title: The need for a culturally-tailored gatekeeper training intervention program in preventing suicide among Indigenous peoples: a systematic review.
abstract: Suicide is a leading cause of death among Indigenous youth worldwide. The aim of this literature review was to determine the cultural appropriateness and identify evidence for the effectiveness of current gatekeeper suicide prevention training programs within the international Indigenous community.
  
  
  
  Using a systematic strategy, relevant databases and targeted resources were searched using the following terms: 'suicide', 'gatekeeper', 'training', 'suicide prevention training', 'suicide intervention training' and 'Indigenous'. Other internationally relevant descriptors for the keyword "Indigenous" (e.g. "Maori", "First Nations", "Native American", "Inuit", "Metis" and "Aboriginal") were also used.
  
  
  
  Six articles, comprising five studies, met criteria for inclusion; two Australian, two from USA and one Canadian. While pre and post follow up studies reported positive outcomes, this was not confirmed in the single randomised controlled trial identified. However, the randomised controlled trial may have been underpowered and contained participants who were at higher risk of suicide pre-training.
  
  
  
  Uncontrolled evidence suggests that gatekeeper training may be a promising suicide intervention in Indigenous communities but needs to be culturally tailored to the target population. Further RCT evidence is required.
authors: Rural Clinical School, School of Medicine, The University of Queensland, Toowoomba, QLD, Australia. b.nasir@uq.edu.au.
authors: Bushra Farah
authors: 0000-0002-8372-4877
authors: BF
authors: Nasir
authors: School of Psychology & Counselling, Queensland University of Technology, Brisbane, QLD, Australia.
authors: Leanne
authors: L
authors: Hides
authors: Rural Clinical School, School of Medicine, The University of Queensland, Toowoomba, QLD, Australia.|Departments of Psychiatry, Community Health & Epidemiology, Dalhouise University, Halifax, Canada.
authors: Steve
authors: S
authors: Kisely
authors: Rural Clinical School, School of Medicine, The University of Queensland, Toowoomba, QLD, Australia.|School of Rural Medicine, University of New England, Armidale, NSW, Australia.
authors: Geetha
authors: G
authors: Ranmuthugala
authors: Rural Clinical School, School of Medicine, The University of Queensland, Toowoomba, QLD, Australia.
authors: Geoffrey C
authors: GC
authors: Nicholson
authors: Rural Clinical School, School of Medicine, The University of Queensland, Toowoomba, QLD, Australia.
authors: Emma
authors: E
authors: Black
authors: Rural Clinical School, School of Medicine, The University of Queensland, Toowoomba, QLD, Australia.
authors: Neeraj
authors: N
authors: Gill
authors: Rural Clinical School, School of Medicine, The University of Queensland, Toowoomba, QLD, Australia.
authors: Srinivas
authors: S
authors: Kondalsamy-Chennakesavan
authors: Rural Clinical School, School of Medicine, The University of Queensland, Toowoomba, QLD, Australia.
authors: Maree
authors: M
authors: Toombs
mesh_terms: D006801:Humans; D001315:Australia; D002170:Canada; D054521:Cultural Competency / Q000193:education; D065246:Culturally Competent Care; D000092864:Suicide Prevention; D014481:United States; D000081034:Indigenous Peoples / Q000523:psychology
keywords: Gatekeeper training; Indigenous; Suicide; Suicide intervention; Suicide prevention