GCRF: South Asia Self Harm research capability building initiative (SASHI)

Lead Research Organisation: University of Manchester
Department Name: School of Health Sciences

Abstract

Our vision is to bring together a critical mass of international expertise and research excellence to build capability and capacity to conduct research on Deliberate Self Harm (DSH).

Our main aim is to produce new and robust information to inform the understanding of the nature of DSH in the context of profound social, political and economic challenges in low and middle-income countries (LMIC) such as India and Pakistan.

Research leaders are thinly spread in LMICs, which limits capability building and restricts capacity. There are serious gaps in knowledge about DSH in South Asia. We will meet these challenges in two ways:
- firstly by conducting research
- secondly by providing training.

Research that is collaboratively designed, culturally appropriate and rigorously implemented is one of the best learning tools for building capability. A trained and skilled workforce will continue to build capability and capacity for research. In this partnership, capability building is reciprocal and sustainable. We will share knowledge across the partnership.

The programme of work will include training in different areas such as research methods, systematic reviews, data analysis and research governance. PhD students will benefit from the training. We will design some of the training ourselves and bring in other experts to help. We will draw on the expertise of people with lived experience to develop our work programme.

A lot of different academic disciplines are involved in the programme. We will work together and share our knowledge to support post doctoral researchers and PhD students who will become the research leaders of the future.

Our research programme will develop new evidence and strengthen our understanding of DSH. We will carry out research using quantitative and qualitative methods.

We will develop a flexible and trained research workforce in India and Pakistan to carry out fieldwork safely, efficiently and rigorously in challenging environments. We will work closely with Non-Governmental Organisation (NGO) partners in Pakistan and India.

We will share our findings widely with a range of stakeholders including the local community, international forums and in high impact scientific journals. Our work will inform the development of culturally relevant community and primary-care responses to DSH and suicide in LMIC. Our work will also inform the development of suicide prevention policies, including public health messages and measures.

We will document and evaluate the development of the partnership and knowledge exchange processes, and disseminate the findings on conducting this work.

Our three core datasets (household survey sample, stakeholder sample, and DSH Register) will help us to examine and describe DSH in local context, explore substantive areas of interest in rich detail, answer a number of research questions and inform policy development and community and health service responses. We will find out more about differences and similarities between India and Pakistan and the differences and similarities between South Asia and other regions of the world.

Technical Summary

Our vision is to bring together a critical mass of international expertise and research excellence to build capability and capacity to conduct research on Deliberate Self Harm (DSH).

Our main aim is to produce new and robust information to inform the understanding of the nature of DSH in the context of profound social, political and economic challenges in low and middle-income countries (LMIC) such as India and Pakistan.

Research leaders are thinly spread in LMICs, which limits capability building and restricts capacity. There are serious gaps in knowledge about DSH in South Asia. We will meet these challenges in two ways:
- firstly by conducting research
- secondly by providing training.

Research that is collaboratively designed, culturally appropriate and rigorously implemented is one of the best learning tools for building capability. A trained and skilled workforce will continue to build capability and capacity for research. In this partnership, capability building is reciprocal and sustainable. We will share knowledge across the partnership.

The programme of work will include training in different areas such as research methods, systematic reviews, data analysis and research governance. PhD students will benefit from the training. We will design some of the training ourselves and bring in other experts to help. We will draw on the expertise of people with lived experience to develop our work programme.

A lot of different academic disciplines are involved in the programme. We will work together and share our knowledge to support post doctoral researchers and PhD students who will become the research leaders of the future.

Our research programme will develop new evidence and strengthen our understanding of DSH. We will carry out research using quantitative and qualitative methods.

We will develop a flexible and trained research workforce in India and Pakistan to carry out fieldwork safely, efficiently and rigorously in challenging environments. We will work closely with Non-Governmental Organisation (NGO) partners in Pakistan and India.

We will share our findings widely with a range of stakeholders including the local community, international forums and in high impact scientific journals. Our work will inform the development of culturally relevant community and primary-care responses to DSH and suicide in LMIC. Our work will also inform the development of suicide prevention policies, including public health messages and measures.

We will document and evaluate the development of the partnership and knowledge exchange processes, and disseminate the findings on conducting this work.

Our three core datasets (household survey sample, stakeholder sample, and DSH Register) will help us to examine and describe DSH in local context, explore substantive areas of interest in rich detail, answer a number of research questions and inform policy development and community and health service responses. We will find out more about differences and similarities between India and Pakistan and the differences and similarities between South Asia and other regions of the world.

