A Youth Culturally adapted Manual Assisted Psychological therapy (Y-CMAP) for adolescent Pakistani patients with a recent history of self-harm.

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

Abstract

Suicide is a serious global public health issue ranked amongst the leading causes of death in many countries. The worldwide rates of suicide have increased by 60% in the last 45 years. The 1.8% total global burden of disease attributed to suicide in 1998 is expected to increase to 2.4% by 2020. The WHO Mental Health Action Plan 2013-2020 and all the member states have committed to work towards the global target of a 10% reduction in the suicide rate by 2020. WHO's Mental Health Gap Action Programme includes suicide as one of the priority conditions and the recent WHO report "Preventing suicide: a global imperative" calls for suicide prevention to be a high priority on the global public health agenda. More than 800,000 people across the world die due to suicide each year and for each suicide there are more than 20 people attempting suicide. Self-harm is one of the strongest predictors of death by suicide in adolescence, increasing the risk approximately 10-fold. Each suicide takes the life of the individual and has a tremendous effect on friends, family and the wider community. Up to 75% of all suicides occur in in low- and middle-income countries (LMIC) where resources and services are limited for treatment and support. There is a clear gap in the robust evaluation of culturally appropriate suicide prevention strategies in LMIC. Individuals who have a history of self-harm are at much higher risk of dying by suicide than individuals who do not have such a history. The WHO recommends offering appropriate treatment as a key component of all suicide prevention strategies.
There are more than 100,000 acts of self-harm in Pakistan annually. The aim of Y-CMAP is to evaluate the clinical and cost-effectiveness of this culturally adapted psychological therapy in adolescent patients with a history of self-harm. Our study in Karachi determined the effectiveness of a 6-8 session CBT-based intervention (C MAP) in adults who had recently self-harmed. The assessments were carried out at baseline, 3 & 6 months. There was a significant reduction from baseline in suicidal ideation and hopelessness in the intervention group compared to the Treatment as Usual (TAU) group at each follow up assessment. The findings from C MAP highlight the applicability of such an intervention to health services in Pakistan for patients who present after a self-harm episode. The proposed research will be conducted in Karachi, Lahore, Rawalpindi, Multan and Hyderabad. Participants will be randomized either to the Intervention (Y-CMAP) or TAU. The existing age appropriate culturally adapted intervention (Y-CMAP) for young people includes an evaluation of the self-harm episode, crisis skills, problem solving and basic cognitive techniques to manage emotions, negative thinking and relapse prevention strategies. The intervention will be delivered in eight sessions over 12 weeks. Assessments will be conducted at baseline and at 3 months (end of intervention), 6 months and 12 months after randomization. The outcome measures will include questionnaires to measure the repetition of self-harm, severity of suicidal ideation; depression; hopelessness; and quality of life. In addition, qualitative interviews and focus groups will provide rich information regarding the experiences of participants, therapists and key stakeholders. This will inform implementation as well as the development of more effective and sensitive services for self-harm management. TAU will be standard routine care delivered by local medical, psychiatric and primary care services according to clinical judgment. A record will be kept of any treatment received by each participant. This trial will inform future research and national clinical practice guidelines. We have established contacts with the ministry of health and will enter discussions to present the results to them and attempt to influence policy change.

Technical Summary

Design: A multi-centre single blind RCT with randomisation by individual patients to compare the Y-CMAP in addition to TAU with TAU alone. There is a built in 12-month internal pilot phase with clear stop/go criteria to prove viability to proceed to a full trial across all the study sites. The pilot phase will be judged successful if sufficient GPs, schools and hospitals are recruited to enrol 200 participants in the first 12 months. Assessments will be conducted for both the groups at baseline, 3 (end of intervention),6,9 and 12 months after randomisation
Setting: Participants will be recruited from general practices, emergency departments, medical wards of participating hospitals and self-referrals.
Intervention: Y-CMAP is based on the principles of Problem Solving and CBT.
Sample size: This is based on the primary outcome, repetition of self-harm in 12-month period (yes/no). The TAU arm of the study has an expected self-harm rate of 20% and a clinically important effect would be a reduction to 7.5% in the intervention group. Under these assumptions, and assuming a 5% significance level and 90% power, a study with no clustering would require 158 patients per arm. The study has a partially nested design due to therapist clustering in the Y-CMAP arm. Based on previous analysis of therapist trials we believe that the ICC is likely to have a value between 0.01 and 0.05 for this type of outcome measure. Assuming an ICC of 0.05, and a cluster size of 16 patients per therapist, a Design Effect of 1.75 is calculated This increases the numbers required to 277 per group. Furthermore, there is expected to be a 15% loss to follow-up, and so the final numbers recruited will be 326 per group, 652 in total.
Primary outcome measure: Repetition rate of self-harm at 12 months after randomisation as measured by the adapted Suicide Attempt Self-Injury Interview (SASII). Client Service Receipt Inventory (CSRI): We will collect information on the use of health and other services.

