South Asia has the highest suicide rate in the world with important risk profile differences from high-income settings. Investigators will conduct formative research to co-design a package of brief interventions and implementation strategies to prevent youth-suicide and then test the package in a pilot feasibility hybrid type 2 cluster randomized controlled trial in Nepal. Potential health impacts may be substantial as results can be applied not only in similar South Asian primary healthcare contexts, but also in low-resource settings in the US and abroad, where the suicide burden remains high.
Using experience-based co-design and equity-focused implementation frameworks, this study will assess the feasibility and acceptability of a Youth-focused, Peer-delivered, Family-engaged Suicide Prevention Package (YPF-SuPP) integrated within existing mhGAP services in Nepal's decentralized primary healthcare system. This pilot trial will generate preliminary data to inform the design of a future fully powered effectiveness trial and potential scale-up of youth suicide prevention strategies.
Who can participate
Age range
12 Years – 24 Years
Sex
ALL
See this in plain English?
AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion Criteria:
Peer Volunteers
* Age ≥18 years
* No current untreated mental disorder or suicide risk, as assessed and confirmed by a Nepali mental health specialist (MD or PhD)
* Meets hiring and eligibility criteria of the local implementing partner NGO
* Fluent in spoken Nepali
Trial Youth Patient Participants
* Age 12-24 years
* Resident of the study site
* Screens positive to the Nepali Ask Suicide Screening Questions or a lifetime history of a suicide attempt
* Ability to provide informed consent or assent
* For participants under 18 years of age, written informed consent from a legal guardian
* Fluent in Nepali
Family Members (intervention group only)
* Family member (defined as any individual that is a parent, grandparent, aunt/uncle, or cousin as well as significant others) selected by the youth participants enrolled in the study
* Resident of the study site
* Over 18 years of age
* Ability to provide informed consent or assent
* Fluent in Nepali
Exclusion Criteria:
Peer Volunteers
* Plans to leave the peer volunteer role within the next 6 months
* Unable to provide voluntary informed consent for any reason
Trial Youth Patient Participants
* Requires immediate psychiatric hospitalization at the time of assessment
* Unable to provide informed consent or assent due to impaired decision-making capacity
* Participants under 18 years of age without written informed consent from a legal guardian
* Planning to leave the study area in the next 6 months
Famil…
Questions worth asking your doctor
Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.
1Based on my diagnosis and history, is this trial worth exploring for me — or is there a standard treatment we should try first?
2What does this trial's phase tell us about how much is already known about its safety and benefit?
3What would taking part actually involve for me — visits, tests, time, and travel?
4What are the known and possible risks or side effects I should weigh, and how would they be monitored?
5If this trial isn't the right fit, what other options or trials would you suggest I look into?
Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.
Questions for the trial coordinator
The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.
What they're measuring
1
Adoption of YPF-SuPP by Peers (Training Attendance)
Timeframe: Baseline
2
Feasibility and Acceptability of YPF-SuPP by Peers
Timeframe: 6 months
3
Peer Competency using ENhancing Assessment of Common Therapeutic (ENACT)