E-mail address:[email protected] (N. Chauliac).
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Abstract

Background

The death rate due to suicide in elderly people is particularly high. As part of suicide selective prevention measures for at-risk populations, the WHO recommends training “gatekeepers”.

Methods

In order to assess the impact of gatekeeper training for members of staff, we carried out a controlled quasi-experimental study over the course of one year, comparing 12 nursing homes where at least 30% of the staff had undergone gatekeeper training with 12 nursing homes without trained staff. We collected data about the residents considered to be suicidal, their management further to being identified, as well as measures taken at nursing home level to prevent suicide.

Results

The two nursing home groups did not present significantly different characteristics. In the nursing homes with trained staff, the staff were deemed to be better prepared to approach suicidal individuals. The detection of suicidal residents relied more on the whole staff and less on the psychologist alone when compared to nursing homes without trained staff. A significantly larger number of measures were taken to manage suicidal residents in the trained nursing homes. Suicidal residents were more frequently referred to the psychologist. Trained nursing homes put in place significantly more suicide prevention measures at an institutional level.

Conclusions

Having trained gatekeepers has an impact not only for the trained individuals but also for the whole institution where they work, both in terms of managing suicidal residents and routine suicide prevention measures.

Keywords

Suicide preventionGeriatric psychiatry and agingQuality of careGatekeeperNursing homeControlled study
Type
Original article
Information
European Psychiatry , Volume 37 , September 2016 , pp. 56 - 62
Copyright
Copyright © European Psychiatric Association 2016

