Health worker delivered Contact and Safety Planning (CASP) for suicide prevention in Chhattisgarh, India: Protocol for a non-randomized, controlled pilot study.

Background: India records the highest number of suicide deaths globally, but suicide prevention efforts are hindered by a lack of trained personnel within the public health system. Given that an index suicide attempt is a strong predictor of future suicide, intervening with individuals who have recently attempted suicide is a targeted prevention approach that can be delivered within the public health system and has potential to be scaled up across low-resource settings. Aim: To test the implementation and preliminary effectiveness of Contact and Safety Planning (CASP) in reducing suicidal behaviour and symptoms of depression among adults with a recent suicide attempt in Chhattisgarh. Methods: We will carry out a non-randomized, controlled pilot study to evaluate the feasibility, acceptability, adoption, reach, implementation (including cost) and preliminary effectiveness of CASP when delivered by health workers - emergency nurses and Community Health Officers - in two districts of Chhattisgarh (n=250). The control group will receive Enhanced Usual Care, consisting of telephonic counselling by trained District Mental Health (n=250) program staff. Data will be collected at baseline and at 6- and 12-month follow- up. Conclusion: This study will shed light on the feasibility of CASP and inform its further refinement to address suicide at scale in India. Trial Registration: Clinical Trials Registry India (CTRI/2022/12/048087) dated 1 October 2022. Link here.