Planned Impact

The South Asia Self Harm research capability building initiative (SASHI) project aims to have significant impact on individuals who experience DSH, families, communities, health and care providers, policy makers and the international research community. There will be a number of direct and indirect pathways to impact.

Individuals at risk of deliberate self harm (DSH) and suicide and their families: Survivors of DSH are at increased risk of recurrent DSH and suicide. This work will provide new empirical evidence about DSH, including the information about prevalence and immediate and short term outcomes. Together with an understanding of how DSH occurs gained through the qualitative work, we will be able to identify what affects help-seeking behaviour, and social and health factors that might be amenable to intervention. Wider engagement with the local communities will raise awareness and encourage understanding about the antecedents (for example, rural debt, mental illness, life events) and consequences (disability, death) of DSH. We anticipate that this will decrease stigma and increase help seeking. We will achieve this through working with survivors, families and health and care providers to identify the best routes and media for disseminating information. Possible examples include use of social media and local media such as community radio and existing community groups.

Health and Care community: Identifying care needs and describing help seeking behaviour will inform service developments and new service models and approaches aimed at reducing DSH and at providing appropriate aftercare. Reducing the number of episodes of DSH will reduce the burden on secondary and intensive care facilities. We will achieve this by working with provider organisations to create joint action plans informed by our findings. We will produce training material based on the experience of implementing the core elements of the project. In particular we will carefully document the process of developing and implementing the DSH Registers in a manual. The research will improve the care of people following an episode of DSH as this has the potential to prevent further episodes and reduces the risk of suicide. To achieve this, wider engagement with policy makers is essential and we will prepare targeted SASHI Policy Briefings on a regular basis.

Academic communities: Enhancing the skill set of the local academic community will have lasting effects and help to build a strong research community and increase capacity for further research planning and activity such as scoping reviews, feasibility studies, trial platforms and systematic reviews. We will achieve this through knowledge exchange activities, research training and mentoring which will leave sustainable legacies for the local academic communities. Training local fieldworkers drawn from the health worker population has the potential to create a sustainable, flexible and efficient research delivery team for future research projects. The composition of the international team will ensure that our findings will be presented to a wide range of disciplines. Through the expansion of our knowledge and understanding of DSH, the work will lay the foundation for further research and evaluation.

The work will be of direct relevance to other Low and Middle Income Countries (LMIC) and will also be of interest to people working with minority immigrant communities in the UK and services providing support following an episode of DSH. Having an impact lead in each country and a strong internet and social media presence through a web site, briefings, Twitter feed and Blog and copy for local, national and international audience, enables us to reach individuals who experience DSH, families, communities, health and care providers, policy makers and the international research community to affect change to improve the health and wellbeing of communities in LMIC.

Publications

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Krishna, M (2019) Mixed methods systematic review of bereavement related to suicide in South Asia. in PROSPERO Registration CRD42019135503

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McPhillips R (2019) . in Knowledge, attitudes, and experiences of self-harm and suicide in low and middle income countries: a systematic review

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Poole, R (2019) Self-Harm & Suicide: Beyond Good Intentions in Self-Harm & Suicide: Beyond Good Intentions

 
Description Antecedents and outcomes of debt and self-harm 
Organisation Grassroots Research and Advocacy Movement
Country India 
Sector Charity/Non Profit 
PI Contribution Profs Robinson and Poole, and Dr Murali Krishna have continued to meet with Dr Balasubramanian Founder of SVYM, for example, during their visit to Mysore in May 2018. Dr Murali Krishna has maintained regular contact with SVYM. SASHI researchers included individuals with a particular interest in social factors. Drawing together a multidisciplinary team with experience in in depth case study research and policy analysis and influence provides a strong partnership to take the debt research and impact work forward.
Collaborator Contribution Dr Balasubramanian will help set up a Memoradum Of Understanding (MOU). He will be leading the project evaluating the impact of debt and the recently implemented debt waiver programme on self-harm among farmers in Mysore. GRAAM are an important policy focused NGO with particular expertise around community engagement and social factors. GRAAM have become an important element of our pathways to impact infrastructure in India.
Impact A MOU will be confirmed between SASHI and GRAAM, in 2019. The proposed project on debt will use an innovative case study approach to debt. We will consider in-depth case studies on the antecedents and consequences of debt from the perspective of individuals, families, communities and policy makers. GRAAM included public health, social policy and medicine. This work will be developed in collaboration with the SACR Team in University of Edinburgh and Sri Lanka.
Start Year 2017
 
