Testing Safety Planning and Cognitive Behavioral Therapy to Prevent Suicide in Mozambican Secondary School Youth

What this Trial Is About

This research aims to evaluate the effectiveness and implementation of suicide safety planning and a transdiagnostic cognitive behavioral therapy CBT intervention to reduce suicidal behaviors among secondary school students in Mozambique. The study addresses the urgent need for adolescent suicide prevention in low- and middle-income countries, particularly in Mozambique where suicide rates among youth are notably high. The project builds on prior work demonstrating feasibility and initial effectiveness of these interventions delivered by non-specialists in Mozambique. Participants will be enrolled from 21 secondary schools randomized into three groups Enhanced Usual Care EUC, Safety Planning Intervention SPI, and Transdiagnostic Cognitive Behavioral Therapy for Suicide Prevention TCBT-S. EUC involves screening and referral to government mental health services. SPI includes a stepwise safety plan tailored to the individual focusing on coping and crisis prevention. TCBT-S combines SPI with psychoeducation, cognitive restructuring, activity linking, problem solving, and relaxation techniques delivered over 6-8 weekly sessions by trained non-specialists. Youth participation includes suicide risk screening, development of safety plans, therapy sessions for those in the TCBT-S group, and follow-up assessments at 2, 3, 4, 6, 12, and 24 months post-intervention. Researchers will measure suicidal behaviors as the primary outcome at 6 months and secondary outcomes including suicidal ideation and depressive symptoms at multiple time points. The study also examines implementation outcomes, costs, and cost-effectiveness to inform future scale-up efforts in Mozambique and similar settings.

Safety Planning and Cognitive Behavioral Therapy for Adolescent Suicide Prevention in Mozambique