Gatekeeper Training to Prevent Suicide in the Emergency Department and in Primary Care

Applied to suicide prevention, a gatekeeper is an individual who can recognize when a person is manifesting signs of psychological distress including depression and suicidal ideation, approach and talk with that person about concerns, and if necessary, make an effective referral to mental health support services. This chapter introduces the reader to new and innovative game-based simulation technology through which primary care professionals and emergency department personnel learn to effectively manage what can be difficult gatekeeper conversations with their patients. The simulations place users in an online environment where they practice role-plays with emotionally responsive virtual patients who have memory and personality and will react like real patients at risk for suicide. It is by practicing these role-plays, and receiving feedback from a virtual coach, that users gain the knowledge, skill, and self-efficacy to successfully apply evidence-based communication strategies such as motivational interviewing to become effective gatekeepers. The chapter overviews the advantages of utilizing virtual humans in role-plays, the learning model embedded into the Kognito conversation platform that drives the simulations, and the results of two outcome studies that examine efficacy.