RECHERCHE ETUDE FRANCE Comment la formation gatekeeper améliore la prévention du suicide pour les personnes âgées dans les maisons de soins infirmiers? Une étude contrôlée dans 24 centres

Original article
How does gatekeeper training improve suicide prevention for elderly people in nursing homes? A controlled study in 24 centres
N. Chauliac a, b, N. Brochard a, C. Payet b, c, The EGEE (Étude Gatekeepers en EHPAD) study group, A. Duclos b, c, J.-L. Terra a, d
a Centre de Prévention du Suicide, Centre hospitalier le Vinatier, 69500 Bron, France
b Université de Lyon, Health Services and Performance Research Lab (HESPER) EA 7425, 69003 Lyon, France
c Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, 69003 Lyon, France
d Université Claude Bernard Lyon 1, Equipe d’Accueil 4129 Laboratoire P2S Parcours Santé Systémique, 69003 Lyon, France
Corresponding author. Service hospitalo-universitaire du pôle Ouest, CH le Vinatier, BP 30039, 69678 Bron cedex, France. Tel.: +33 43791 5120/+33 43791 5586; fax: +33 43791 5122.
Received 22 January 2016, Revised 2 May 2016, Accepted 23 May 2016, Available online 20 August 2016
European Psychiatry Volume 37, September 2016, Pages 56–62


http://dx.doi.org/10.1016/j.eurpsy.2016.05.011

Comment la formation gatekeeper améliore la prévention du suicide pour les personnes âgées dans les maisons de soins infirmiers? Une étude contrôlée dans 24 centres

Contexte Le taux de décès dû au suicide chez les personnes âgées est particulièrement élevé. Dans le cadre des mesures sélective de prévention  du suicide pour les populations à risque, l'OMS recommande la formation gatekeeper.
Méthodes : Afin d'évaluer l'impact de la formation gatekeeper pour les membres du personnel, nous avons réalisé une étude contrôlée quasi-expérimentale  au cours d'une année, en comparant 12 maisons de soins infirmiers, où au moins 30% du personnel avait suivi une formation gatekeeper avec 12 maisons de soins infirmiers sans personnel formé.
Conclusions la formation gatekeeper a un impact non seulement sur les personnes formées, mais aussi pour toute l'institution où ils travaillent, tant en termes de gestion des résidents suicidaires que sur les mesures de prévention du suicide du quotidien.


Résumé original 
Abstract Background
The death rate due to suicide in elderly people is particularly high. As part of suicide selective prevention measures for at-risk populations, the WHO recommends training “gatekeepers”.
Methods

In order to assess the impact of gatekeeper training for members of staff, we carried out a controlled quasi-experimental study over the course of one year, comparing 12 nursing homes where at least 30% of the staff had undergone gatekeeper training with 12 nursing homes without trained staff. We collected data about the residents considered to be suicidal, their management further to being identified, as well as measures taken at nursing home level to prevent suicide.
Results

The two nursing home groups did not present significantly different characteristics. In the nursing homes with trained staff, the staff were deemed to be better prepared to approach suicidal individuals. The detection of suicidal residents relied more on the whole staff and less on the psychologist alone when compared to nursing homes without trained staff. A significantly larger number of measures were taken to manage suicidal residents in the trained nursing homes. Suicidal residents were more frequently referred to the psychologist. Trained nursing homes put in place significantly more suicide prevention measures at an institutional level.
Conclusions

Having trained gatekeepers has an impact not only for the trained individuals but also for the whole institution where they work, both in terms of managing suicidal residents and routine suicide prevention measures.
Keywords  Suicide prevention; Geriatric psychiatry and aging; Quality of care; Gatekeeper; Nursing home; Controlled study