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Csomay Center - Gatekeeper Training

Background of Gatekeeper Training

The materials provided here were developed as part of the Mental Health of the Rural Elderly Outreach Program, a title that was later abbreviated as the Elderly Outreach Program or EOP. The EOP was a demonstration project that evaluated alternative, “non-traditional” mental health services for older adults, including use of community gatekeepers. The program was funded by the Administration on Aging (Grant #07AM0310-02), the National Institute of Mental Health (Grant #87-001-401-6920-2464-01) and the State of Iowa Department of Mental Health, Mental Retardation and Developmental Disabilities (Grant #87-001-413-0413-2464-06) over a three-year period between 1986 and 1989, and is still in use today in an altered form.

The Gatekeeper Model used in the EOP was based on the highly successful program of care initiated in 1978 in Spokane, Washington under the leadership of Ray Raschko. The Gatekeeper Model trains people who, in the course of their daily activities, come into frequent contact with older people. The Model assumes that people who live and work in the community are often in the best position to recognize early changes in the behavior of local residents that might indicate the beginnings of mental or emotional distress. These community members are caring and concerned people who are already making observations about the people around them, but who many not know what to do or how to help. Gatekeeper training was developed to enlist community members’ assistance by helping them recognize older people who may be experiencing difficulties, and refer them to the EOP.

The EOP proved to be a successful model for providing mental health services to older adults living in rural settings, has been replicated in other settings, and is described in the literature. Because gatekeeper training continues to be a popular method for identifying older adults who may be in need of mental health services, the modules and supportive materials are provided for free here, as a service of the HCGNE. The Gatekeeper Training materials are copyrighted, and are used with permission by the HCGNE. Permission is granted for individuals to print, copy and otherwise reproduce these materials in an unaltered form for use as personal development activities, inservice education, or other continuing education programs for which no, or only fees to cover expenses, are charged. Use of these materials for personal profit is prohibited. Users are asked to give credit to the original authors and the HCGNE as the current source of the materials, using the suggested reference. We also ask that you notify the Center about how and when the materials are used so that we can better evaluate the need for updated or modified versions.

Gatekeeper Training Manuals/Materials

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PDF file Gatekeeper1

Gatekeeper Training Manual, Part I provides the basic information needed to be a community gatekeeper. The intent of this module is to provide key information in a short period of time, thus accommodating busy community members and workers.

PDF file Gatekeeper2

Gatekeeper Training Manual, Part II provides an overview of common mental disorders that might affect older adults, causing the behavior changes described in the Part I manual. This training is intended to follow Part I, and is considered supplemental learning for interested community members. In many cases, Part II training was provided to service providers and other professionals.

PDF file Gatekeeper3

Gatekeeper Training Supportive Materials. The third set of information provided was developed to assist others to use the Gatekeeper Training Manuals, Part I and II. These materials provide additional information about gatekeeper training in general, and offer a word-for-word trainer’s script that explains all information in the manual as if real-life training was being provided. A film used during the EOP, titled “Old Friends” is also reviewed and discussed to illustrate how training was conducted. Although the table of contents refers to order forms, these materials are no longer available. Information formerly provided by Abbe Center is now posted on this website for general use.

Related Literature

  • Buckwalter, K., Smith, M., Zevenbergen, P. & Russell, D. (1990). Mental Health of the Rural Elderly Outreach Program. The Gerontologist, 31(3), 408-412.
  • Smith, M. and Buckwalter, K. (1999). Outreach to mentally ill older adults in rural communities: An important role for nurses. The Journal of the California Alliance for the Mentally Ill, 10(3), 42-45.
  • Smith, M., Buckwalter, K., Zevenbergen, P., Kudart, P., Springer-Brenneman, D., & Garand, L. (1993). An administrator's dilemma: Keeping innovative mental health and aging programs alive after the grant funds end. Journal of Mental Health Administration, 20(3), 212-222.
  • Buckwalter, K., Abraham, I., Smith, M., & Smullen, D. (1993). Nursing outreach to the mentally ill rural elderly. Hospital and Community Psychiatry, 44(9), 821-823.
  • Abraham, I., Buckwalter, K., Snustad, D., Smullen, D., Thompson-Hiesterman, A., Neese, J., & Smith, M. (1993). Psychogeriatric outreach to rural families: The Iowa and Virginia models. International Psychogeriatrics, 5(2), 203-211.
  • Raschko, R. (1985). Systems integration at the program level: Aging and mental health. The Gerontologist, 25, 460-463.
  • Substance Abuse and Mental Health Services Administration. (2002). Gatekeepers, Spokane, WA, in Promoting Older Adult Health: Aging Network Partnerships to Address Medication, Alcohol, and Mental Health Problems (pp. 31-36). U.S. DHHS Publication No. (SMA) 02-3628. Washington, DC: author.
  • Substance Abuse and Mental Health Services Administration. (2002). PATCH, Balimore, MD, in Promoting Older Adult Health: Aging Network Partnerships to Address Medication, Alcohol, and Mental Health Problems (pp. 37-40). U.S. DHHS Publication No. (SMA) 02-3628. Washington, DC: author.

Suggested References

  • McDonald, T., Buckwalter, K., Smith, M., Stewart-Dedmon, M., & Van Hoozer, H. (1986). Gatekeeper Training Manual, Part 1: Introduction to the Gatekeeper Role. Retrieved from the University of Iowa College of Nursing Hartford Center of Geriatric Nursing Excellence on [add date retrieved] from http://www.nursing.uiowa.edu/hartford/
  • Smith, M., Buckwalter, K., McDonald, T., Stewart-Dedmon, M., & Van Hoozer, H. (1986). GateKeeper Training Manual, Part II: Specific Disorders, Signs and Symptoms. Retrieved from the University of Iowa College of Nursing Hartford Center of Geriatric Nursing Excellence on [add date retrieved] from http://www.nursing.uiowa.edu/hartford/
  • Smith, M. (1989). Gatekeeper Training Supportive Materials. Retrieved from the University of Iowa College of Nursing Hartford Center of Geriatric Nursing Excellence on [add date retrieved] from http://www.nursing.uiowa.edu/hartford/