Description Cardiff University 
Organisation Cardiff University
Department School of Social Sciences
Country United Kingdom 
Sector Academic/University 
PI Contribution We worked in collaboration to develop an extension to the SASHI work in South Asian countries including preparation of a major grant application.
Collaborator Contribution We worked in collaboration to develop an extension to the SASHI work in South Asian countries including preparation of a major grant application.
Impact Social work and Computer Sciences. We submitted an outline grant application.
Start Year 2017
 
Description Developing research collaboration with Apnagharashram for Homeless People 
Organisation Apna Ghar Ashram
Country India 
Sector Charity/Non Profit 
PI Contribution We are bringing research expertise to the partnership to address a gap in work on poverty and women. I have also secured PhD funding from NIHR School for Social Care Research which will focus on homelessness in England so it is timely to have some parallel work in South Asia. My intention is to collaborate with the Stephen Campbell and colleagues in the NIHR PSTRU in Manchester. We also have a link with the TATA foundation and will pursue that as a potential source of funding.
Collaborator Contribution This is a large organisation with the main site in Rajasthan - with 30 other sites across India and one in Pakistan and one in Nepal. There are high levels of mental disorder and learning disability. It is run like a therapeutic community. They are collecting a lot of routine data and are keen to evaluate their services and carry out some analysis of the costs.
Impact Develop plans to apply for joint funding.
Start Year 2019
 
Description Discussion potential roll out of self ham register and further research with All India Institute of Medical Sciences (AIIMS) 
Organisation All India Institute of Medical Sciences Bhubaneswar
Country India 
Sector Hospitals 
PI Contribution We bring research expertise to this developing partnership. I reengaged with a senior AIIMS psychiatrist who had previously expressed interest in rolling out the SASHI self harm register work in Odisha, in the first instance in the AIIMS hospital. I had the opportunity to reengage with the forthcoming Director of Psychiatry at PGI Chandigarh and to meet the Head of Department of Psychiatry in AIIMS Delhi. There is considerable interest in pursuing common areas of research. .
Collaborator Contribution Potential roll out site for self harm register and research partner for further grant applications.
Impact Further meetings are planned to take the work forward
Start Year 2019
 
Description IIHMR University 
Organisation IIHMR University
Country India 
Sector Academic/University 
PI Contribution We worked in collaboration to develop an extension to the SASHI work in South Asian countries including preparation of a major grant application. We have met regularly, including collaborating on a major meeting in Jaipur in February 2019 in collaboration with the WPA
Collaborator Contribution We worked in collaboration to develop an extension to the SASHI work in South Asian countries including preparation of a major grant application. The SASHI Team and members of IIHMR have met regularly, including collaborating on a major meeting in Jaipur in February 2019 in collaboration with the WPA and meetings in late 2019 and early 2020
Impact Psychiatry, Clinical Psychology, Public Health
Start Year 2017
 
Description Indian Institute of Health Management Research Jaipur 
Organisation IIHMR University
Country India 
Sector Academic/University 
PI Contribution We have started to plan a number of pieces of work which relate to global mental health and provision of services and support in rural areas in India. We have explored the gap in services for people with serious mental illness and adults with learning disability. We will continue to explore opportunities to extend our work in collaboration and have started to prepare research questions about supervision of health workers in remote areas, identifying the needs of adults with learning disability and psychological autopsy in rural communities.
Collaborator Contribution IIHMR bring particular expertise related to public health and research on the management of service provision in low and middle income countries. They train graduates in health management and recruit students from a number of countries. Their research interests are closely aligned with the SASHI group and we are working together to increase capacity and capability in research to extend the SASHI research both within India and in other countries in South Asia. IIHMR members will meet with the wider group in December 2018 in the SASHI meetings in Sharjah.
Impact IIHMR were collaborators in a large grant application to extend the scope and reach of the SASHI network. IIHMR includes public health and psychology and health management.
Start Year 2017
 
