Objectives: Patients with mental disorders (PMD) are at high risk of suicide, and family intervention is effective in preventing suicide of PMD. On the other hand, existing training programs only emphasize the role of the family and do not present specific contents. This review examines the components, problems, and improvement measures of gatekeeper training and proposes points to be considered in gatekeeper training programs for families in high-risk suicide groups (e.g., PMD). Methods: The review included 16 academic papers and research reports, and a literature search was conducted on the following websites: PubMed, APA PsycARTICLES, DBpia, and Korea Foundation for Suicide Prevention. Results: Most of the gatekeeper training was provided to the general public, and it can improve knowledge, attitude, self-efficacy, and behavioral intention for suicide prevention. Nevertheless, the training programs specialized for families of PMD and the effectiveness studies based on the randomized controlled trial were insufficient. Conclusion In the future, it will be necessary to develop customized training programs for participants who are closely related to high-risk suicide groups (e.g., families of PMD) and continue research on the effectiveness.

Objective: Given the high suicide risk among people with schizophrenia and other mental disorders and the significance of intervention in the daily life setting, tailored gatekeeper training is necessary for families of people with mental disorders. This study evaluated the effectiveness of a suicide prevention education program for families of people with mental disorders (SPEM-F), developed by the Korea Foundation for Suicide Prevention. Methods: Fifty-nine family members of people with mental disorders were recruited from eight community psychiatric rehabilitation centers in Korea and enrolled in a cluster randomized controlled trial. Four facilities were randomized to the experimental group (n=30) and four to the control group (n=29). The study parameters were measured at baseline, post-intervention, and 1-month follow-up; the effects of SPEM-F (90 minutes, conducted offline) were analyzed using repeated-measures analysis of variance. The dependent variables were suicide-related knowledge, attitude, self-efficacy, preventive behavioral intention, and family problem-solving communication. Results: The experimental group showed significant increases in suicide-related knowledge (p<0.001), self-efficacy (p<0.05), and preventive behavioral intention (p<0.01) compared with the control group until the 1-month follow-up, including an upward trend in improved family problem-solving communication (p=0.069). Conclusion The results confirm that SPEM-F is an effective evidence-based gatekeeper training program for families of people with mental disorders, as it focuses on knowledge, self-efficacy, preventive behavioral intention, and communication improvement. As families of people with mental disorders including schizophrenia, are both highly motivated and close to people at high risk for suicide, SPEM-F can effectively promote suicide prevention and gatekeeper activities.