Determine the feasibility, acceptability and efficacy of an adapted digitally delivered CMAP (CMAP-SI) intervention (CAMI) compared to treatment as usual (TAU) for patients presenting with suicidal ideation.
The reported suicide rates in South Asia are high compared to the global average. These figures are likely to be an underestimate since suicide data from many LMICs such as Pakistan is lacking and what is available is not reliable (Jordans et al., 2014). According to an estimate, 5,000 to 7,000 suicides take place each year in Pakistan (Hafeez, 2016) and at least 10 to 20 suicide attempts happen for every suicide. Mobile health is a novel and emerging field in psychiatric and psychological care and treatment of mental health difficulties, it involves the use of telecommunications to provide health care, support and intervention from a distance. The proposed study will be carried out in two phases; Stage 1) adaptation of an already existing culturally adapted manual assisted problem solving intervention (CMAP) for patients with suicidal ideation presenting to primary care in Pakistan and further adaptation into a digital intervention. Stage 2) feasibility Randomised Control trial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
80
Culturally Adapted manual-assisted problem solving training based Mobile Intervention (CAMI) for Suicidal Ideation. CMAP is a manual-assisted intervention which has been adapted from a self-help guide called Life After Self-Harm based on the principles of Cognitive behavioral therapy (CBT). This intervention is an evaluation of suicidal ideation, crisis skills, problem-solving and CBT techniques to manage emotions, negative thinking, interpersonal relationships and relapse prevention strategies.
Quetta Site
Quetta, Balochistan, Pakistan
Peshawar Site
Peshawar, KPK, Pakistan
Lahore Site
Lahore, Punjab Province, Pakistan
Multan Site
Multan, Punjab Province, Pakistan
Suicide Ideation .
The BSI is a 19-item self-report instrument for detecting and measuring the current intensity of the patient's attitudes, behaviors and specificity of a patient's thoughts to die by suicide during the past week. Higher scores indicate greater severity of suicidal ideation
Time frame: Change in scores from baseline to 3 and 6-month post-randomization
Depression
Beck Depression Inventory (BDI), which is a 21-item scale measuring symptoms of depression. Higher scores on the scale indicate greater severity of depression.
Time frame: Change in scores from baseline to 3 and 6-month post-randomization
Hopelessness
Beck Hopelessness Scale (BHS) (Beck, A and Steer, R, 1988) is a self-report instrument designed to measure three aspects of hopelessness: feelings about the future, loss of motivation and expectations during the past week. Higher scores indicate greater severity of hopelessness.
Time frame: Change in scores from baseline to 3 and 6-month post-randomization
Health-related quality of life
Quality of life-EuroQoL (EQ-5D) (Brooks, R. and Group, E., 1996): This is a standardised instrument to measure health-related quality of life. It consists of a self-report questionnaire covering five dimensions of health (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). Higher scores indicate better quality of life.
Time frame: Change in scores from baseline to 3 and 6-month post-randomization
Client Service Receipt Inventory
Detailed description of the use of health services will be collected using the Client Service Receipt Inventory (CSRI)
Time frame: Change in scores from baseline to 3 and 6-month post-randomization
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Rawalpindi Site
Rawalpindi, Punjab Province, Pakistan
Hyderabad Site
Hyderābād, Sindh, Pakistan
Karachi Site
Karachi, Sindh, Pakistan
Client Satisfaction Questionnaire
The Client Satisfaction Questionnaire (Attkisson, Zwick, \& planning, 1982) is an 8 item measure of client satisfaction with services. Higher scores indicate greater satisfaction with the services received.
Time frame: level of satisfaction at end of intervention i.e., 3-month post-randomization