Peer Delivered Youth Suicide Prevention in Nepal

Sponsor
Yale University
Study ID
NCT07680179
Status
Not Yet Recruiting

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Conditions

  • Suicide
  • Suicide Prevention

Eligibility Criteria

Sex
ALL
Age
12 Years - 24 Years
Healthy Volunteers
Not accepted

Interventions

  • Enhanced Usual Care (EUC) — BEHAVIORAL
    Standard government mental health services provided by mhGAP-trained clinicians.
  • Youth-focused, Peer-delivered, Family-engaged Suicide Prevention Package (YPF-SuPP) — BEHAVIORAL
    YPF-SuPP consists of two evidence-based components delivered by a trained and supervised Peer: (1) a Nepali-adapted "aashako kiran" ("ray of hope and light") safety planning intervention, which provides psychosocial support and identifies coping and help-seeking strategies and problem solving for challenges. It also includes the selection of a "safe" family member and provides culturally anchored family engagement to address escalating distress, social support, uptake of local suicide-specific prevention resources, and environmental safety strategies; (2) peer-delivered contact follow-up, consisting of up to 12 Peer led sessions with the youth over six months, conducted under supervision of a mental health clinician to enhance hopefulness, connectedness, and confidence accessing personalized help-seeking.

Study Details

South Asia has the highest suicide rate in the world with important risk profile differences from high-income settings. Investigators will conduct formative research to co-design a package of brief interventions and implementation strategies to prevent youth-suicide and then test the package in a pilot feasibility hybrid type 2 cluster randomized controlled trial in Nepal. Potential health impacts may be substantial as results can be applied not only in similar South Asian primary healthcare contexts, but also in low-resource settings in the US and abroad, where the suicide burden remains high. Using experience-based co-design and equity-focused implementation frameworks, this study will assess the feasibility and acceptability of a Youth-focused, Peer-delivered, Family-engaged Suicide Prevention Package (YPF-SuPP) integrated within existing mhGAP services in Nepal's decentralized primary healthcare system. This pilot trial will generate preliminary data to inform the design of a future fully powered effectiveness trial and potential scale-up of youth suicide prevention strategies.

Key Dates

First listed
Jul 2, 2026
Start date
Jun 30, 2026
Status verified
Jun 2026
Primary completion
Jun 30, 2028
Completion
Jun 30, 2028

Study Design

Enrollment
160 participants (estimated)
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION

Arms

  • Active Comparator: Enhanced Usual Care (EUC)
    Participants will receive standard government mental health services provided by mhGAP-trained clinicians and a referral to a Community Counselor for psychosocial counseling. mhGAP training is based on the World Health Organization (WHO) mental health Gap Action Programme (mhGAP) Intervention Guide version 2.0. Clinicians are trained to detect and treat all common mental health conditions. Following training, prescribers participate in regular supervision sessions with a psychiatrist. Community Counselors hold a government approved certificate in counseling and receive supportive supervision from a Nepali psychologist. Youth participants in this arm will receive care according to mhGAP treatment protocols. Participants requiring additional care may be referred to a psychiatrist at a local specialty service and will remain in the assigned study arm following referral.
  • Experimental: EUC + YPF-SuPP
    Participants in this arm will receive EUC plus the Youth-focused, Peer-delivered, Family-engaged Suicide Prevention Package (YPF-SuPP). Participants are matched with a trained Peer who will deliver 12 sessions over 6-months. Peers are supervised by Nepali clinicians. Peers co-design an individualized culturally adapted Aashako Kiran (Ray of Hope) Safety Plan through indigenous jewelry and a bespoke book. Participants will also identify a trusted adult who will receive three psychoeducational sessions focused on recognizing emotional distress and suicide risk, supporting implementation of the safety plan, strengthening communication, and facilitating help-seeking. Peers provide structured contact follow-up including emotional support, problem-solving, and fun activities to target self-efficacy, belonging, and social connections.

Primary Outcome Measure

Adoption of YPF-SuPP by Peers (Training Attendance) [ Time Frame: Baseline ]

Central Contacts

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