ENGAGE - Centre for Mental Health Law & Policy

ENGAGE is an online gatekeeper training program to train secondary and higher secondary school teachers to identify, assess, support and refer at-risk adolescents for suicide prevention support in Chhattisgarh, India.

Why ENGAGE?

India accounts for a third of suicides globally. India also has the highest number of adolescents in the world (approximately 253 million). A nationally representative mortality survey carried out determined that suicide is the leading cause of death among older adolescents, in India.

The state of Chhattisgarh has the third highest rate of suicide in India. At 31.8 deaths by suicide per population of 100,000 persons, it is close to double the national average of 12.0. While suicide is a major public health issue that needs immediate attention, Chhattisgarh’s public healthcare infrastructure is inadequately equipped to address this concern. Furthermore, there are no suicide prevention programs being implemented in the state.

With poor access to psychosocial services, limited resources and its conflict-prone context, Chhattisgarh requires a low-cost and resource-effective suicide prevention strategy.

Chhattisgarh’s State Suicide Prevention Strategy identifies gatekeeper training as one of the strategic interventions to reduce suicides and attempted suicides. Community members can play an important role as gatekeepers to create awareness, reduce stigma and fill the gap in suicide prevention services for all persons including adolescents. The World Health Organization recognises teachers as important community members to provide suicide prevention support and help save the lives of adolescents.

Existing evidence supports the effectiveness of gatekeeper training courses in improving knowledge, attitude and self-efficacy outcomes. However, there is little evidence for sustainable long-term behavioural changes in teachers who complete such courses.

How are we addressing the issue?

ENGAGE is an adolescent suicide prevention programme in Chhattisgarh, India. As part of this project, we are co-designing, implementing and evaluating an e-learning gatekeeper training course on suicide prevention. The programme aims to train secondary and higher secondary public school teachers in three rural districts of Chhattisgarh.

The self-paced e-learning course comprises of nine modules. These modules will be delivered to school teachers in Hindi through their mobile phones. The course will train them as gatekeepers to identify, support and refer adolescents at risk of suicide for further support to the District Mental Health Programme.

The project has adopted a human-centred and participatory design approach. The e-learning course modules have been developed in close consultation with teachers, youth with lived experiences, local experts and civil society organisations.

In order to identify the best strategy to ensure behavioural change amongst teachers, each of the three districts will be provided with a distinct approach of the gatekeeper training program.

In the 1st district, teachers will receive only the online training course.

In the 2nd district, teachers will receive (a) the online training course and (b) an online refresher training at 3 months follow-up.

In the 3rd district, teachers will receive (a) the online training course (b) an online refresher training at 3 months follow- up and (c) online mentoring and supervision from the project team.

To evaluate the effectiveness of the program, we will collect data on the number of teachers practicing as gatekeepers and the number of adolescents identified and referred in each of the districts.

What is the potential impact?

Through ENGAGE, we expect that teachers completing the online gatekeeper training program will improve their knowledge, attitudes, skills and confidence to identify, support and refer at-risk adolescents for suicide prevention support. This will lead to a potential reduction in the number of adolescent suicides and attempted suicides.

We will also find out which is the most effective strategy to ensure behavioural change among school teachers as gatekeepers.

Where have we reached?

We have recently received formal approval from the Department of Health and Family Welfare and the Department of Education, Chhattisgarh, to implement the programme.

We are now working with these departments to roll out the e-learning course. The course will soon be available to teachers through a government mandated e-learning platform.