Background
Suicide is one of the preventable and common causes of death among adolescents. Preventive strategies are effective in reducing adolescent suicide. However, there are limited preventive approaches in Nepal.
Aim
To contextualise and evaluate the preliminary effectiveness, feasibility, and acceptability of a suicide prevention program for secondary school students in Nepal.
Methods
This was a multi-method study.
Phase 1 was a systematic review to identify the available suicide prevention programs for adolescents, their contextualisation, and effectiveness.
Phase 2 was a qualitative study to contextualise the safeTALK™ program through focus groups with adolescents, parents, schoolteachers, health care providers, and policymakers.
Phase 3 was a single-group pre-post-test study to assess baseline Suicidal behaviours and help seeking intentions, to deliver the contextualised SafeTALK™ program, and to assess effectiveness.
Phase 4 was a qualitative study, using individual interviews with diverse groups to assess the feasibility and acceptability of the program.
Results: Results: The review identified 53 eligible articles. Most studies (64.2%) were from High-Income-Countries, and no study was from Lower-Middle-Income-Countries. The safeTALK™ program was contexualised. The pre-test survey identified that suicidal behaviour was present among 18.3% of the participants. Following program delivery to 115 adolescents; post-test survey among 105 adolescents found effective in reducing suicidal behaviours (17.5% pretest vs 10% posttest) and increasing help-seeking intentions with mean differences 4.9 and 8.7 for personal emotional problems and suicidal thoughts respectively. Overall, the program was acceptable, however participants recommended further contextualiation, national level strategies and resources.
Conclusion: The contextualised safeTALK™ program was effective in reducing suicidal behaviours, increasing help-seeking intentions. However, further contextualisation and resource development is required.