Devassy Saju Madavanakadu, Scaria Lorane, Benny Anuja Maria, Cheguvera Natania, Varghese Jaicob, Joubert Lynette
Department of Social Work, Rajagiri College of Social Sciences (Autonomous), Kochi, India.
Department of Social Work, Melbourne School of Health Sciences at the University of Melbourne, Carlton, VIC, Australia.
Front Psychiatry. 2022 Jul 28;13:915568. doi: 10.3389/fpsyt.2022.915568. eCollection 2022.
Suicide is a substantial public health concern for countries worldwide. Effective preventive and curative interventions for self-harm behavior (SHB) are imperative for nations with an alarmingly high rate of suicide and self-harm behaviors. The intervention protocol named consists of comprehensive assessment, Attachment-Based Family Therapy (ABFT), and community linkages for people presenting with suicide or self-harm in emergency departments of tertiary hospitals.
This article reports the design and protocol for a cluster randomized control trial for suicide prevention and management. After the developed intervention is pilot tested in a tertiary hospital in Kerala, the intervention will be scaled up to be implemented in various tertiary hospitals in Kerala. Each hospital emergency department will be considered a cluster, and these clusters will be randomized to the intervention group and control group in a 1:1 ratio. The eligible people from the intervention clusters will undergo a baseline assessment, a structured moderate intense intervention with twelve sessions spread across 6 months by the trained social workers supervised by the Mental health team, and a follow-up assessment at the end. Participants will be recruited after obtaining consent and explaining the study. The primary outcome includes suicidality measured by the Depressive Symptom Inventory-Suicidality Subscale (DSI-SS), Depression, Anxiety and Stress Scale (DASS), MOS Social Support Survey, and Brief resilience scale (BRS).
Knowledge generated from this trial can significantly affect new programmatic policy and clinical guidelines that will improve the reduction of suicide rates in the country.
Prospectively registered in Clinical Trial Registry India (ICMR-NIMS) on 18/10/2021 (ref number- REF/2021/10/048264).
自杀是全球各国都极为关注的公共卫生问题。对于自杀和自残行为发生率高得惊人的国家而言，针对自我伤害行为（SHB）的有效预防和治疗干预措施势在必行。名为 的干预方案包括对三级医院急诊科出现自杀或自我伤害行为的人员进行全面评估、基于依恋的家庭治疗（ABFT）以及社区联系。
本文报告了一项预防和管理自杀的整群随机对照试验的设计和方案。在喀拉拉邦的一家三级医院对制定好的干预措施进行试点测试后，该干预措施将扩大规模，在喀拉拉邦的多家三级医院实施。每家医院的急诊科将被视为一个整群，这些整群将以1:1的比例随机分为干预组和对照组。来自干预整群的符合条件的人员将接受基线评估、由心理健康团队监督的训练有素的社会工作者进行的为期6个月、共12节的结构化中度强化干预，以及最后的随访评估。在获得同意并解释研究内容后招募参与者。主要结局包括通过抑郁症状量表自杀亚量表（DSI - SS）、抑郁、焦虑和压力量表（DASS）、MOS社会支持调查和简易复原力量表（BRS）测量的自杀倾向。
从该试验中获得的知识可显著影响新的规划政策和临床指南，这将有助于该国降低自杀率。
于2021年10月18日在印度临床试验注册中心（ICMR - NIMS）进行前瞻性注册（注册号 - REF/2021/10/048264）。
