Moving beyond gatekeeping: Increasing community capacity to prevent suicide on their own terms

Youth suicide is a significant problem particularly for Indigenous populations which have extremely high rates of suicide and suicidal behavior. One prevalent approach to prevention is gatekeeper training, a strategy to encourage early identification and referral of potentially suicidal youth to mental health services. Gatekeeper training is currently utilized in most of the federally-funded youth suicide prevention programs in the nation. The presentation will critically examine the basic content and educational strategies used in gatekeeper training models, and specifically describe some limitations for use in rural American Indian and Alaska Native (AI/AN) communities. The presentation, then, will describe the theoretical underpinnings, curriculum and sequenced process of Professional-Community Collaborations for At-Risk (youth) Engagement and Support (P-C CARES), an innovative approach to community capacity building to prevent suicide in Native communities. In PC-CARES, lay health providers and mental health clinicians work together to deliver key information, thus deepening the linkages between clinical and community-based services. Main content of PC-CARES is facilitated through storytelling about personal experiences, thus promoting engaged learning. Because much of the content comes from participants' experiences, it is also more likely to be culturally relevant and applicable to daily life. PC-CARES holds much promise for delivering an empowering community training to enhance everyday social support as well as promote suicide prevention in Native and other marginalized communities.