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References

World Health, Organization, Preventing suicide: A global imperative. WHO 2015 http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/ (accessed January 8, 2015)Google Scholar
Eurostat, Suicide death rate, by age group 2013 http://ec.europa.eu/eurostat/tgm/refreshTableAction.do?tab=table&plugin=1&pcode=tsdph240&language=en (accessed April 6, 2013)Google Scholar
Institut National de la santé et de la recherche médicale (Inserm) le Centre d’épidémiologie sur les causes médicales de décès - CépiDC (Epidemiologic Center for Death Medical Causes) 2015 http://www.cepidc.inserm.fr/site4/ (accessed August 20, 2015)Google Scholar
Prévot, JLes résidents des établissements d’hébergement pour personnes âgées en 2007 Direction de la recherche, des études, de l’évaluation et des statistiques (DREES) Ministère du Travail, des Relations sociales, de la Famille, de la Solidarité et de la Ville Ministère de la Santé et des Sports Ministère du Budget, des Comptes publics, de la Fonction publique et de la Réforme de l’État; 2009Google Scholar
Casadebaig, FRuffin, DPhilippe, ASuicide in the elderly at home and in retirement homes in France. Rev Epidemiol Sante Publ 2003; 51: 55–64Google ScholarPubMed
Franc, RFaisant, CNacache, LRichez, AMoron, PLa maison de retraite, lieu de suicide ou lieu de prévention ?. Psychol Med 1993; 25: 316–319Google Scholar
Mezuk, BRock, ALohman, MCChoi, MSuicide risk in long-term care facilities: a systematic review Int J Geriatr Psychiatry 2014; 29, 1198–211 10.1002/gps.4142CrossRefGoogle ScholarPubMed
Murphy, BJBugeja, LPilgrim, JIbrahim, JECompleted suicide among nursing home residents: a systematic review. Int J Geriatr Psychiatry 2015; 30: 802–814http://dx.doi.org/10.1002/gps.4299CrossRefGoogle ScholarPubMed
Scocco, PRapattoni, MFantoni, GGaluppo, MDe Biasi, Fde Girolamo, Get al.Suicidal behaviour in nursing homes: a survey in a region of north-east Italy. Int J Geriatr Psychiatry 2006; 21: 307–311http://dx.doi.org/10.1002/gps.1452CrossRefGoogle Scholar
Draper, BMSuicidal behaviour and suicide prevention in later life. Maturitas 2014; 79: 179–183http://dx.doi.org/10.1016/j.maturitas.2014.04.003CrossRefGoogle ScholarPubMed
Lapierre, SErlangsen, AWaern, MDe Leo, DOyama, HScocco, Pet al.A systematic review of elderly suicide prevention programs. Crisis 2011; 32: 88–98http://dx.doi.org/10.1027/0227-5910/a000076CrossRefGoogle ScholarPubMed
World Health, Organization, Public health action for the prevention of suicide: a framework Geneva, Switzerland: World Health Organization; 2012Google Scholar
Snyder, JAThe use of gatekeepers in crisis management. Bull Suicidol 1971; 8: 39–44Google Scholar
Knox, KLLitts, DATalcott, GWFeig, JCCaine, EDRisk of suicide and related adverse outcomes after exposure to a suicide prevention programme in the US Air Force: cohort study. BMJ 327 2003 1376 10.1136/bmj.327.7428.1376CrossRefGoogle ScholarPubMed
Mann, JJSuicide prevention strategies: a systematic review. JAMA J Am Med Assoc 2005; 294: 2064–2074http://dx.doi.org/10.1001/jama.294.16.2064CrossRefGoogle ScholarPubMed
Walker, BLOsgood, NJPreventing suicide and depression: a training program for long-term care staff. OMEGA. J Death Dying 2001; 42: 55–69http://dx.doi.org/10.2190/73TM-4X4W-RG2P-YHEWCrossRefGoogle Scholar
Ziervogel, APfeiffer, THegerl, UHow effective is advanced training concerning depression and suicidality among the elderly? Results of a pilot study. Arch Suicide Res Off J Int Acad Suicide Res 2005; 9: 11–17http://dx.doi.org/10.1080/13811110590512822CrossRefGoogle ScholarPubMed
Séguin, MTerra, J.-L.Formation à l’intervention de crise suicidaire : manuel du formateur Paris: Ministère de la santé et de la protection sociale; 2004Google Scholar
New South Wales, Department of Health New South Wales, Department of Health, Suicide prevention for older people early intervention, assessment and referral options for staff working with older people who may be at risk of suicide: training manual North Sydney, NSW: NSW Dept. of Health; 2003Google Scholar
Cross, WMatthieu, MMCerel, JKnox, KLProximate outcomes of gatekeeper training for suicide prevention in the workplace. Suicide Life Threat Behav 2007; 37: 659–670http://dx.doi.org/10.1521/suli.2007.37.6.659CrossRefGoogle ScholarPubMed
Katz, SFord, ABMoskowitz, RWJackson, BAJaffe, MWStudies of illness in the aged: the index of ADL: a standardized measure of biological and psychosocial function. JAMA 1963; 185: 914–919http://dx.doi.org/10.1001/jama.1963.03060120024016CrossRefGoogle ScholarPubMed
Hoyl, MTAlessi, CAHarker, JOJosephson, KRPietruszka, FMKoelfgen, Met al.Development and testing of a five-item version of the Geriatric Depression Scale J Am Geriatr Soc 1999; 47: 873–878CrossRefGoogle ScholarPubMed
Sheikh, JYesavage, JGeriatric Depression Scale (GDS): Recent evidence and development of a shorter versionTerry, LBrink, Clin. Gerontol. Guide Assess. Interv. New York: Haworth Press; 1986.165–173Google Scholar
Yesavage, JABrink, TLRose, TLLum, OHuang, VAdey, Met al.Development and validation of a geriatric depression screening scale: a preliminary report J Psychiatr Res 1982; 17: 37–49CrossRefGoogle ScholarPubMed
Lancaster, PGMoore, JTPutter, SEChen, PYCigularov, KPBaker, Aet al.Feasibility of a web-based gatekeeper training: implications for suicide prevention. Suicide Life Threat Behav 2014; 44: 510–523http://dx.doi.org/10.1111/sltb.12086CrossRefGoogle ScholarPubMed
Harrod, CSGoss, CWStallones, LDiGuiseppi, CInterventions for primary prevention of suicide in university and other post-secondary educational settings. Cochrane Database Syst Rev 10 2014 CD009439 10.1002/14651858.CD009439.pub2Google Scholar
Guo, BHarstall, CFor which strategies of suicide prevention is there evidence of effectiveness? Copenhagen: WHO Regional Office for Europe; 2004Google Scholar
Harrod, CSGoss, CWStallones, LGliner, JADiGuiseppi, CInterventions for primary prevention of suicide in the post-secondary educational setting Cochrane Database Syst. Rev., John Wiley & Sons, Ltd; 1996Google Scholar
Bartsch, DARodgers, VKStrong, DOutcomes of senior reach gatekeeper referrals: comparison of the Spokane gatekeeper program. Colorado Senior Reach, and Mid-Kansas Senior Outreach. Care Manag J J Case Manag J Long Term Home Health Care 2013; 14: 11–20Google ScholarPubMed
Lipson, SKA comprehensive review of mental health gatekeeper-trainings for adolescents and young adults. Int J Adolesc Med Health 2014; 26: 309–320http://dx.doi.org/10.1515/ijamh-2013-0320CrossRefGoogle ScholarPubMed
Michelmore, LHindley, PHelp-seeking for suicidal thoughts and self-harm in young people: a systematic review. Suicide Life Threat Behav 2012; 42: 507–524http://dx.doi.org/10.1111/j.1943-278X.2012.00108.xCrossRefGoogle ScholarPubMed
Wasserman, CHoven, CWWasserman, DCarli, VSarchiapone, MAl-Halabí, Set al.Suicide prevention for youth - a mental health awareness program: lessons learned from the Saving and Empowering Young Lives in Europe (SEYLE) intervention study. BMC Public Health 12 2012 776 10.1186/1471-2458-12-776CrossRefGoogle ScholarPubMed
Pompili, MLester, DInnamorati, MDel Casale, AGirardi, PFerracuti, Set al.Preventing suicide in jails and prisons: suggestions from experience with psychiatric inpatients. J Forensic Sci 2009; 54: 1155–1162http://dx.doi.org/10.1111/j.1556-4029.2009.01122.xCrossRefGoogle ScholarPubMed
Isaac, MElias, BKatz, LYBelik, S.-L.Deane, FPEnns, MWet al.Gatekeeper training as a preventative intervention for suicide: a systematic review Can J Psychiatry Rev Can Psychiatr 2009; 54: 260–268CrossRefGoogle ScholarPubMed
Szanto, KKalmar, SHendin, HRihmer, ZMann, JJA suicide prevention program in a region with a very high suicide rate. Arch Gen Psychiatry 2007; 64: 914–920http://dx.doi.org/10.1001/archpsyc.64.8.914CrossRefGoogle Scholar
Caisse Nationale de Solidarité pour l’Autonomie (CNSA) Les soins en EHPAD en 2012 : le financement de la médicalisation et le bilan des coupes PATHOS; 2013Google Scholar
Brown, CHWyman, PABrinales, JMGibbons, RDThe role of randomized trials in testing interventions for the prevention of youth suicide. Int Rev Psychiatry Abingdon Engl 2007; 19: 617–631http://dx.doi.org/10.1080/09540260701797779CrossRefGoogle ScholarPubMed
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