Planned Impact

Impact on service users: The overall objective of the trial is to bring about a reduction of self-harm, overall morbidity, a reduction in rates of suicide and a better quality of life. In low income countries there is a huge treatment gap and up to 9 out of 10 people with mental health difficulties do not receive appropriate treatment. Outcomes from our earlier studies provide a strong foundation to build on and aid the translation of research into action. There can be other wide ranging positive outcomes, including increased awareness, improvements in relationships and academic performance. It is suggested that therapies which enhance self-efficacy such as Cognitive Behavioural

Therapy (CBT) may reduce relapse and recurrence rates of many mental disorders including depression and anxiety.
Community awareness: The participants understanding of mental health issues will improve. We have experience of promoting our research within the Pakistani community including presentations or seminars with community leaders, local Pakistani media (newspapers, TV & radio), and promotional material in GP surgeries. The importance of addressing mental health difficulties promoted through general public awareness will guide people to seek early clinical help for their mental health problems.

Service users as co-researchers: We organise an annual course on the fundamentals of qualitative research methods at the Pakistan Institute of Living and Learning, and service users are invited to attend. Service users on the advisory board were trained in research methods and will contribute to the qualitative analysis in the proposed trial. Our team has significant expertise in this area and we have trained over 70 users and carers in research methods. Service users provide helpful additional insights into the themes emerging from the data and contribute greatly to the interpretation of findings. We will continue to offer this training to service users and carers.
Impact on services: There is limited data available to guide treatment choices for clinicians in Pakistan. The outcome of this trial will have implications for health services, in terms of helping to improve the organization of care and interventions offered for patients who self-harm and thus improve the quality of health services with potential reduction in overall costs. One of the outputs of this study will be a portfolio of user-defined, evidence-based, manual assisted intervention; a resource pack and training programme on 'how to do it' for use across local health services. This trial will provide detailed clinical and cost-effectiveness analyses which will inform future research and national clinical practice guidelines. Together these data will be useful to inform planning of effective and culturally appropriate interventions in Pakistan.

Research and clinical capacity: There is limited research capacity in Pakistan if funded we will be able to train research assistants in robust research methods. There will be workshops on fundamentals of quantitative and qualitative research methods, which will be open for aspiring academics from outside the research team. We have developed the curriculum and trained more than 500 clinicians in Tier-1 psychosocial interventions for mental illness. We have initiated discussions with the nursing schools and departments of psychology that if the results show that Y-CMAP is effective it should be included in the curriculum.

Impact on policy: Research from the Global Mental Health Group have recommended that scaling up services for people with mental disorders is the most important priority for global mental health. We have contacts with the ministry of health (See letter of support) and once the trial is completed we will enter discussions to present the results to them to take this work towards implementation.

Publications

10 25 50
 
Description All parliamentary mental health summit
Geographic Reach Asia 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
 
Description Khyber pakhtun khwan mental health summit
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description Mental health summit - Balochistan
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description Older adults mental health summit
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description Preconception and Pregnancy mental health summit
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description Punjab mental health summit
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description Sindh mental health summit
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description Summit Session focused on young people
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description Working adults group mental health summit
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description CUST university 
Organisation Health Services Academy
Country Pakistan 
Sector Hospitals 
PI Contribution MOU signed by PILL for strengthening capacity and capability of both partners
Collaborator Contribution MOU signed by PILL for strengthening capacity and capability of both partners
Impact MOU signed by PILL for strengthening capacity and capability of both partners
Start Year 2021
 
