Suicide Prevention by Empowering Adolescents in Pakistan
(SEPAK): A Feasibility Study for Research Capability and
Trial Readiness in Pakistan
Suicide is a public health concern that transcends borders. A multitude of research suggests that social and cultural factors play an important role in discerning suicide rates. Globally, suicide is the second leading cause of death amongst adolescents. There is a disproportionate number of suicides in low-and-middle-income countries (LMICs). In Pakistan, a highly conservative Islamic state, suicide and self-harm remain a criminal act, both socially and religiously condemned. However, there is mounting evidence indicating that self-harm and suicide rates have been increasing in the country.
A large number of international policy strategies recommend suicide prevention approaches that operate across clinical, educational, workplace and community settings. Despite school-based suicide prevention interventions being widely needed, they are scant in high-income countries and virtually non-existent in LMICs like Pakistan.
Our vision is to create the infrastructure to undertake the largest suicide prevention trial in Pakistan and across other LMICs. This includes developing the research to deliver a large scale cRCT, including training staff, identifying recruitment pathways, culturally adapting outcome measures and establishing a patient-public voice network.
PILL has a stellar track record in evaluating culturally adapted suicide prevention interventions (see other programs: CMAP and Y-CMAP).
This feasibility study is broken into 2 parts:
- Part 1 – culturally adapt the three interventions used in the SEYLE trial, identify the referral facilities and, create a Participant and Public Voice (PPV) Research User Group (to help in the designing, implementing and dissemination of research)
- Part 2 – conduct an open-label feasibility study using 12 secondary schools, targeting students (12-17 years) and teachers from these schools in low income urban areas; primary health care professionals from the hospitals near the participating schools
Trial infrastructure developed and ready for a large-scale cRCT for the three SEPAK interventions
- The three SEPAK interventions be tested and modified appropriately, based on results from the feasibility test
- A grant application proposing a full cRCT to run this at all study sites