Development of a Suicide Prevention Educational Package Based on the Gatekeeper Model for Iranian Military Personnel: A Qualitative Delphi Study

Introduction Suicide among military personnel poses a significant threat to both individual well-being and organizational readiness. This study aimed to develop a structured suicide prevention educational package based on the Gatekeeper model tailored for military duty and career personnel in the Islamic Republic of Iran Army. Methods A qualitative study using the Delphi approach was conducted in 2022-2023. Participants were 20 mental health experts including psychiatrists and psychologists, working in army hospitals across Tehran, selected via purposive sampling. Semi-structured interviews were conducted across three Delphi rounds until theoretical saturation and consensus were reached. Data were analyzed using MAXQDA software. Results A total of 130 open codes were extracted from initial interviews, which were refined into 10 core thematic categories and one central theme: a gatekeeper-based educational intervention. These themes included psychological traits of gatekeepers, suicide risk factors in military settings, warning signs, appropriate and harmful gatekeeper actions, referral protocols, and system-level improvements. Conclusion The resulting package equips military commanders and personnel with the competencies to recognize, engage, and refer at-risk individuals. This model offers a scalable and evidence-informed approach for suicide prevention within military institutions.