FASE-family and social engagement model for prevention and management of self harm behavior-a study protocol for cluster randomized control trial in India

Saju Madavanakadu Devassy; Lorane Scaria; Anuja Maria Benny; Natania Cheguvera; Jaicob Varghese; Lynette Joubert

doi:10.3389/fpsyt.2022.915568

FASE-family and social engagement model for prevention and management of self harm behavior-a study protocol for cluster randomized control trial in India

Front Psychiatry. 2022 Jul 28:13:915568. doi: 10.3389/fpsyt.2022.915568. eCollection 2022.

Authors

Saju Madavanakadu Devassy^{1

2

3}, Lorane Scaria^{1

3}, Anuja Maria Benny^{1

3}, Natania Cheguvera³, Jaicob Varghese⁴, Lynette Joubert²

Affiliations

¹ Department of Social Work, Rajagiri College of Social Sciences (Autonomous), Kochi, India.
² Department of Social Work, Melbourne School of Health Sciences at the University of Melbourne, Carlton, VIC, Australia.
³ International Centre for Consortium Research in Social Care (ICRS), Rajagiri College of Social Sciences (Autonomous), Kochi, India.
⁴ Department of Critical Care Medicine, Rajagiri Hospital, Kochi, India.

Abstract

Background: Suicide is a substantial public health concern for countries worldwide. Effective preventive and curative interventions for self-harm behavior (SHB) are imperative for nations with an alarmingly high rate of suicide and self-harm behaviors. The intervention protocol named FASE (Family and Social Engagement) consists of comprehensive assessment, Attachment-Based Family Therapy (ABFT), and community linkages for people presenting with suicide or self-harm in emergency departments of tertiary hospitals.

Methods: This article reports the design and protocol for a cluster randomized control trial for suicide prevention and management. After the developed intervention is pilot tested in a tertiary hospital in Kerala, the intervention will be scaled up to be implemented in various tertiary hospitals in Kerala. Each hospital emergency department will be considered a cluster, and these clusters will be randomized to the intervention group and control group in a 1:1 ratio. The eligible people from the intervention clusters will undergo a baseline assessment, a structured moderate intense intervention with twelve sessions spread across 6 months by the trained social workers supervised by the Mental health team, and a follow-up assessment at the end. Participants will be recruited after obtaining consent and explaining the study. The primary outcome includes suicidality measured by the Depressive Symptom Inventory-Suicidality Subscale (DSI-SS), Depression, Anxiety and Stress Scale (DASS), MOS Social Support Survey, and Brief resilience scale (BRS).

Discussion: Knowledge generated from this trial can significantly affect new programmatic policy and clinical guidelines that will improve the reduction of suicide rates in the country.

Trial registration: Prospectively registered in Clinical Trial Registry India (ICMR-NIMS) on 18/10/2021 (ref number- REF/2021/10/048264).

Keywords: India; emergency care; family-based intervention; public mental health; social support; suicide behavior management; suicide prevention.