CSTS podcast series
Episode 106: GATEKEEPERS

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NOTES

AUDIO
REVEREND SETH STILL: When I was in seminary a militarychaplain came to talk to our class and told us stories about
what they did.

3.

REVEREND SETH STILL: I had an uncle who served in
Vietnam and had a Purple Heart. And both my granddaddies
served in World War Two. And so, I pretty much immediately
knew that's what I wanted to do.

4.

REVEREND SETH STILL: When I got done with chaplain
school, it was probably three years before I deployed.

5.

REVEREND SETH STILL: I joined the National Guard in2010. I'm the wing chaplain of the 172 Airlift Wing in Flowood,
Mississippi.

6.

REVEREND SETH STILL: I volunteered for it because I was
counseling so many people who'd been to Afghanistan. And I
wanted to go there and be a part of what was happening so I
could know what it's like to leave your wife and your kids andknow what it's like to be in a war zone. That was just really
important to me.

17.

Transition to
new beat

8.

REVEREND SETH STILL: When I'd been there a month I
really started to question how prepared I was.

9.

REVEREND SETH STILL: I was seeing sometimes 20
people in a day. Lots of lots of people in crisis, lots of people
that did either spouses had left or were in the process ofleaving, people that were suicidal, people who that had
committed crimes, people just wanting to get stuff off theirchest where they went back home.

10. Transition to
new beat
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REVEREND SETH STILL: After I'd been there a few months,
I started to realize I wasn't doing too well. I wasn't callinghome as much or checking in with people. I was angry,
cynical, starting to really just look at the world as this terrible
place.

12.

REVEREND SETH STILL: When I came home, I was excitedand ready to get back to my family.

13.

REVEREND SETH STILL: I had a month leave. And so wewent down to the beach and that was great. But when we got
back from that is when I started to realize I wasn't able tocome back into any sense of normalcy.

14.

REVEREND SETH STILL: I was having a hard timeconnecting with my wife, my kids. My daughter, she was a2

year and a half at the time. And for months, she just acted likeshe didn't know me. I was afraid that it was always going to
be like that, and I'd really messed her up. I was kind of
spiraling down.
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REVEREND SETH STILL: Not long after I got back home. I
became concerned about the firearms in our home.

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REVEREND SETH STILL: I had a Glock that I would keep in
my drawer. Every time I would, I would look at it, I would justhave a suicidal thought. At first I kind of brushed it off anddidn't think about it. But as time went on, it started to reallyfreak me out.

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REVEREND SETH STILL: After a few months, those dark
thoughts became a lot stronger. I ended up telling my wife.

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REVEREND SETH STILL: I was really ashamed and reallyanxious about what she was going to think of me, but she
handled it really well. It was powerful how when I talked to her
it didn't go away completely, but it just wasn't nearly as strong
as it was before I talked to her. It was a big relief.

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new beat
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DR WEST: Rev Seth Still is a “gatekeeper”. A trusted
member of a community who has exposure to many people
and in a position to offer care, empathy, and help.

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21.

REVEREND SETH STILL: I would define a gatekeeper asprotector, as somebody who is there to defend.

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DR WEST: Seth was used to being a gatekeeper for others.
But when he began to have suicidal thoughts of his own, hestruggled to initiate a conversation that could lead to getting
help.

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REVEREND SETH STILL: I needed somebody to come inand protect me. Even though I didn't really know it. I told somany people already just to get this stuff out of the dark andtell somebody and here I hadn't done the very thing I told somany people to do.
transition to new
beat

24.

DR WEST: I’m Dr Curt West: Associate Professor of
Psychiatry and Scientist at the Center for the Study ofTraumatic Stress. Today, in Let’s Talk About Your Guns we’ll
talk to Reverend Seth Still about his own experience withsuicidal thoughts and guns in his home… and how thatexperience changed how he thinks about his role as agatekeeper. We'll also talk to Dr. Rajeev Ramchand,
psychiatric epidemiologist, about the role gatekeepers play insuicide prevention and firearm safety.