Description JSS Medical College and Hospital 
Organisation JSS Medical College and Hospital
Country India 
Sector Academic/University 
PI Contribution Discussion about the potential for doctors and other mental health professionals undertaking postgraduate training to work with the SASHI team on their dissertation projects where this work is relevant to self-harm or suicide prevention. Profs C Robinson and Poole met Dr Kushalappa PA Director, Dr B Manjunath, the registrar, Dr Basavanna Gowda Patil, Principal, and Dr Rajesh Raman Head of the Department of Psychiatry at JSS University of Mysore to set up a Memorandum Of Understanding (MOU) in May 2018. Dr Murali Krishna is continuing to work with them for setting up of this MOU. The SASHI team will work with JSS on gaining a better understanding about self-harm and suicide and the pathways and barriers to prevention and support.
Collaborator Contribution Discussion about the JSS Hospital participating in the self-harm register research Prof Rajesh Raman is helping us draft and set up the MOU. He is helping in the preparatory work for setting up of a self-harm register at JSS Hospital Mysore. He will be working jointly with Dr Murali Krishna on a wide range of planned activities for building up self-harm research capacity at JSS University. He will also guide us in the receiving the necessary clearances from the ethics and clinical research committee at the JSS University. He will attend the SASHI meeting at Sharjah in December 2018 to refine the plans about students and self-harm.
Impact Psychiatry, nursing, clinical psychology, medical social work 1. The MOU between the Centre for Mental Health and Society (CFMHAS), Bangor, and JSS university will be signed in December 2018. 2. Dr Murali Krishna, Senior Research Fellow Bangor University and SASHI researcher has been offered an adjunct faculty at the Department of Psychiatry, JSS University. 3. Setting up of the Self harm Register at JSS Hospital in Mysore 4. Jointly develop the SASHI self-harm and mental health project for the student populations in Mysore 5. Dr Shivanand, Associate Professor at the Department of Psychiatry, JSS will register for a PhD programme examining the social and psychosexual determinants of self-harm in Mysore. 6. Dr Megha has registered the mental health and suicidality among the adolescents for her Master's dissertation (MD). To commence from 2019. 7. Dr Sashanth has registered 'the social and clinical determinants of self-harm among older adults in Mysore' for his Master's dissertation (MD). To commence from 2019
Start Year 2017
 
Description JSS University of Mysore 
Organisation JSS University
Country India 
Sector Academic/University 
PI Contribution Profs C Robinson and Poole met Dr Kushalappa PA Director, Dr B Manjunath, the registrar, Dr Basavanna Gowda Patil, Principal, and Dr Rajesh Raman Head of the Department of Psychiatry at JSS University of Mysore to set up a Memorandum Of Understanding (MOU) in May 2018. Dr Murali Krishna is continuing to work with them for setting up of this MOU. The SASHI team will work with JSS on gaining a better understanding about self harm and suicide and the pathways and barriers to prevention and support. JSS are now the main project partner. The collaboration agreement is due to be signed off shortly and Dr Rajesh Rahman will be part of the Co Investigator group.
Collaborator Contribution Prof Rajesh Raman is helping us draft and set up the MOU. He is helping in the preparatory work for setting up of a self-harm register at JSS Hospital Mysore. He will be working jointly with Dr Murali Krishna on a wide range of planned activities for building up self harm research capacity at JSS University. He will also guide us in the receiving the necessary clearances from the ethics and clinical research committee at the JSS University. He will attend the SASHI meeting at Sharjah in December 2018 to refine the plans about students and self harm.
Impact 1. The MOU between the Centre for Mental Health and Society (CFMHAS), Bangor, and JSS university will be signed in December 2018. 2. Dr Murali Krishna, Senior Research Fellow Bangor University and SASHI researcher has been offered an adjunct faculty at the Department of Psychiatry, JSS University. 3. Setting up of the Self harm Register at JSS Hospital in Mysore 4. Jointly develop the SASHI self-harm and mental health project for the student populations in Mysore 5. Dr Shivanand, Associate Professor at the Department of Psychiatry, JSS will register for a PhD programme examining the social and psychosexual determinants of self harm in Mysore. 6. Dr Megha has registered the mental health and suicidality among the adolescents for her Master's dissertation (MD). To commence from 2019. 7. Dr Sashanth has registered 'the social and clinical determinants of self harm among older adults in Mysore' for his Master's dissertation (MD). To commence from 2019
Start Year 2018
 
