Saving and Empowering young lives in PAKistan (SEPAK): An Exploratory Cluster Randomized Controlled Trial (cRCT)



Panagioti, M, Kiran, T, Irshad, S, Sattar, R, Hodkinson, A, Tofique, S, Tyler, N, Angelakis, I ORCID: 0000-0002-1493-7043, Zadeh, Z, Maqsood, A
et al (show 8 more authors) (2023) Saving and Empowering young lives in PAKistan (SEPAK): An Exploratory Cluster Randomized Controlled Trial (cRCT). European Psychiatry, 66 (S1). S317-S317.

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Abstract

<jats:sec id="S0924933823007034_sec03200" sec-type="intro"><jats:title>Introduction</jats:title><jats:p>Suicide is a leading cause of death among young people and most deaths by suicide occur in low and middle-income countries. School is the best place where we can identify and respond to youth suicide risk. School-based interventions for suicide prevention in young people have been successful across US, Europe and Australia, but require adaptations to be acceptable and feasible in Pakistan.</jats:p></jats:sec><jats:sec id="S0924933823007034_sec03201"><jats:title>Objectives</jats:title><jats:p>To develop and test culturally adapted preventative interventions for suicidal behaviours among pupils in secondary schools in Pakistan. The qualitative component aimed at exploring the views of students, parents, teachers and general practitioners on cultural adaptation, experience of participation, areas of improvement and suggestions for scale-up of the school-based suicide prevention program (SEPAK).</jats:p></jats:sec><jats:sec id="S0924933823007034_sec03202" sec-type="methods"><jats:title>Methods</jats:title><jats:p>A clustered randomised controlled trial. The four culturally modified interventions 1) Linking Education and Awareness of Depression and Suicide Awareness (LEADS) Training for pupils (students=260) 2) the Question, Persuade, and Refer (QPR) for teachers (students=203) 3) QPR for parents (students=445); 4) Screening by Professionals (Profscreen) (students=260) were compared against control intervention (educational posters) (students=227). Structured questionnaires were administered at baseline and 1-month post-intervention to assess suicidal behaviours, psychological well-being and quality of life. A total of 8 focus groups (FGs) were conducted at pre and post intervention stage with each stakeholders.</jats:p></jats:sec><jats:sec id="S0924933823007034_sec03203" sec-type="results"><jats:title>Results</jats:title><jats:p>Patient and public involvement and Engagement (PPIE) was strongly embedded in the project to ensure meaningful benefits for participants. A total of 40 schools were recruited from 8 cities across Pakistan. A total of 243 students attended LEADS intervention, 92 teachers and 304 parents completed QPR training, and 9 general practitioners were trained in ProfScreen. The retention rate at follow-up was 99% that shows feasibility of delivering intervention package in Pakistan. All participants marked SEPAK as effective in identifying risk of and preventing self-harm and suicide in young people and in improving pathways to treatment. Interventions were perceived as helpful in improving knowledge about mental health, impact of mental health difficulties on functioning, reducing stigma, equipping stakeholders to identify and signpost at-risk people. Improvement in clinical and teaching practice as well as understanding others behaviors were also reported.</jats:p></jats:sec><jats:sec id="S0924933823007034_sec03204" sec-type="conclusions"><jats:title>Conclusions</jats:title><jats:p>This study suggest feasibility of integrating a suicide prevention program in existing educational system and highlights positive role of creating awareness about suicide in youth, introduction of school-based mental health programs, parental counseling and strengthening of the health system by training general practitioners in early identification of suicide risk and promoting suicide prevention strategies</jats:p></jats:sec><jats:sec id="S0924933823007034_sec03205"><jats:title>Disclosure of Interest</jats:title><jats:p>None Declared</jats:p></jats:sec>

Item Type: Article
Uncontrolled Keywords: Behavioral and Social Science, Suicide, Pediatric, Suicide Prevention, Depression, Clinical Trials and Supportive Activities, Mental Health, Prevention, Clinical Research, 3.1 Primary prevention interventions to modify behaviours or promote wellbeing, 3 Prevention of disease and conditions, and promotion of well-being, Mental health, 3 Good Health and Well Being, 4 Quality Education
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 16 Aug 2023 08:55
Last Modified: 15 Mar 2024 19:33
DOI: 10.1192/j.eurpsy.2023.703
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3172214