Pathare 2020.
| Study name | Evaluation of the SPIRIT integrated suicide prevention programme |
| Methods |
Study design: cluster‐RCT Country: India |
| Participants | Adolescent students (14‐16 years) and adult community members Inclusion criteria: For primary sampling units (villages): a. Village Council has agreed to participate in the study; b. there is a high school in the village with more than 35 students and the school has agreed to participate in the study; c. total population of the village is ≤ 6000 people (the population size was determined considering the distance travelled by villagers to access the central storage facility (CSF)); d. primary occupation of the villagers is farming or agriculture‐related work involving use of pesticides. For secondary sampling units (participants): a. adolescents in grade 9 in public high schools (14–16 years of age) and adult community members (18 years and older) residing in rural villages in Mehsana district Exclusion criteria: not specified Stated purpose: to evaluate the public health impact of an integrated suicide prevention programme implemented in 62 villages and compared to 62 control villages in Mehsana district of Gujarat, India, by evaluating: 1) the reach and adoption of the SPIRIT interventions in the target villages; 2) the effectiveness of the prevention programme in reducing suicide rates and suicidal behaviours in target populations; 3) the economic costs of delivering the suicide prevention programme. |
| Interventions |
Interventions: Intervention 1: school‐based intervention (Youth Aware of Mental health (YAM)) The school‐based intervention consists of a universal mental‐health promotion programme in schools within intervention villages aimed at preventing depression, reducing suicidal ideation, and promoting mental health amongst students in grade 9 who are between 14 and 16 years of age. The school‐based suicide prevention programme consists of a locally adapted version of the Youth Aware of Mental Health Programme (YAM). YAM is an interactive programme for adolescents delivered within a teacher‐free space, aiming to promote discussion and increase knowledge about mental health and the development of problem‐solving skills and emotional intelligence. YAM is a manualized 5‐h programme broken down into 3 h of role‐play sessions and 2 h of interactive lectures and discussions about mental health at the beginning and end of the intervention. In addition, students receive a booklet on mental health issues and strategies to deal with difficult life events. Intervention 2: community storage of pesticides This intervention consists of setting‐up community storage boxes placed in the Village Council office premises or at a central location. Each farming household is offered a locker at this facility free of charge and the family is encouraged to store all pesticides in this box. A trained attendant (facility manager) will be stationed at the community storage facility and will document use of the boxes on a day‐to‐day basis. Intervention 3: community health worker (CHW) training in identification, support and referral of persons with suicidal risk and behaviour This intervention consists of training and a follow‐up programme for CHWs in the intervention villages to identify people at risk of self‐harm and suicide and to support and refer such persons to appropriate local services. The training is based on the World Health Organization Mental Health Action Programme (mhGAP), Self‐harm/Suicide module. The training module includes information on how to identify and act in cases of persons at risk of self‐harm and suicide, when and to whom to refer, and type of psychosocial support to provide at different stages. Control: Usual care (not receive any intervention to prevent suicide other than enhanced usual care, which involves provision of brochures with information on available mental health services and other resources for seeking help, such as emergency helpline numbers and contact details of public and non‐governmental healthcare services) |
| Outcomes |
Participants'outcomes of interest for this review
Economic outcomes Intervention costs (costs of implementation and intervention, and the intervention impact) Time points: baseline, post‐intervention (3 months and 12 months follow‐up) |
| Starting date | 1 August 2018 (first enrolment) |
| Contact information | Soumitra Pathare, spathare@cmhlp.org |
| Notes |
Source of funding: National Institutes of Mental Health (NIMH) through grant number 5U19MH113174–03 REVISED awarded to SP, LV and LSZ (PIs) Prospective trial registration number: CTRI/2017/04/008313 |