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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*
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:Nicolas.Chauliac@ch-le-vinatier.fr (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.

Type
Original article
Copyright
Copyright © European Psychiatric Association 2016

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