Description Fatima jinnah university 
Organisation Fatima Jinnah Women's University
Country Pakistan 
Sector Academic/University 
PI Contribution In collaboration with PILL and Fatima jinnah university, global mental health and research group University of Manchester launched National Center for Research on Suicide Prevention - Creating hope through actions. Strengthen capacity and capability in suicide prevention program.
Collaborator Contribution In collaboration with PILL and Fatima jinnah university, global mental health and research group University of Manchester launched National Center for Research on Suicide Prevention - Creating hope through actions. Strengthen capacity and capability in suicide prevention program.
Impact In collaboration with PILL and Fatima jinnah university, global mental health and research group University of Manchester launched National Center for Research on Suicide Prevention - Creating hope through actions. Strengthen capacity and capability in suicide prevention program.
Start Year 2021
 
Description Government College University Lahore 
Organisation Government College University
Country Pakistan 
Sector Academic/University 
PI Contribution MOU signed between GC university Lahore and PILL supported by Manchester Global mental and Culture psychiatry research group for strengthening capacity and capability of both partners and reporting research in mental health in Pakistan.
Collaborator Contribution MOU signed between GC university Lahore and PILL supported by Manchester Global mental and Culture psychiatry research group for strengthening capacity and capability of both partners and reporting research in mental health in Pakistan.
Impact MOU signed between GC university Lahore and PILL supported by Manchester Global mental and Culture psychiatry research group for strengthening capacity and capability of both partners and reporting research in mental health in Pakistan.
Start Year 2021
 
Description Iqra university 
Organisation Iqra University
Country Pakistan 
Sector Academic/University 
PI Contribution MOU signed by PILL for strengthening capacity and capability of both partners
Collaborator Contribution MOU signed by PILL for strengthening capacity and capability of both partners
Impact MOU signed by PILL for strengthening capacity and capability of both partners
Start Year 2021
 
Description Lahore General Hospital 
Organisation Lahore General Hospital
Country Pakistan 
Sector Hospitals 
PI Contribution Lahore General Hospital
Collaborator Contribution MOU signed by PILL supported by Manchester Global mental and Culture psychiatry research group for strengthening capacity and capability of both partners
Impact MOU signed by PILL supported by Manchester Global mental and Culture psychiatry research group for strengthening capacity and capability of both partners
Start Year 2021
 
Description Liaquat University of Medical and Health Science (LUMHS) and Civil hospital Hyderabad 
Organisation Liaquat University of Medical & Health Sciences
Country Pakistan 
Sector Academic/University 
PI Contribution Liaquat University of Medical and Health Science (LUMHS) and Civil hospital Hyderabad. PILL Liaquat University of Medical and Health Science and Civil hospital Hyderabad. MOU signed between LUMHS/ Civil hospital Hyderabad and PILL supported by Manchester Global mental and Culture psychiatry research group for strengthening capacity and capability of both partners like Strengthen capacity in research by offering supervision, training programs to students in developing research protocols.
Collaborator Contribution Liaquat University of Medical and Health Science (LUMHS) and Civil hospital Hyderabad. PILL Liaquat University of Medical and Health Science and Civil hospital Hyderabad. MOU signed between LUMHS/ Civil hospital Hyderabad and PILL supported by Manchester Global mental and Culture psychiatry research group for strengthening capacity and capability of both partners like Strengthen capacity in research by offering supervision, training programs to students in developing research protocols.
Impact Liaquat University of Medical and Health Science (LUMHS) and Civil hospital Hyderabad. PILL Liaquat University of Medical and Health Science and Civil hospital Hyderabad. MOU signed between LUMHS/ Civil hospital Hyderabad and PILL supported by Manchester Global mental and Culture psychiatry research group for strengthening capacity and capability of both partners like Strengthen capacity in research by offering supervision, training programs to students in developing research protocols.
Start Year 2021
 
Description RIPHAH International University 
Organisation Riphah International University
Country Pakistan 
Sector Academic/University 
PI Contribution MOU signed by PILL supported by Manchester Global mental and Culture psychiatry research group for strengthening capacity and capability of both partners
Collaborator Contribution MOU signed by PILL supported by Manchester Global mental and Culture psychiatry research group for strengthening capacity and capability of both partners
Impact MOU signed by PILL supported by Manchester Global mental and Culture psychiatry research group for strengthening capacity and capability of both partners
Start Year 2021
 
