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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