25.

DR WEST: Firearm safety in the home is built around fiveprinciples. Weapons should be stored unloaded. They should
be taken apart or stored with a disabling device engaged.
They should be stored in locked containers, and ammunition4

should be stored in a separate locked container. Finally,
firearm safety in the home involves having a plan for storingguns in an alternate location during times of crisis.
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DR WEST: In this episode, we’ll discuss best practices forgatekeepers in having conversations about firearm safety.
And we’ll talk about how to overcome obstacles to having
them.

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DR WEST: This podcast isn’t about whether you are for oragainst firearms. It’s about how to have open and honest
conversations about safe storage. Conversations that may
save a life.
So now… Let’s Talk about Your Guns.

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new beat
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DR WEST: Seth in this episode, we're talking about
gatekeepers. Do you think of yourself as a gatekeeper?

30.

REVEREND SETH STILL: Yeah, I would say so. When I think
about my job for the 172, the spiritual care for 1400 members,
and then my calling and the local church to care for thosemembers. Yeah, I think that's a good, good word for it.

31.

DR WEST: When did you first became familiar with that term?

32.

REVEREND SETH STILL: I became familiar with the term
gatekeeper through guard training. We have something called
Wingman Day every year. That's our suicide prevention day.

5And that idea of being a defender for others, especially when
they're going through something that they can't handle.
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DR WEST: In your training in seminary, in pastoral counselingas a military chaplain? Did you ever receive information on
guns and safety in people’s homes?

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REVEREND SETH STILL: Never came up. I know a coupleof people who had killed themselves with the gun, but still had
never even thought about not having guns in the home.

35.

DR WEST: Why do you think that was?

36.

REVEREND SETH STILL: That was the culture I grew up in.
Everybody had guns. You always had a gun in your house.
Every man I knew growing up carried a gun on them or in
their vehicle. That thought never occurred to me that there'dbe a time in my life where I didn't have a gun. I don't think I'dever heard of anybody giving a gun to somebody else to holdfor them. Looking back, I remember feeling, yeah, a lot ofshame around that of like, I'm too weak to even have my own
gun in my in my home. But now, looking back at it and all theconversations I've had with people since, it seems like that is
the most normal thing to do if you're struggling withsomething, hey, take this for me and let them handle it.

37.

DR WEST: So when you were in crisis, you shared thosethoughts with your wife. How did she react?

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REVEREND SETH STILL: She freaked out, which was good,
because I wasn't freaking out about it. I just was pretty laissez
faire about it. I was like, well, everybody has thoughts likethat. You know, and part of that was how many people had
told me about thoughts like that over the past six months.

39.

DR WEST: In this case, your wife had that conversation withyou. But if it was someone else who had initiated thatconversation, do you think you would have listened?

40.

REVEREND SETH STILL: I think I would have listened tothem if I knew that they were really concerned for me and that
it was about their care for me and not just, you know, apolitical viewpoint or this is right or this is wrong. Trust had a
lot to do with why I was open to what she had to say, because
I knew she wasn't attacking me. That was a pretty deeply
ingrained worldview or belief, you know, that I, as a man
should have this gun in my home. And just the way that she
was able to get around that. And I think that's a hard thing to
do. I think if you come straight out, somebody has long held
belief they're going to get defensive. And I probably did get
defensive what their some but that trust that I had in her I
think allowed me to listen to what she was really saying.

41.

DR WEST: So what you're saying is that two very importantqualities in the messenger are trust and caring.
SETH STILL: Definitely.

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new beat7

43.

DR WEST: Dr. Rajeev Ramchand studies the role ofgatekeepers in suicide prevention. He believes that
confidentiality and trust is a crucial part of their success.

44.