Description Rashid Lalif Medical Complex 
Organisation Rashid Latif Medical College
Country Pakistan 
Sector Academic/University 
PI Contribution MOU signed by PILL for strengthening capacity and capability of both partners
Collaborator Contribution MOU signed by PILL for strengthening capacity and capability of both partners
Impact MOU signed by PILL for strengthening capacity and capability of both partners
Start Year 2021
 
Description Rashid Lalif Medical Complex 
Organisation Rashid Latif Medical College
Country Pakistan 
Sector Academic/University 
PI Contribution MOU signed by PILL for strengthening capacity and capability of both partners
Collaborator Contribution MOU signed by PILL for strengthening capacity and capability of both partners
Impact MOU signed by PILL for strengthening capacity and capability of both partners
Start Year 2021
 
Description Services Hospital Lahore (SHL) 
Organisation Lahore General Hospital
Country Pakistan 
Sector Hospitals 
PI Contribution Collaboration between SHL and PILL to be supported by Manchester Global mental and Culture psychiatry research group for strengthening capacity and capability of both partners.
Collaborator Contribution Capacity and capability building
Impact Capacity and capability building
Start Year 2021
 
Description University of Punjab (Institute of Psychology) 
Organisation University of the Punjab
Country Pakistan 
Sector Academic/University 
PI Contribution University of Punjab - To explore joint work in research particularly in the area of self-harm. MOU signed by PILL supported by Manchester Global mental and Culture psychiatry research group for strengthening capacity and capability of both partners.
Collaborator Contribution University of Punjab - To explore joint work in research particularly in the area of self-harm. MOU signed by PILL supported by Manchester Global mental and Culture psychiatry research group for strengthening capacity and capability of both partners.
Impact University of Punjab - To explore joint work in research particularly in the area of self-harm. MOU signed by PILL supported by Manchester Global mental and Culture psychiatry research group for strengthening capacity and capability of both partners.
Start Year 2021
 
Description All Parliamentary Mental Health Summit 
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 Summit Inaugural was by President of Pakistan showing commitment to support mental health research and innovation in Pakistan.Each session was jointly chaired by a parlimentarian and mental health expert. This group will develop aa mental health strategy and an implementation plan align with the sustainable developmental goals

PILL in collaboration with the Prof Husain from University of Manchester, MNA Mr Riaz Fatyana SDGs Taskforce and other parliamentarians organized the first Pakistan mental health summit 2020

Outcomes include Learning from our research work in Pakistan and input from other internationally renowned stakeholders on the day and further 18 months will provide a unique opportunity to work out a road map for Pakistan Mental Health Strategy and the
SDG's 2020-2030.
Year(s) Of Engagement Activity 2020
 
Description Awareness session on self-harm and suicide prevention 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Undergraduate students
Results and Impact Two awareness sessions on on self-harm and suicide prevention attended by students and their teachers at University of Sindh Jamshoro & Multan - Mian Nawaz Sharif University.
Year(s) Of Engagement Activity 2021
 
Description CAMH (Child and adolescent mental health) Program 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Postgraduate students
Results and Impact Lecture on depression, it's role in self -harm. Also discussed prevention strategies for self-harm, warning signs , myths and available support in Pakistan
Year(s) Of Engagement Activity 2020
 
Description CIMH - 2020 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The Global Mental Health and Cultural Psychiatry research group (Lancashire and South Cumbria NHS Foundation Trust, University of Manchester, Manchester Global Foundation, Pakistan Institute of living and learning) has held the 10th annual Culture and International Mental Health (CIMH) Conference with this year's theme 'Turning the world upside down'. Turning the World Upside Down authored by Lord Nigel Crisp explores what richer countries can learn from poorer ones and suggests that, instead of talking of international development - where the richer help the poorer - we should think in terms of co-development, each learning from the other. This vision of global health inspired by the words of Lord Nigel Crisp formed the theme for this years' CIMH conference.

