Development of a Community-Participatory Suicide Prevention and Intervention Model with Multi-Stakeholder Networks in Huai Thap Than District, Sisaket Province

Abstract

     This was research and development study aimed to develop a community-participatory suicide prevention and intervention model engaging local multi-stakeholder networks. The research comprised four phases: (1) analysis of the situational context and factors associated with depression; (2) model development and design; (3) implementation; and (4) follow-up and evaluation. The data collection tools used included the DASS-21 assessment form and the Local Community Mental Health Index (DMHI) from the Department of Mental Health Promotion and Development. Data were analyzed using multivariable logistic regression, content analysis, Paired t-test and the independent t-test.

     Completed suicides occurred predominantly among working-age women in agriculture, whereas attempts were concentrated among female adolescents experiencing depressive risk and relationship problems, compounded by economic hardship, fragile family relationships, limited service access, and insufficient screening and referral skills among village health volunteers. Two factors were significantly associated with depression: a history of physical and psychological abuse (adjusted OR = 4.81; 95% CI: 2.02–11.42) and psychological protective factors (adjusted OR = 0.14; 95% CI: 0.07–0.29). The model comprised six activities: (1) developing community and school mental health teams; (2) developing mental health mentors (MCATT); (3) strengthening surveillance and prevention; (4) improving treatment and referral pathways; (5) developing the information system; and (6) conducting supportive follow-up visits and treatment monitoring. After implementation, community and school mental health workers showed significantly higher mean scores in knowledge, attitudes toward depression and suicide prevention, and skills in surveillance, screening, and primary assistance than before. When scaled to the school and community levels, post-experiment results indicated that compared to the control group, the experimental group demonstrated a statistically significant decrease in DASS-21 scores and an increase in DMHI scores (p < 0.05).