CULTURALLY ADAPTED MANUALLY ASSISTED PROBLEM SOLVING TRAINING (CMAP)

The culturally adapted psychological intervention C-MAP utilizes problem solving components within a brief intervention that can be widely utilized in clinical practice. It has recently been shown that it is feasible to carry out large randomized control trials to evaluate psychological interventions in self-harm patients in low and middle income countries (14) and shows reduction in repetition of self-harm. Thus a strong rationale exists for the robust evaluation of C-MAP in order to clearly determine the clinical and cost effectiveness of this intervention.

Suicide: A global public health problem

  • Every 40 seconds someone dies of suicide.
  • Suicide ranked amongst the leading causes of death in many countries.
  • Each year more than 800,000 people worldwide kill themselves.
  • More than 75% of these are in the low and middle income countries (LAMIC).
  • Suicide is the second leading cause of death among 15 – 29 year olds.
  • There is no official data on suicide from Pakistan.
  • Both suicide and attempted suicide are illegal acts, as well as socially and religiously condemned.

Self harm: A predictor of Suicide

  • A prior history of self-harm is the strongest predictor of a future suicide attempt or completed suicide
  • For each suicide there are more than 20 people attempting suicide.
  • In the year following a suicide attempt, the risk of a repeat attempt or death by suicide may be up to 100 times greater than that seen in people who have never attempted suicide

Causes of self harm

Problem Solving Skills

People who attempt suicide have poor problem solving skills.