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Co-developing suicide prevention guidelines for pakistan: a mixed-methods Delphi consensus study.

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This study co-developed suicide prevention guidelines for gatekeepers in Pakistan, addressing high stigma and limited resources. The consensus-based guidelines offer culturally relevant strategies to aid individuals experiencing suicidal ideation.

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Area of Science:

  • Public Health
  • Mental Health Research
  • Psychiatry

Background:

  • Suicide is a global public health issue, particularly in low- and middle-income countries like Pakistan.
  • Pakistan faces challenges including high stigma, low help-seeking rates, and limited mental health professionals.
  • Community-based suicide prevention programs, like first-aid guidelines, are cost-effective but lack evidence in Pakistan.

Purpose of the Study:

  • To co-develop contextually relevant suicide prevention guidelines for gatekeepers in Pakistan.
  • To assist individuals experiencing suicidal ideation or behaviors.
  • To support stakeholders, including mental health professionals, in suicide prevention efforts.

Main Methods:

  • A two-phase Delphi expert consensus study was employed.
  • Phase 1 involved developing a semi-structured questionnaire based on existing guidelines and multi-disciplinary stakeholder consultations.
  • Phase 2 utilized a Delphi process with experts by profession and experience to reach consensus on guidelines through in-person and online rounds.

Main Results:

  • A total of 72 experts (45 professional, 27 lived experience) participated.
  • 564 statements were rated, with 478 accepted across eleven thematic sections.
  • Context-specific recommendations included culturally relevant warning signs, non-judgmental communication, and urgency assessment.

Conclusions:

  • Culturally adapted suicide prevention guidelines were successfully developed through mixed-methods research and stakeholder engagement in Pakistan.
  • The guidelines incorporate culturally appropriate examples of warning signs, methods, and reasons for self-harm.
  • These consensus-based guidelines will inform public health initiatives to enhance awareness, education, and capacity for suicide prevention.