Adaptation and Feasibility assessment of a primary suicide prevention intervention for school adolescents in Nigeria

Suicide is the second leading cause of death for adolescents worldwide. Although suicide is preventable, 79% of suicides occurred in low- and middle-income countries (LMICs) where resources and personnel to help those in need are scarce. A recent World Health Organization (WHO) publication have suggested that Nigeria have one of the highest rates of suicide in the world with estimated > 15 per 100,000 population.

Primary prevention interventions delivered before the onset of suicidal behaviours are the preferred strategy in many LMICs. They are mostly cost effective, can be delivered to all youths, and do not require screening. Most importantly, since mental illnesses which are the major risk factors for suicidal behaviours develop in 50% of affected individuals before the age of 14 years, the delivery of primary prevention intervention at this critical development period is of paramount importance. The primary prevention programme for adolescent suicide often focused on social skill-building, reducing stigma, and increasing suicide awareness, help-seeking, and mental health knowledge

Schools are particularly important in addressing the reduction of risk factors and promotion of protective factors prior to the onset of suicidal behaviours which have the potential to reduce adolescent suicide rate. Schools are also ideal for testing the effectiveness of preventive interventions in a particular culture and environment before scaling up to out-of-school adolescents.

In many low and middle income countries, using interventions with proven effectiveness in the western culture can save human and financial resources associated with generating evidence from the scratch. However, the differences in the norms, resources and delivery structure to the original context sometimes render such imported intervention ineffective or even harmful. It is necessary to ensure the appropriateness, feasibility and acceptability of such evidence based intervention due to differences...