DR RAMCHAND: Trust is so important because you're
confiding in this individual a very intense thought that you
have that you're thinking about harming yourself, that you're
thinking about ending your life. You're providing thisinformation. If somebody's asking me about this and I want toanswer truthfully, I have to trust that they are going to treat
that information as almost sacred. So I do believe that trust isperhaps the most important thing. Somebody needs to knowthat they'll trust an individual.

45.

DR WEST: The concept of a gatekeeper might be new forsome listeners. Can you give me some specific examples oftypes of jobs where somebody could consider themself agatekeeper?

46.

DR RAMCHAND: There are these people who occupy
positions of real importance within their communities. And I
use that term communities very broadly. It could be ageographic community. It could be a socially definedcommunity, it could be a community on social media that's
very geographically dispersed. There are gatekeepers withineach of those. A gatekeeper could be anyone from a chaplain
to a priest but usually I think it's someone in the community
who knows the pulse of the community, who understands thecommunity, understands the resources are available. They're
local. They're just, you know, somebody who's there and8who's trusted, who's well respected, and who you interact
with, with regular frequency. But I also think a gatekeeper
could be somebody who's in your community, but maybe alittle bit removed from your community. So, for example, abartender doesn't necessarily interact with your friends or ispart of your social circle. And that might be where the trust
comes in because they're not part of that network. So you
might feel a little bit more comfortable disclosing something tothem because they're not part of your network.
47.

DR WEST: How is the relationship between a gatekeeper andsomebody that they serve different from the relationship that,say, a therapist would have with a patient?

48.

DR RAMCHAND: The gatekeeper differs from a therapeutic
relationship in many ways. If I decide to see a therapist or if I
refer someone to a therapist I expect that therapist to do acomprehensive assessment of the person and then to follow
evidence-based guidelines on identifying what their symptoms
are, what their diagnoses may be, and what evidence-based
treatments are available to manage their symptoms throughthe course of treatment. That's a very structured and very
defined relationship. Gatekeeper’s a little bit looser and we're
not asking for a comprehensive assessment. We're notthinking about a diagnosis. We don't want the person to go
back every week and receive some type of check ins. The
Gatekeepers relationship is very informal and it's just knowing
how to listen, how to recognize when things seem a little bit
distressful, critically important, having the confidence and theability to recognize when you need to ask, hey, are you
9thinking about harming yourself or are you thinking aboutsuicide? And then that follow up question, well, have you
thought about how you might do that? Do you have, youknow, do you have a firearm in the house? How is it stored?
Do you think you might, you know, temporarily remove it fromthe house, give it to a friend? So I think that's theconversation. It's providing that immediate help so that, when
you feel safe when you guys part ways and again it's a very
informal relationship.
49.

DR WEST: So tell me a little bit about your work specifically
helping gatekeepers think about their role in suicide
prevention.

50.

DR RAMCHAND: So we started our work on gatekeepers
because we. Really understood that a lot of effort was being
placed on gatekeeper education. So we saw a lot of publiccampaigns that were directed towards gatekeepers so thatwere oriented towards suicide prevention. So California, forexample, had a campaign called Know the Signs. So it wasfor gatekeepers to identify signs of suicide risk. We saw in the
Army there was a lot of effort being placed on thesegatekeeper campaigns and wanted to know, well, do thesework? Are they effective? So we first started, by looking at theliterature. What do we know about these campaigns and what
do we know about these efforts. And we saw a lot of evidence
that you could teach these things, that people learn thesethings.

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We then went and our next kind of set of studies was to lookat noncommissioned officers NCOs in the Army and theMarine Corps, as well as chaplains in the Army. And we reallywanted to understand their role, their gatekeeper role. What
we really were interested in looking at is did they know theresources to refer people? Did they have knowledge andawareness of suicide risk? Did they think it was important?
Did they feel efficacious in referring people? And did they everexpress any reluctancy to do these things? And we actually
had some really interesting findings, that they felt very theyfelt capable of doing these things, but they also felt reluctant
to do them. So we had to untangle how could you be both
comfortable, confident in doing something, but also reluctant
about doing it?
51.