In line with the current social distancing guidelines and the UK national lockdown, the conference was held virtually over zoom. The team were delighted to welcome 96 attendees at the conference and a fantastic programme with 13 speakers from across the globe. The discussions focused on suicide and self-harm prevention in adults and young people, parental mental health and anxiety in adolescents across the UK, Pakistan, Turkey, Uganda, Nigeria and Kenya and Sub-Saharan Africa.

Close to 800,000 people die due to suicide each year and 78% of suicides occur in low-middle income countries (WHO). Poor parental mental health can have a detrimental effect on the health and development of children, leading to an increased risk of mental health problems for the children themselves.

Professor Imran Bashir Chaudhry, consultant psychiatrist and chairman psychiatry at Ziauddin group of Hospitals Karachi provided a keynote speech on 'Suicide prevention: From evidence generation to policy development. Professor Chaudhry spoke of the impressive research work delivered by the Pakistan Institute of Living and Learning, funded by the Medical Research council and led by the University of Manchester. The work has led to a parliamentary summit and working with the presidential office and parliament to contribute to the development of policy on suicide prevention in Pakistan including a proposal to decriminalize suicide.

Special guest speaker at CIMH 2020 was Professor Carolyn Chew Graham, GP Principal in Central Manchester, Professor of General Practice Research at Keele University, Honorary Professor of Primary Care Mental Health at Midlands Partnership Foundation Trust, Honorary Professor of Primary Care, University of Manchester, and Visiting Professor at the University of York. Professor Chew Graham focused her discussion on the valuable qualitative work on suicide and self-harm prevention in Pakistan. Presenting powerful quotes from participant's, Professor Chew Graham provided valuable learning on adapting to context and that public health initiatives should ensure that the importance of mental health and illness are recognised and a stronger emphasis placed on training for the management of self-harming behaviours.

Professor Nusrat Husain who leads the organisation of the conference said:

"The CIMH conference provided an excellent programme and range of opportunities to learn, and develop skills with a broader outlook on mental health through talks by international and national speakers from globally diverse cultural backgrounds. The conference highlighted the strong need to develop research on suicide prevention as a top priority."
Year(s) Of Engagement Activity 2020
 
Description CIMH conference presentation - Suicide Prevention: From Evidence Generation to Policy Development 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Prof Imran Chaudhry (PI) presented the roadmap of CMAP research and its impact in Pakistan at the 2020 Culture and International Mental Health conference which was held online this year.
Year(s) Of Engagement Activity 2020
 
Description Child and Adolescent mental health course - Training program 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Interactive Child and Adolescent mental health course with Students, Health professionals, Teachers.
Year(s) Of Engagement Activity 2021
 
Description Conference 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact International Psychiatric Conference organised by Pakistan Psychiatric Society- presented on evidence based research on self-harm/suicide prevention work, delegates included with doctors, researchers, students.
Year(s) Of Engagement Activity 2021
 
Description Consolidated newsletter on common mental health problems and Self harm / Suicide Information Leaflet 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Consolidated version of newsletter on common mental disorders associated with self-harm and suicide developed both in Urdu and English for general public. Spreading awareness regarding mental disorders among general public for reducing stigma and increasing awareness on mental health issues.
Year(s) Of Engagement Activity 2020
 
Description Effective supervision Level 1  
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Effective supervision Workshop - Level 1 - Interactive workshop on effective supervision and it's role in clinical settings.
Year(s) Of Engagement Activity 2022
 
Description First Round Table Conference to develop suicide prevention strategy 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Organized in Collaboration with University of Manchester and SDGs Taskforce( Mr. Riaz Fatyana, member of National assembly of Pakistan at the Royal College of Psychiatris
This was organized to develop Pakistan suicide prevention strategy and road map for future research.
In Pakistan self harm is a criminal offense, the main output of this meeting was presentation of a bill in the Parliament by Mr Riaz fatyana to decriminalize self-harm and suicide in Pakistan which is a tremendous milestone.
Year(s) Of Engagement Activity 2019
 
Description Importance of involving psychologists in Self harm and Suicide prevention work in Pakistan 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Presented Role and Scope of using psychologists in self-harm and suicide prevention work.
Year(s) Of Engagement Activity 2019
 