Description MMCRI Burns Unit 
Organisation Mysore Medical College
Country India 
Sector Academic/University 
PI Contribution Discussion about working together to augment the routinely collected data on the burns unit to enable a burns unit register to be established as part of the SASHI self-harm register research and to also serve the needs of the burns unit. Discussion about the creation of a care pathway between the burns unit and psychiatry and the burns unit and NGOs. Discussion about the role of stigma and substance misuse. Discussion about the role of routinely collected data and follow-up of individuals.
Collaborator Contribution Discussion about working together to augment the routinely collected data on the burns unit to enable a burns unit register to be established as part of the SASHI self-harm register research and to also serve the needs of the burns unit. Discussion about the role of stigma and substance misuse. Discussion about the role of routinely collected data and follow-up of individuals.
Impact Plastic surgery and hospital medicine
Start Year 2018
 
Description MMCRI Community Medicine 
Organisation Mysore Medical College
Country India 
Sector Academic/University 
PI Contribution Discussion about postgraduate trainees working with SASHI to develop research questions about self-harm and suicide prevention in their dissertation research. Discussion about the role of alcohol in self harm and suicide. Discussion about stigma in the role of suicide and self-harm.
Collaborator Contribution Discussion about postgraduate trainees working with SASHI to develop research questions about self-harm and suicide prevention in their dissertation research. Agreed that a member of faculty would work directly with the SASHI team on the SASHI household survey. Agreed that substance misuse and mental illness will be an important focus in SASHI.
Impact public health and community medicine
Start Year 2018
 
Description Meeting about research work with Rajasthan Police 
Organisation Rajasthan Police Academy
Country India 
Sector Public 
PI Contribution We met with the Director General of the Rajasthan police force about the potential to undertake some research and development work about the well-being of members of the police force and suicide and self harm and about potential collaboration with the Police University.
Collaborator Contribution Potential research partner providing access to a large number of police employees
Impact Agreement for further work
Start Year 2019
 
Description Middlesex University 
Organisation Middlesex University
Country United Kingdom 
Sector Academic/University 
PI Contribution We worked in collaboration to develop an extension to the SASHI work in South Asian countries including preparation of a major grant application. We are preparing a number of other grant applications
Collaborator Contribution We worked in collaboration to develop an extension to the SASHI work in South Asian countries including preparation of a major grant application.
Impact We submitted an outline grant application.
Start Year 2017
 
Description NIMHANS Developing Funding Applications together 
Organisation National Institute of Mental Health and Neurosciences
Country India 
Sector Hospitals 
PI Contribution We bring research expertise and understanding of the funding requirements.
Collaborator Contribution NIMHANS is a highly respected institution and they can provide access to potential research participants.
Impact Psychiatry, nursing, social work. We discussed firms planed to collaborate on the wider digital agenda (telemedicine initiative) and this work may be of interest to the group in the University of Manchester led by Professor Niels Peak. We met with the Head of Department and Faulty and discussed plans for collaboration.
Start Year 2019
 
Description National Institute of Mental Health & Hospital (NIMH) 
Organisation National Institutes of Health (NIH)
Department National Institute of Mental Health (NIMH)
Country United States 
Sector Public 
PI Contribution Agreed to collaborate to extend the SASHI work in South Asian countries including preparation of a major grant application.
Collaborator Contribution Agreed to collaborate to extend the SASHI work in South Asian countries including preparation of a major grant application.
Impact Psychiatry, Clinical Psychology
Start Year 2017
 
Description PGI Chandigarh 
Organisation Post Graduate Institute of Medical Education and Research (PGIMER)
Country India 
Sector Academic/University 
PI Contribution Discussion about PGI faculty collaborating in SASHI research, particularly in relationship to substance misuse and self-harm and suicide. We discussed creating a memorandum of understanding.
Collaborator Contribution Discussion about PGI faculty collaborating in SASHI research, particularly in relationship to substance misuse and self-harm and suicide. Discussion about sources of funding to extend the SASHI research platform in India.
Impact PGI faculty includes psychiatry, clinical psychology and medical social work
Start Year 2018
 
Description QMUL 
Organisation St Bartholomew's Hospital
Department School of Medicine and Dentistry
Country United Kingdom 
Sector Hospitals 
PI Contribution We worked in collaboration to develop an extension to the SASHI work in South Asian countries including preparation of a major grant application.
Collaborator Contribution We worked in collaboration to develop an extension to the SASHI work in South Asian countries including preparation of a major grant application.
Impact Psychiatry, Clinical Psychology
Start Year 2017
 