DR WEST: I realize this is probably speculation, but what
could you imagine being the barriers to gatekeepers talking
with the people that they interact with?

52.

DR RAMCHAND: I think the number one barrier is for agatekeeper about talking about guns and safety is talking
about guns and safety. I think that for whatever reason, ourculture, we've created a world in which that question, Do you
have access to a firearm and how is it stored? Has become
so wrought with emotion and politicized and the sense that
this is an infringement on someone's rights to even ask thattype of question is so pervasive that I think that that's thebiggest hindrance currently right now. That question has
become so loaded that that people are really afraid to ask it.

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53.

DR WEST: Is there a way in your mind that we can overcomethat barrier?

54.

DR RAMCHAND: Podcasts like this, opening up thediscussion, elevating the importance of talking about it, is one
step. I'm a researcher, so the first place I would go is to theresearch literature also and to see comparable examples. Soeven though we're talking about suicide right now, you know,
there were efforts to educate parents of kids to ask when they
go on play dates is there a firearm in the house? How is it
kept stored? I think there have been educational efforts there
and to see which of those have been successful and which
haven't would be a starting point for us to be thinking about
how we can educate gatekeepers to have these discussions
about do you have a firearm available, how are you storing itright now?

55.

DR WEST: Help me think through this. How does agatekeeper transition from their role as the barber, thebartender, the librarian into the role of either I'm concerned
about you or the role of can I talk to you about how to makeyour environment more safe? How might they do that?

56.

DR RAMCHAND: I don't know if it's a transition to a role, butrather integrating those practices into what they're alreadydoing. And I think in some cases they're probably alreadydoing that. So the bartender might be doing that by saying,
Hey, you've had too much to drink. Let's call you a cab. That'sintervening. That's kind of gatekeeping in a different way. So I
do think that sometimes they're used to having those12

conversations. And when something gets at a threshold, kindof having that discussion. Let's take another example. The
barber shop. Let's say you're having this conversation andsomebody's telling you, you know, that sounds really stressful.
How are you dealing with that? How are you making sure
you're staying, you know, safe? What are you doing? What
are you doing with your guns? Why don't we just, like
integrate all these questions in part of our normal kind of
dialog?
57.

DR WEST: It might be awkward to go that deep withsomebody. Especially if you don't feel that you're obligated to.

58.

DR RAMCHAND: I think a lot of people are willing to do it. I
think a lot of people can be equipped to do it. I think a lot of
people if they just had the resources, would be really good at
it. But it's not obligatory. It's obligatory for a social worker, a
psychiatrist and a psychologist to know how to respond to
somebody when they say that they're thinking about ending
their lives or thinking about suicide. We could say that that's
kind of a requirement for the job. Clergy, maybe. Maybe we
could say you should have something in place, you should betrained. You should know what to do. When we start talking
about some of these other gatekeepers, it’s not an obligatory
or a requirement.

59.

DR WEST: As you think about your experience with inquiring
about suicide risk and gatekeepers. Did you encounter thisconcern about it being an expectation or a requirement?

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60.

DR RAMCHAND: In the military. We did. I think that in the
military context, there was a level of expectation. In the sense
that. Okay. So we'll train you. We'll give you this training andsuicide prevention. What are the signs of suicide prevention?
What are the resources? So everyone gets trained in this andthen somebody in your unit dies by suicide. So then thequestion isn't so it's not what can we learn from this? How can
we do better? It's what did you miss? Because we gave you atraining. What did you miss? What did you not do? Right.
Because we gave you this training. It may have been an hour
in a lecture hall or something with the dark lights, but we did
give you this training. So that's what I'm worried about isholding people accountable if something goes wrong.

61.

DR WEST: It's not about being at fault If you missed it. It's
taking that opportunity to promote the healthier choices, topromote the healthy behaviors.

