A comprehensive review of mental health gatekeeper-trainings for adolescents and young adults.

Mental disorders account for a larger burden of disease among adolescents and young adults than any other class of health conditions, and most of these disorders are untreated. Gatekeeper-trainings represent a potentially powerful mechanism for increasing access to treatment. This article is a comprehensive review of 21 gatekeeper-training studies conducted in schools and other youth settings around the world. Despite the widespread use of these programs, little is known about how they actually affect the abilities and actions of trained gatekeepers and the subsequent help-seeking behaviors of adolescents and young adults. Certain outcomes (knowledge, attitudes, and self-efficacy) have been commonly measured whereas others (behaviors, skills, and population-level outcomes) have rarely been assessed. The studies reviewed here also suggest that positive training effects often diminish over time. The article identifies opportunities for advancing gatekeeper-training research and practice.