Description Mental Health Care and Suicide Nexus event 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact "Policy Dialogue-Mental Health Care and Suicide Nexus", was organized by Riphah Institute of Public Policy attended by PILL team for informative discussion on mental health care and suicide.
Year(s) Of Engagement Activity 2021
 
Description Mental Health Question Time 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Policymakers/politicians
Results and Impact PILL in collaboration with the Prof Husain from University of Manchester and MNA Mr Riaz Fatyana SDGs Taskforce organized "Mental Health Question Time" on the 10th March at Pakistan National Council of Arts
People from all walks of life attended and had the opportunity to interact with others and mental health experts from Pakistan and across the Globe to discuss issues around mental health
"Question time" session was conducted in order to increase awareness regarding different mental health issues. Stake holders, general public and service users fully participated in discussions. Feedback was very positive. Informational material around common mental disorders also distributed.


..
Year(s) Of Engagement Activity 2020
 
Description Mental Health Question Time 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Awareness session -PILL in collaboration with the Prof Husain from University of Manchester and MNA Mr Riaz Fatyana SDGs Taskforce organized "Mental Health Question Time" on the 10th March at Pakistan National Council of Arts
People from all walks of life attended and had the opportunity to interact with others and mental health experts from Pakistan and across the Globe to discuss issues around mental health

"Question time" session was conducted in order to increase awareness regarding different mental health issues. Stake holders, general public and service users fully participated in discussions. Feedback was very positive. Informational material around common mental disorders also distributed.
Year(s) Of Engagement Activity 2020
 
Description Newsletter - Self-harm and suicide prevention  
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Translated newsletter in Sindhi language to increase awareness among community about self-harm and suicide prevention in Pakistan.
Year(s) Of Engagement Activity 2021
 
Description PRIMARY CARE AND MENTAL HEALTH RESEARCH OPPORTUNITIES IN PAKISTAN - GLOBAL CHALLENGES - MANCHESTER SOLUTIONS! 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Organised by PILL and global mental health and cultural psychiatry research group - Presentations on self-harm suicide prevention work, translational research, still birth, digital mental health, multi-morbidity and older adults.
Year(s) Of Engagement Activity 2021
 
Description Pakistan Mental health Policy 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Summit to support mental health and research in Pakistan and to develop mental health policies. 6 discussion group with stakeholders taking a life course approach from preconception to older adults. Identification in Gaps in knowledge. Suggestions and recommendations for mental health policy-Pakistan
Year(s) Of Engagement Activity 2020
 
Description Parenting Matters in Children and Adolescents: Challenges and Way Forward Webinar 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Parenting Matters in Children and Adolescents: Challenges and Way Forward webinar organised by Punjab University and PILL - Informative talk on parenting styles and it's impact on child mental health.
Year(s) Of Engagement Activity 2021
 
Description Parliamentary summit - Policy on suicide in Pakistan 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Policymakers/politicians
Results and Impact A parliamentary initiative to develop policy and healthcare provision for individuals at risk of self harm and suicide. Discussions on the decriminalization of suicide in Pakistan
Year(s) Of Engagement Activity 2020
 
Description Presentation on " Self-harm and suicide prevention in Pakistan" 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presented work done in Pakistan on Self-harm and Suicide prevention.
Year(s) Of Engagement Activity 2019
 
Description Presentation on "self-harm and suicide prevention: Evidence from Pakistan" at Round table conference on 9th September 2019 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presented work done in Pakistan on Self harm and Suicide prevention and their findings.
Year(s) Of Engagement Activity 2019
 
Description Prisoner and Suicidal ideation 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact PILL and central prison Karachi - discussion with police personal and researcher on role of EMDR in prison setting and capacity building of police staff.
Year(s) Of Engagement Activity 2021
 
Description Radio program  
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact National/international Radio show hosted by Pendle community radio Awaz 103.1 for raising awareness, reducing the stigma around suicide and encouraging well-informed action.
Year(s) Of Engagement Activity 2021
 
Description Research Integrity Day -workshop  
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Research Integrity Day workshop focused on Plagiarism: fostering a culture of academic integrity with students, professionals and researchers to ensure that research is carried out to the highest possible standards.
Year(s) Of Engagement Activity 2022
 
