SEPAK

Background

Suicide is a leading global public health concern, claiming nearly 800,000 lives annually, with one person dying every 40 seconds. Among young people, suicide is particularly alarming, accounting for an estimated 6% of all deaths worldwide. It stands as the second leading cause of death among females and the third among males aged 10-24 years. The situation is even more concerning in low- and middle-income countries (LMICs), which house over 90% of the world’s youth population and contribute to more than 79% of global suicide deaths. However, the epidemiology of adolescent suicide and suicidal behaviors in LMICs, including Pakistan, remains poorly understood compared to high-income countries.

The Need for Intervention

Schools and colleges, where most adolescents spend a significant portion of their time, present a critical opportunity for suicide prevention. Despite the urgent need for school-based suicide prevention programs, they are scarce in high-income countries and virtually non-existent in Pakistan. This research program seeks to address this gap by developing a comprehensive national youth suicide prevention strategy tailored to the cultural context of Pakistan. The initiative will focus on training school teachers and healthcare professionals to effectively screen and manage adolescents exhibiting suicidal behaviors.

Objectives

The primary goal of this research program is to create a culturally adapted, universal suicide prevention strategy for Pakistan. The strategy will include three key interventions:

Question, Persuade, and Refer (QPR): A gatekeeper training module aimed at school personnel to equip them with the skills to identify, persuade, and refer at-risk students for further help.

Youth Aware of Mental Health Program (YAM): A universal intervention that engages adolescents in interactive role-play sessions and lectures focused on mental health awareness and suicide prevention.

Professional Screening: A screening process conducted by healthcare professionals, designed to identify at-risk adolescents and ensure they receive appropriate referrals and support.

Implementation and Feasibility Study

Once the interventions are culturally adapted, an open-label feasibility study will be conducted across 12 secondary schools in low-income urban areas of Pakistan. The study will target students aged 12-17 years, teachers from these schools, and primary healthcare professionals from nearby hospitals. The outcomes of this study will inform the development of a scalable national strategy aimed at reducing youth suicide rates in Pakistan.

This program represents a crucial step towards addressing the mental health crisis among Pakistani youth, ensuring they receive the support and intervention they need to lead healthy, fulfilling lives.