QPR Instructor Tool Kit Addition January 2008

We are often asked, “Who should we train as Gatekeepers?”

As you know the literature regarding the potential role community Gatekeepers might play in reducing suicide attempts and completions has been summarized in the National Strategy for Suicide Prevention. These potential Gatekeepers include physicians, police officers, school teachers, case managers and many others. But who else should be trained?

Formal Support Network Gatekeepers
Each of us has both formal and informal support networks. Our formal support network includes those professionals with whom we interact around issues of health and well being whether these are physical, emotional or spiritual. These Gatekeepers would include our physician, dentist, pastor, or perhaps a job coach, therapist, mentor or personal trainer. Some of these support professionals assist us with health and health monitoring, while others may help us with emotional, psychological or spiritual needs. For example, a busy working executive’s formal support might his or her physician, business mentor and personal trainer whereas a soldier’s formal support might include his or supervisor, chaplain and unit medical professional.

Informal Support Networks
Informal support networks consist of those persons closest to us: family members, adolescent or adult children, close lifelong friends. As described by Kahn and Antonucci (1980), these “inner circle” relationships may change over the life span but they constitute our most important and stable source of social support. These intimate others may also be the ones most likely to recognize our distress and take positive action.

The Name-Generation Exercise
Sarason, Levin, Basham, & Sarason (1983) published a helpful paper to identify this “inner circle” of supporters who could become Gatekeepers. Called a “name-generation” exercise, any one of us can be asked just three questions to generate a QPR training list. The three questions are:

  1. Whom can you really count on to listen to you when you need to talk?
  2. Whom can you count on to console you when you are very upset?
  3. Whom could you really count on to help you out in a crisis situation, even though they would have to go out of their way to do so?

The short list of names generated by this survey will identify membership in the individual’s “inner circle” of informal support. This list is usually short, not long. Someone who cannot generate a single name may be dangerously isolated.

As an example, for frail older male veterans, Abbot et.al. (2007) found that, on average, only three names were generated by these questions. Sixty-three percent of older veterans identified these “inner circle” people as immediate family members, with a smaller percentage identifying “family and friends.” For most married, older, male veterans, the top names listed were wife, adult son or adult daughter.

Remember one of the slogans of the QPR Institute: “The person most likely to prevent your suicide is someone you already know.” In this regard, we are happy to report that in a recently published article about Gatekeeper training by Wendi Cross, Ph.D. and her colleagues at the University of Rochester (Cross, et.al. 2007), considerable diffusion of the QPR training-related information had occurred at six week follow-up. Discussion of the training was shared by trainees with coworkers (67%), spouse, significant other, partner (40%), friend, non-coworker (40%) and family member (33%), children (7%). QPR materials were also shared with others as above, but less frequently.

The point?

When you teach QPR to one person, you are also generating conversations about suicide and its prevention within that person’s “inner circle” and, hopefully, increasing the odds that should someone among those touched by your training become suicidal, someone close to them will know what to do.

Abbot, K.H., Stoller, E.P., & Rose, J.H. (2007). The structure and function of frail male veteran’s informal networks. J. Aging Health: 19, 757-777.

Cross, W., Matthieu, M.M., Cerel, J. & Knox, K.L. (2007). Proximate outcomes of a Gatekeeper training for suicide prevention in the workplace. Suicide and Life-Threatening Behavior 37, (6). 659-670.

Kahn, R.L., & Antonucci, T.C. (1980). Convoys over the life course: Attachment, roles and social support. In P.B. Baltes & O. Brim (Eds.), Life-span development and behavior (pp.253-286). New York: Oxford University Press.

Sarason, I., Levin, H., Basham, R.B., & Sarason, B. (1983). Assessing social support: The social support questionnaire. Journal of Personality and Social Psychology, 44, 127-139.