Key Components and Barriers in Online Suicide Prevention Gatekeeper Training: a Systematic Narrative Review (Preprint)

BACKGROUND Online gatekeeper training programs (GTPs) are increasingly used in suicide prevention to equip community members with the skills to identify and support individuals at risk. However, the design, delivery, and effectiveness of these digital interventions vary widely, and little is known about what makes them work. OBJECTIVE This systematic narrative review aims to identify the key components of and barriers to the design, delivery and usability of online GTPs. METHODS We systematically searched CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science to identify peer-reviewed articles published between 2000 and 2023 that involved online GTPs. We used a content analysis to identify key components and barriers to the delivery and receipt of the GTPs. RESULTS We reviewed 37 articles discussing 27 online GTPs. Key design considerations included ensuring accessibility, customizability, privacy, and long-term sustainability. Relevant content focused on didactic topics—including the role of gatekeepers and the available referral services and resources—and the development of essential gatekeeping skills and competencies. Identified pedagogical strategies comprised interactive learning activities, periodic knowledge checks, and the integration of reminders and booster sessions. Additionally, fostering a sense of community among participants and promoting trainees’ autonomy during the training process were highlighted as critical components of training delivery. CONCLUSIONS Online GTPs offer potential in suicide prevention. Future research should focus on the acceptability and feasibility of programs while also refining them for diverse populations. Such efforts can contribute to the evidence of GTPs’ role in comprehensive suicide prevention strategies.