title: Gatekeeper training and access to mental health care at universities and colleges.
abstract: OBJECTIVE
  Gatekeeper training (GKT) programs are an increasingly popular approach to addressing access to mental health care in adolescent and young adult populations. This study evaluates the effectiveness of a widely used GKT program, Mental Health First Aid, in college student populations.
  
  
  METHODS
  A randomized control trial was conducted on 32 colleges and universities between 2009 and 2011. Campus residence halls were assigned to the intervention (Mental Health First Aid plus pre-existing trainings) or control condition (pre-existing trainings only) using matched pair randomization. The trainings were delivered to resident advisors (RAs). Outcome measures include service utilization, knowledge and attitudes about services, self-efficacy, intervention behaviors, and mental health symptoms. Data come from two sources: (1) surveys completed by the students (resident advisors and residents; N = 2,543), 2-3 months pre- and post-intervention; and (2) utilization records from campus mental health centers, aggregated by residence.
  
  
  RESULTS
  The training increases trainees' self-perceived knowledge (regression-adjusted effect size [ES] = .38, p < .001), self-perceived ability to identify students in distress (ES = .19, p = .01), and confidence to help (ES = .17, p = .04). There are no apparent effects, however, on utilization of mental health care in the student communities in which the trainees live.
  
  
  CONCLUSIONS
  Although GKT programs are widely used to increase access to mental health care, these programs may require modifications to achieve their objectives.
authors.affiliation: Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan; Center for the Study of Higher and Postsecondary Education, University of Michigan School of Education, Ann Arbor, Michigan.
authors.forename: Sarah Ketchen
authors.initials: SK
authors.lastname: Lipson
authors.affiliation: Intermountain Neuroimaging Consortium, University of Colorado, Boulder, Colorado.
authors.forename: Nicole
authors.initials: N
authors.lastname: Speer
authors.affiliation: Vanderbilt University Kennedy Center, Vanderbilt University, Nashville, Tennessee.
authors.forename: Steven
authors.initials: S
authors.lastname: Brunwasser
authors.affiliation: Harvard Graduate School of Education, Cambridge, Massachusetts.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Hahn
authors.affiliation: Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan. Electronic address: daneis@umich.edu.
authors.forename: Daniel
authors.initials: D
authors.lastname: Eisenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D003142:Communication; D003376:Counseling / Q000193:education*; D003419:Crisis Intervention / Q000193:education*; D005260:Female; D020793:Gatekeeping; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D007318:Inservice Training / Q000379:methods*; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D011314:Preventive Health Services; D018794:Problem-Based Learning / Q000379:methods; D055815:Young Adult
keywords: College students; Gatekeeper training; Mental health