Implementation Strategies for Suicide Prevention among Youth in Nepal - PROJECT SUMMARY / ABSTRACT Suicide is a major public health concern. Globally, over 700,000 people die of suicide each year. It is the 4th leading cause of death among youth throughout the world. The World Health Organization (WHO) recently set a goal to reduce global suicides by 1/3rd by 2030. One major area of opportunity is within low- and middle- income countries (LMICs), where over 77% of all suicides occur. Throughout the world, health systems have begun implementing prevention and intervention approaches that have demonstrated effectiveness to reduce suicide in numerous studies. This collection of evidence-based approaches make-up the Zero Suicide (ZS) model, which has now penetrated the national health systems in >20 countries worldwide along with hundreds of United States (US) health systems. Despite this success, this full model may be challenging to implement in LMICs due to limited mental health infrastructures. However, several studies support the effectiveness of brief, pragmatic approaches that may be adapted and implemented in LMICs. Nepal, a small country in South Asia, serves as an optimal location to adapt and test these suicide prevention approaches. The suicide rate in Nepal is more than double the US rate, and young people are disproportionately affected. In October 2022, a National Suicide Prevention Symposium was cohosted by the Nepalese Government Ministry of Health and Population, the GTA Foundation, and Henry Ford Health. In the meeting, youth were identified as the highest priority sub-population. There was consensus that very little suicide prevention is being implemented, but there was clear support for new research and program implementation. The established research and community partnership between Henry Ford Health and the GTA Foundation in Nepal provides an ideal infrastructure to learn from stakeholders about the feasibility of suicide prevention approaches and how best to implement them in Nepal. The overall goal of the proposed R21 project is to work in partnership with stakeholders to develop implementation strategies for adopting suicide prevention approaches among youth in Nepal. The specific aims are to 1) Examine the feasibility of evidence-based suicide prevention approaches for youth in Nepal via stakeholder surveys and interviews, and 2) Develop and evaluate implementation strategies for prevention and intervention among youth at risk for suicide through a multi-step process informed by focus groups with key stakeholders. Stakeholders will include national and local government leaders, community organization staff, administrators and clinicians at hospitals and health clinics, school personnel, parents and youth. The proposed project will generate data to inform a future hybrid trial of the proposed implementation strategies and the design of a national suicide prevention strategy in Nepal.