Description RCPsych 
Organisation Royal College of Psychiatrists
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Agreed to collaborate to extend the SASHI work in South Asian countries including preparation of a major grant application. We have held a series of meetings with their internationalisation lead to advise RCPsych about getting involved in global mental health research, including working with the SASHI network. We have also discussed other global health related research funding streams and about research on supervision in the context of scale-up activity.
Collaborator Contribution Agreed to collaborate to extend the SASHI work in South Asian countries including preparation of a major grant application. We have held a series of meetings with their internationalisation lead to advise RCPsych about getting involved in global mental health research, including working with the SASHI network. We have also discussed other global health related research funding streams and about research on supervision in the context of scale-up activity.
Impact The collaboration with RCPsych has resulted in the submission of one outline proposal and discussion about the potential to collaborate on other research activity related to global mental health, in particular the topic of supervision
Start Year 2017
 
Description Self Harm Register Roll out in Rajasthan 
Organisation Sawai ManSingh Medical College and Hospital
Country India 
Sector Academic/University 
PI Contribution We met in 2019 with the Director of Medical Education (who also has state-wide responsibilities) and the Director of Forensics and Toxicology. We discussed the opportunity for the SASHI Self Harm register process (supervised implementation by the SASHI team) to be adopted by the hospital. We met again in February 2020 to firm up plans. We discussed the collaboration on the upcoming MRC programme grant call.
Collaborator Contribution The hospital has an ED and a Trauma Centre. The Director of Forensics manages the routinely collected data about medico-legal cases which are key to SASHI processes. SMS is also a focus for autopsies at a time when death registration in India is being reformed. We also met with the secretary and the minister for Health and Family Welfare in Rajasthan and both support a roll-out of the Self Harm Register across state hospitals.
Impact Initial draft plans for SASHI Self Harm Register roll-out. To have access to this sort of support and infra-structure to roll out the SASHI surveillance system is significant and a major outcome for SASHI.
Start Year 2019
 
Description Submission of a GCRF-University grant application with a focus on Social inclusion in deprived tribal communities in India 
Organisation Institute of Public Health Bengaluru
Country India 
Sector Charity/Non Profit 
PI Contribution We developed and submitted a grant application , the application was led by P. Huxley in Bangor. Unfortunately we were unsucessful in this very competitive round. This is a developing partnership and the group is exploring further options.
Collaborator Contribution The organisations provided their knowledge of the local context to the application. This is a collaborative partnership. The proposed work was going to be conducted by partners in India
Impact A grant application was submitted. The partnership is with a University (https://iphindia.org/about-us/) and a TSO (http://www.vgkk.org/).
Start Year 2019
 
Description Submission of a GCRF-University grant application with a focus on service user engagement in self harm and suicide research in South Asia 
Organisation Chhahari Nepal for Mental Health
Country Nepal 
Sector Charity/Non Profit 
PI Contribution We developed and submitted a grant application together, the application was led by A.Krayer in Bangor. Unfortunately we were unsucessful in this very competitive round. This is a developing partnership and the group is meeting this summer to collaboratively develop another research proposal.
Collaborator Contribution We developed and submitted a grant application together at the end of 2019. The research was going to take place in India (http://www.graam.org.in/about-us/) and Nepal (https://chhaharinepal.org.np/), with the South Asia partners being equal partners and conducting the field work
Impact This collaboration is with two NGOs - one in Nepal and one in India. An output is the grant proposal which we submitted the end of 2019.
Start Year 2019
 
Description Submission of a bid for a GCRF funded PhD at University of Manchester on 'Deliberate Self-Harm and Suicide in Women in India' 
Organisation JSS University
Country India 
Sector Academic/University 
PI Contribution An application for a GCRF funded PhD was developed collaboratively with Indian partners who have first hand knowledge and experience of the Indian context. At the time of writing (11/03/2020) the proposed project has been shortlisted, advertised for student applications, and a nominated candidate has been approved for interview.
Collaborator Contribution The partners provided their knowledge and experience of the local context to the application. If successful the proposed work will be conducted in close collaboration with partners in India and the PhD student will spend a significant proportion of time in India with partners.
Impact A grant application was submitted.
Start Year 2019
 
