Caia

This research aims to evaluate the effectiveness and implementation of suicide prevention interventions among secondary school students in Mozambique. The study focuses on reducing suicidal behaviors by testing two interventions: a Suicide Safety Planning Intervention (SPI) and a transdiagnostic cognitive behavioral therapy for suicide prevention (TCBT-S). These interventions are being tested against Enhanced Usual Care (EUC) in a region where suicide rates are significantly higher than the global average, and where youth often experience co-occurring mental health symptoms like depression, anxiety, and PTSD. Participants will be assigned to one of three groups: SPI alone, TCBT-S which integrates cognitive behavioral therapy with safety planning, or EUC which involves screening and referral to government youth-friendly mental health services. All behavioral interventions are delivered by trained non-specialist healthcare workers in secondary schools. The study will evaluate these approaches using a three-arm cluster randomized trial across 21 schools. During the study, youth will be assessed for suicidal behavior and ideation, as well as depressive symptoms. Researchers will measure outcomes at six months post intervention and gather data on the costs and implementation factors affecting each intervention. The study also includes qualitative and quantitative methods to understand barriers and facilitators to implementation, aiming to inform future broader scale-up of effective suicide prevention strategies in Mozambique and similar settings.