62.

DR RAMCHAND: That's right. While it's great to havebartenders and people in these roles serve as gatekeepers,
it's not part of their job responsibility. People may be ill
equipped, because they may have had experiences
themselves that are too recent, that they're coming to termswith or maybe they just don't want to assume that role. I don't
think we necessarily need to say everyone who's a bartender,
everyone who's a barber needs to be equipped. So we needto make sure that when we're empowering them, we're notalso creating a holding them accountable for everything,
everything that happens after.

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63.

DR WEST: When we talked with Seth, one of the things hebrought up was that he talks about his own experience when
he's counseling people. Is that something that is helpful for
gatekeepers to share their own experience with people thatthey're trying to help?

64.

DR RAMCHAND: When it comes to gatekeepers sharing
their own experiences, that can always be helpful. It is not thesame relationship as somebody has with a psychologist
where it's just a one-way relationship. This is somebody
where you expect at least some two-way relationship with.
You expect when you go to the barber to hear about their kid's
birthday party the weekend before, you know, you expect tobe there more of an exchange. So I do think when they say,
you know, I had a really stressful time and you know what I
did? I took my gun and I gave it to my brother and he held it
for a few months until, you know, we got through this as afamily or whatnot. The harm comes when somebody thinks sostrongly that this thing works so well for them that it's going towork for you. Like for somebody fly fishing might be theperfect thing to do to calm their nerves. So they're referring,
you've got to start fly fishing. You've got to start fly fishing.
That's not really a great gatekeeper because you have tomeet the person where they're at. You have to say, you know
what, fly fishing, work for me. Let's find out what might workfor you. So becoming too strongly held in your convictions
that what worked for you is going to work for everyone.

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65.

DR WEST: I like that. Listening to people and then meetingthem where they are.

66.

DR RAMCHAND: To be a gatekeeper, you've got to be agood listener. You just have to. That's part of the that's part of
the responsibility. It's not about you. It's almost like being agood friend, to be honest. You know, it's not always aboutyou. You sometimes have to be there for the other person andnot turn it into the you know, in my case, it's not the Rajeev
story at this point.

67.

DR WEST: If I'm listening to this show and I'm wondering,well, how do I know if I'm a gatekeeper? That would be agood question to answer. How? If I'm not sure…

68.

DR RAMCHAND: Then you are. That's my attitude. I thinkthat if you aren't sure if you're a gatekeeper, you probably are.
You probably occupy some role that you could be empowered
to serve in this role. And so what do you do? You find theresources that are available, you know, for you. There aretrainings offered by Livingworks called Assist that are that are
gatekeeper trainings. There's one called QPR. There's moreon the Suicide Prevention Resource Centers website training
sites. So if you think that you could be in the position to help
somebody go through a some type of crisis where they might
be at risk of suicide, then I would encourage you to kind of getthat training so that you know what to do and you know whatquestions to ask, because I really think that if you think thatyou're in that role, you could potentially have the opportunity
to save a life.
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69. Transition to
new beat
70.

DR WEST: Reverend Seth Still is one gatekeeper whose own
experience with suicidal thoughts and gun safety allowed him
to have deeper conversations with the people he serves.

71.

REVEREND SETH STILL: I think I'm just a lot more aware
now of what people are trying to hide or trying to or ashamed
to talk about. It doesn't have to be that they've told me they're
having suicidal ideations or anything like that. But if they'regoing through a really difficult time, I'll ask them about theirguns and just tell them my own story and ask them if that's
ever a thought to them. I usually tell people to either lockthem or store a clip and the gun separately or sometimes justto say, hey, it helped me a lot just to be out of sight, out of
mind.

72.

DR WEST: And how do people respond to that?

73.

REVEREND SETH STILL: I haven't had anybody come backand say that, you know, I wouldn't be here if we hadn't hadthat conversation. But I've definitely had some people comeback and say how much it gave them a lot more headspace to
not have to have that thought that, you know, I got this gun in
my house and now that it's out, it's just I don't think about it
anymore.