Description Submission of a bid for a GCRF funded PhD at University of Manchester on 'Responsible Reporting of Deliberate Self-Harm and Suicide in the Indian Media' 
Organisation University of Mysore
Country India 
Sector Academic/University 
PI Contribution An application for a GCRF funded PhD was developed collaboratively with Indian partners who have first hand knowledge and experience of the Indian media. Unfortunately this application was unsuccessful.
Collaborator Contribution The partners provided their knowledge and experience of the local context to the application. If successful the proposed work would have been conducted in close collaboration with partners in India.
Impact A grant application was submitted.
Start Year 2019
 
Description The All India Institute of Speech and Hearing Mysore 
Organisation The All India Institute of Speech and Hearing
Country India 
Sector Academic/University 
PI Contribution Profs Robinson and Poole, and Dr Murali Krishna, had a meeting with Prof S Goswami at the All India Institute of Speech and Hearing, Mysore. This meeting identified AIISH as an important resource for capacity building, and carrying out training and dissemination activities. Further work has involved a joint workshop and successful joint funding application with Dr Ira Leroi (SASHI Co-Investigator)
Collaborator Contribution Prof Goswami is helping us draft and set up a Memorandum of Understanding (MOU) between the Bangor University, University of Manchester, Oxford University, PILL, MMCRI and AIISH, Mysore. He has specifically sought permission for SASHI-India staff to use the state of the art facilities at his institution for training and public engagement activities. Further work has involved a joint workshop and successful joint funding application with Dr Ira Leroi (SASHI Co-Investigator)
Impact 1. MOU between Bangor University, University of Manchester, Oxford University, PILL, MMCRI and AIISH to be drafted by December 2018; 2. AIISH is a premier institution of the Central Ministry of Health and Family Welfare. This provides a direct pathway for the policy impact in India; 3. Resources (e.g. lecture theatres, halls and auditorium, and AV facilities) will be made available for the SASHI team for effectively conducting public engagement, training and scientific dissemination activities in Mysore; 4. Prof Goswami will collaborate with us in conducting the self-harm studies among the immigrant populations in Mysore. 5. Funded research project starting in March 2019
Start Year 2018
 
Description The Department of Anthropology, University of Mysore 
Organisation University of Mysore
Country India 
Sector Academic/University 
PI Contribution Profs. Robinson and Poole, and Dr Murali Krishna had a meeting with Prof. Gangadhar, Head of the Department of Anthropology at University of Mysore. This meeting identified the University of Mysore as an important resource for capacity building, and developing educational and training resources. The potential for SASHI staff to co-supervise MA and MSc students is under discussion.
Collaborator Contribution Prof. Gangadhar is helping us set up a Memorandum Of Understanding (MOU) between the SASHI Collaborators and the University of Mysore. In addition, he has made provision for CFHMAS, Bangor and SASHI India team to use the multimedia resources available at University of Mysore for developing educational training resources.
Impact 1. The MOU between the SASHI Collaborators and the Department of Anthropology, University of Mysore, has been drafted and will be formalised in November 2018 during a knowledge exchange visit. 2. The team and SASHI India team have access to the multimedia studio at University of Mysore for developing educational training resources that can be broadcast to all graduate and postgraduate educational organisations in the State of Karnataka. 3. The Department of Anthropology are considering identifying student undertaking Masters level dissertations to work with the SASHI team.
Start Year 2018
 
Description University of Chester 
Organisation University of Chester
Department Faculty of Health and Social Care
Country United Kingdom 
Sector Academic/University 
PI Contribution We worked in collaboration to develop an extension to the SASHI work in South Asian countries including preparation of a major grant application. The SASHI team are involved in some knowledge exchange work to extend their work on self-harm and suicide prevention with particular occupational groups including known to be of high risk for self harm and suicide. The SASHI group bring particular expertise in self-harm research, narrative methods and the use of routinely collected data.
Collaborator Contribution We worked in collaboration to develop an extension to the SASHI work in South Asian countries including preparation of a major grant application. Professor Vimal Sharma chairs the World Psychiatric Association interest group on rural mental health. Professor Sharma developed the Global Mental Health Assessment Tool (GMHAT) for use by non-specialist workers. The GMHAT may become part of the Self Harm Register additional data set.
Impact We submitted an outline grant application. Psychiatry and Nursing are included in the disciplines from University of Chester. We are developing a further grant application in relation to learning disability.
Start Year 2017
 
Description University of Warwick 
Organisation University of Warwick
Department Warwick Medical School
Country United Kingdom 
Sector Academic/University 
PI Contribution We worked in collaboration to develop an extension to the SASHI work in South Asian countries including preparation of a major grant application.
Collaborator Contribution We worked in collaboration to develop an extension to the SASHI work in South Asian countries including preparation of a major grant application.
Impact We submitted an outline grant application.
Start Year 2017
 
Description Academic emergency medicine: a UK perspective by Emily Bebbington 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact 20 doctors from JSS ED attended the talk which gave insight into the SASHI project and led to discussions about research development at the hospital and region as a whole.

