Community-based suicide prevention training in regional and rural communities: An evaluation of training effectiveness.

To examine the immediate and longer term effectiveness and application of "gatekeeper" suicide prevention training for trainees from rural and regional communities.This study was conducted in the Illawarra and Shoalhaven regions of New South Wales, Australia.Participants were local community members who had completed Question, Persuade, and Refer suicide prevention training facilitated by Lifeline South Coast.Online surveys were completed by trainees prior to and at completion of gatekeeper training (n = 458).A follow-up survey comprising fixedand open-ended questions was completed by a subset of participants (n = 23).Outcome measures included suicide literacy, gatekeeper selfefficacy, and intention to intervene (pre-post training) and attitudes to suicide prevention, reluctance to intervene, gatekeeper self-efficacy, and skills application (at follow-up).Participation in gatekeeper training was associated with positive changes, with strong effect sizes in suicide literacy ( p < .001,partial η 2 = .15),gatekeeper self-efficacy ( p < .001,partial η 2 = .42),and intention to intervene ( p < .001,partial η 2 = .44),from prepost training.Over half (60.87%) of the trainees who completed the follow-up survey had applied gatekeeper skills at least once since completing the training, with 29.2% having applied the skills six or more times.This study contributes to a growing evidence base relating to the value and application of gatekeeper training, particularly in regional and rural settings where support and referral pathways for those at risk of suicide may be limited.Future studies that examine the effectiveness of community-based suicide prevention training programs in these settings over longer time periods are warranted.