74.

DR WEST: Do you have words of wisdom for othergatekeepers that might be dealing with somebody in crisis?

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75.

REVEREND SETH STILL: Words of wisdom for othergatekeepers. When it comes to guns, I would say to have theconversation. I know where I live and our culture in
Mississippi. That is not something that is on the table. And I
would like for it to be I think it needs to be. I've seen way too
many accidents and too many people who have gone aheadand committed suicide that I think could have been stopped ifthey didn't have that easy access to guns. So, yeah, having
the conversation is really important. I would also say as far aswords of wisdom on being a gatekeeper, telling your own
story and not being afraid to, that you're going to look weak orvulnerable. I think that that has helped more people, me being
able to share my story of what happened. And so I would
encourage people to do that.

76. Transition to
new beat
77.

DR WEST: In this episode of Let's Talk About Your Guns, we
opened up the conversation to think about people in ourcommunities, gatekeepers, people who come into contact
with many of us, sometimes in times of stress. It’s my hopethat after listening to this podcast, gatekeepers will feel more
confident talking to those people they help about firearms andsafety in their home. This conversation is not specifically
about preventing a suicide. It's about creating an environment
where there's time and space between a suicidal thought even if you think you'll never have it - and that fatal act. We
can all create time and space in our lives to stay safe.

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78.

DR WEST: Thank you to Reverend Seth Still and Dr Rajeev
Ramchand for participating in this discussion.

79.

DR WEST: You’ve been listening to Let’s Talk about Your
Guns. This podcast is made possible by The Henry M.
Jackson Foundation for the Advancement of Military
Medicine. It’s produced by Podville Media for the Center for
the Study of Traumatic Stress at the Uniformed Services
University.

80.

DR WEST: Be sure to subscribe to the show on your favorite
podcast app and leave a five-star review.
Thanks for listening.

81.

PRESENTER: The views expressed are those of the
speakers and do not necessarily reflect the views, opinions,or policies of the Uniformed Services University, theDepartment of Defense, the US Government, or The Henry
M. Jackson Foundation for the Advancement of Military
Medicine, Inc.

82.

PRESENTER: Mention of trade names, commercial products,
or organizations does not necessarily constitute or imply
endorsement by the Uniformed Services University, theDepartment of Defense, or the US Government or The Henry
M. Jackson Foundation for the Advancement of Military
Medicine, Inc.

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Let’s Talk About Your Guns
episode 106: GATEKEEPERS
SOCIAL SNIPPET
1.

DR RAMCHAND: A gatekeeper could be anyone froma chaplain to a priest but usually I think it's someone in
the community who knows the pulse of the community,
who understands the community, understands theresources are available. The Gatekeepers relationshipis very informal and it's just knowing how to listen, how
to recognize when things seem a little bit distressful,having the confidence and the ability to to recognize
when you need to ask, hey, are you thinking about
harming yourself or are you thinking about suicide?
And then that follow up question, do you have afirearm in the house? How is it stored?

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Let’s Talk About Your Guns
episode 106: GATEKEEPERSEPISODE TITLE AND DESCRIPTIONEPISODE 6
EPISODE TITLE: Gatekeepers
EPISODE DESCRIPTION: Each year thousands of ordinary Americans have achance to say "Yes" to saving the life of a colleague, neighbor, or acquaintance. How?
Simply by having a conversation about firearm safety. In this episode, we explore howtrusted members of a community act as gatekeepers in suicide prevention. We hearfrom Reverend Seth Still, whose experience with his own guns in a dark time changed
the conversations with the people he serves. We’ll also hear from Dr. Rajeev
Ramchand, an epidemiologist who discusses how gatekeepers can make adifference.
Resources, transcripts and more athttps://www.cstsonline.org/suicide-prevention-program/podcasts

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