Suicide prevention by empowering

adolescents in Pakistan (SEPAK):

A feasibility study for research capability and

trial readiness in Pakistan

Close to 800 000 people die due to suicide every year, this is one person every 40 seconds. Worldwide, suicide accounts for an estimated 6% of all deaths among young people.  As the second leading cause of mortality among females and the third leading cause among males aged 10–24 years, youth suicide is a major global public health concern. Low- and middle-income countries are home to more than 90% of the world’s children and youth and also account for over 79% of global suicide deaths. However, compared to high-income countries relatively little is known about the epidemiology of adolescent suicide and suicidal behaviors in low- and middle-income countries.  A large number of international policy strategies recommend suicide prevention approaches that operate across clinical, educational, workplace and community settings. Most adolescents attend schools and colleges, which makes these an appropriate setting for reaching young people. Although school-based suicide prevention interventions are much needed, they are sparse in high income countries and non-existent in Pakistan.

The aim of this research programme is to develop national youth suicide prevention strategy in Pakistan including the training of school teachers and healthcare professionals in screening and managing adolescents with suicidal behaviours. For this purpose universal suicide prevention strategies will be culturally adapted which includes three separate interventions (1) the Question, Persuade, and Refer (QPR), a gatekeeper training module targeting school personnel, (2) the Youth Aware of Mental Health Programme (YAM), a universal intervention which engaged adolescents in role-play sessions and interactive lectures about mental health and (3) the screening by professionals (ProfScreen) with referral of at-risk adolescents. Once the interventions will be culturally adapted an open-label feasibility study will be conducted 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.