Description Self care day event 
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 Interactive session on self-care, embedded with progressive muscle relaxation exercise and Dialectical behavior therapy (DBT).
Year(s) Of Engagement Activity 2021
 
Description Self-harm and Suicide Prevention: Evidence from Pakistan 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Policymakers/politicians
Results and Impact Roundtable conference to develop suicide prevention strategy in Pakistan
Year(s) Of Engagement Activity 2020
 
Description Self-harm and Suicide prevention in Pakistan: Our response to a public health tragedy 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presented work done in Pakistan on Self-Harm and Suicide prevention
Year(s) Of Engagement Activity 2019
 
Description Seminar - World Mental Health Day 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Postgraduate students
Results and Impact Pakistan Institute of Living & Learning in collaboration with Ziauddin University and Dow University of Health Sciences organized World Mental Health Day seminar to raise awareness about mental health issues and highlighted inequalities in mental health in Pakistan and globally.
Year(s) Of Engagement Activity 2021
 
Description Suicide bereavement " leave no one behind" seminar 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Suicide bereavement " leave no one behind" seminar organised by PILL and global mental health and cultural psychiatry - Informative talk on suicide bereavement, it's impact on loved ones, stigma and gaps in research.
Year(s) Of Engagement Activity 2021
 
Description Suicide prevention day 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Supporters
Results and Impact Suicide prevention day-contributed to awareness sessions on self-harm and suicide prevention with non-managerial staff at all four sites of GSK in Karachi (west wharf, korangi, site area and Jamshoro) Self-harm and suicide awareness session delivered to almost 400 non health professional staff.
Year(s) Of Engagement Activity 2019
 
Description Suicide prevention day 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Jointly translated WSPD information leaflet in Urdu. Translated version shared with WSPD and uploaded on PILL website and other social sites as well distributed printed copies at school, colleges, universities, communities and GPs clinics.

Printed on newspaper (local and national) as well
Year(s) Of Engagement Activity 2021
 
Description Suicide prevention day - virtual event 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Role play and informative talk on Self harm and suicide prevention.
E-Information leaflets were also shared with participants
Year(s) Of Engagement Activity 2020
 
Description Talk on developing research in suicide and self harm prevention 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Undergraduate students
Results and Impact A talk delivered by study CI Prof Nusrat Husain at the Department of Psychology, Foundation University, Islamabad, Rawalpindi Campus
Year(s) Of Engagement Activity 2019
 
Description Understanding Self Harm: Perception of Clinicians from Pakistan 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Presented qualitative work done in Pakistan on self-harm and suicide prevention (CMAP)
Year(s) Of Engagement Activity 2019
 
Description Workshop - World Mental Health day 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Improving employee mental health through art therapy and mindfulness activities and an interactive engagement session on employee mental health.
Year(s) Of Engagement Activity 2021
 
Description World Suicide Prevention Day (WSPD) 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Jointly translated WSPD information leaflet in Urdu with a translated version available on WSPD website
Year(s) Of Engagement Activity 2019
 
Description World mental health day - Awareness walk and seminar  
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact World mental health day Awareness walk and seminar organized jointly by Pakistan Institute of Living and Learning, Phoenix Foundation for Research and Development attended by researchers, para medical staff, students and psychologists to raise awareness on mental health issues.
Year(s) Of Engagement Activity 2021
 
Description World mental health day Radio program 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact World Mental Health day Radio program: COVID 19 and it's impact on mental health. Team member of Pakistan Institute of Living and Learning (PILL) talked about Covid-19 and its Impact on Mental Health during a radio program "Kaam ke BAAt" with Rubina Alvi on FM 96.
Year(s) Of Engagement Activity 2021
 
Description World mental health day conference  
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact World mental health day conference organised by PILL in collaboration with global mental health and cultural psychiatry research group, delegates included researchers, para-medical staff, students, psychologists to raise awareness on mental health issues around the world and to mobilize efforts in support of mental health.
Year(s) Of Engagement Activity 2021
 
Description World mental health day- Awareness seminar  
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact World mental health day Awareness seminar delivered by PILL Quetta team to raise awareness on mental health issues with members of the public.
Year(s) Of Engagement Activity 2021