Led to future potential research collaborations with the JSS ED
Year(s) Of Engagement Activity 2019
 
Description Decriminalisation of suicide in India" at Offender Health Research Network Wales North Wales conference 22 May 2019 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Third sector organisations
Results and Impact More details required
Year(s) Of Engagement Activity 2019
 
Description Presentation 'The Decriminalisation of Suicide in India' by Rob Poole  
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Needs content
Year(s) Of Engagement Activity 2019
 
Description Presentation School of Health Sciences Bangor University 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Talked about the SASHI work with a specific focus on research issues that need to be considered when conducting research on suicide and self harm in South Asia. This led to questions and discussion and participants told me that they learnt a lot.
Year(s) Of Engagement Activity 2020
 
Description Presentation on Effective suicide prevention is a public health at British Pakistani Psychiatrists Association (BPPA) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presentation sparked a lot of questions and discussions.
Year(s) Of Engagement Activity 2019
URL https://www.bppa.info/bppa-annual-meeting-9th-and-10th-november-2019/
 
Description Presentation summer research school, Bangor University 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact SASHI Co-Is and researchers in training delivered sessions at the two summer school weeks at the School of Health Sciences, Bangor University. Sessions covered:
- introduction to SASHI
- research protocol development
- capacity building theory and practice
- considerations when setting-up a burns register.

The sessions sparked a lot of interest and discussion. A connection with Emily Bebbington was made in the first summer school in 2018. She stayed in touch and met several times with the team. Based on this she submitted a PhD funding application and received funding. Her PhD focuses on setting up a burns register and Catherine Robinson (PI) and Rob Poole (Co-I) are her supervisors. She presented at the Summer school in 2019.
Year(s) Of Engagement Activity 2018,2019
 
Description Research ethics at JSS Hospital, Mysore, India 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact 17 health and research professionals and postgraduate students attended an interactive workshop on research ethics. The aim of the workshop was knowledge exchange between facilitators from the SASHI team and attendees. The workshop sparked much discussion regarding the ways in which ethical risks and issues can be managed in the Indian context. Feedback forms filled out by attendees indicated that the session had increased their understanding of how to identify and deal with ethical risks and issues.
Year(s) Of Engagement Activity 2019
 
Description SASHI research training for Research Assistants at Public Health Institute, Mysore 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Other audiences
Results and Impact Training in research methods delivered to assistant psychologists at the Public Health Research Institute, Mysore.
The training focused on development of questionnaires and administration of the questionnaire in a standardised manner for women in the community. Basic principles and ethical issues in conducting community research were taught and discussed
Year(s) Of Engagement Activity 2018
 
Description Symposium Presentation at World Psychiatric Association (WPA) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact International perspectives on social factors and mental Health Symposium based on SASHI work chaired by Peter Huxley (CoI):

Presentation by Catherine Robinson (CI): Care for People following Self-Harm: perspectives from health care providers
Presentation by Rob Poole (CoI): Developing Effective Suicide Prevention Strategies in South Asia
Year(s) Of Engagement Activity 2018
URL https://www.wpanet.org/post/world-congress-of-psychiatry-mexico-2018-meet-the-expert-sessions
 
Description Talk on Trauma systems: Prevention to treatment by Emily Bebbington 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact 20 doctors from JSS ED attended the talk which gave insight into the SASHI project and led to discussions about research development at the hospital and region as a whole.

Strengthening links with ED's across Karnataka and exposure to the SASHI project
Year(s) Of Engagement Activity 2019
 
Description Workshop on skills training with carers on managing children with intellectual disabilities, pariculalry those who self-harm 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Patients, carers and/or patient groups
Results and Impact Carers attended a workshop on skills training to learn about managing children with intellectual disabilities, with a particular focus on managing self-harm behaviours. At the Government Shadab Institute of Special Children
Year(s) Of Engagement Activity 2018