Gatekeeper training and access to mental health care at universities and colleges

Sarah Ketchen Lipson, Nicole Speer, Steven Brunwasser, Elisabeth Hahn, Daniel Eisenberg

Research output: Contribution to journalArticlepeer-review

63 Scopus citations


Purpose 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.

Original languageEnglish (US)
Pages (from-to)612-619
Number of pages8
JournalJournal of Adolescent Health
Issue number5
StatePublished - Nov 1 2014
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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