JMIR Res Protoc. 2025 Dec 12;14:e67193. doi: 10.2196/67193.
ABSTRACT
BACKGROUND: Globally, around 800,000 people die by suicide annually, with 77% of these deaths occurring in low- and middle-income countries. Suicidal ideation, frequently observed among adolescents, is directly linked to suicide attempts. Pakistan has witnessed a marked escalation in suicide rates in recent years, with Gilgit-Baltistan (GB) reporting the highest incidence. Extensive research indicates that tailored suicide prevention strategies can mitigate suicidal ideation, attempts, and related fatalities.
OBJECTIVE: This study aims to validate and evaluate the efficacy of suicide prevention programs, RAAHI (the guide) and safeTALK, tailored to the cultural and social context of GB, Pakistan, in preventing suicidal ideation and improving the mental well-being of school-going adolescents.
METHODS: The investigation will assess the efficacy of the RAAHI intervention among 267 adolescents across 4 private schools in GB using an interrupted time-series design with a pre-post test framework. The first intervention, RAAHI, a suicide literacy module, is designed to empower participants with the knowledge and skills to recognize signs of suicidal ideation, engage them empathetically, and connect individuals in crisis with appropriate support. The second intervention, safeTALK, a 4-hour educational workshop, incorporates presentations, videos, discussions, and interactive sessions to teach participants the tell, ask, listen, and keep safe steps. Outcome measures include changes in knowledge, confidence, willingness to intervene, and help-seeking behaviors, analyzed using descriptive statistics, 2-tailed paired t tests, and ANOVA. Ethics approval was granted by the Aga Khan University Ethics Review Committee (2023-8509-24844).
RESULTS: As of April 2025, 267 participants have been recruited from 2 of the 4 schools; data collection commenced in March 2025 and is projected to conclude in August 2025. Final results are expected to be published by February 2026.
CONCLUSIONS: This study will offer critical insights into the adaptation and effectiveness of the RAAHI suicide prevention intervention in a low-resource, culturally specific setting. The findings are anticipated to inform scalable suicide prevention initiatives in school settings across Pakistan and similar low- and middle-income contexts, ultimately contributing to reduced suicidal ideation and attempts among adolescents.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/67193.
PMID:41385277 | DOI:10.2196/67193
