Suicide Prevention ECHO
Blended Training Certificate Course on Suicide Prevention Gatekeeper Training
NIMHANS Digital Academy | Centre for Addiction Medicine
July 2020 - December 2020
The Suicide Prevention Crisis
⚠️ A Global Emergency
Around 804,000 people die due to suicide every year worldwide
- Every 40 seconds: One suicide death occurs
- Every 3 seconds: A suicide attempt is made by youth (15-29 years)
- Suicide is among the top 3 causes of death in the younger generation
India's Suicide Burden
The National Mental Health Survey (2016) revealed alarming statistics:
- Suicide rate: 10.6% per lakh population (2014 criminal records)
- High-risk population: 0.9% show high suicidal risk, especially in 40-49 age group
- Gender differences: Females have high suicide attempts; Males have high suicide completion
- Annual suicide deaths in India: 230,314
- Global contribution: 36.6% female and 24.3% male suicide deaths worldwide
- Rising trend: Suicide rate increased from 6.3% (1978) to 11.4% (2010)
Critical Risk Factors
Association of socioeconomic status, gender, education, unemployment, and current sociopolitical conditions are strongly related to suicide as potential risk and causal factors. These conditions not only increase the risk for suicide but also block the process of preventing suicidal risks.
The Knowledge Gap
WHO reports that lack of adequate knowledge and human resources in communities are potential roadblocks for preventing suicide.
Policy Context
- WHO Mental Health Gap Action Programme (2008) - Suicide prevention as primary goal
- National Suicide Prevention Strategy by WHO (2018)
- Decriminalization of Suicide - Section 115, Mental Health Care Act 2017, India
The Solution: Gatekeeper Training
This course is designed for counselors working in the community to identify early signs and deliver timely crisis intervention, addressing the critical knowledge and resource gap in suicide prevention.
VKN NIMHANS ECHO vs Traditional Telemedicine
❌ Traditional Telemedicine
- Focus is direct service delivery
- Usually one-to-one
- Unidirectional flow of information
- Single expert providing opinion
- The specialist manages the patient remotely
✓ VKN NIMHANS ECHO
- Focus is on education and capacity building
- One-to-many (hub and spokes)
- Multidirectional flow of knowledge
- Ongoing, based on learner's needs
- Multidisciplinary expert team providing mentoring
Impact of Suicide Prevention ECHO
Program Success Metrics
Through Suicide Prevention ECHO, 37 accredited mental health professionals (nurses, psychologists, social workers, and counselors) from Chhattisgarh are now equipped to identify early warning signs, assess suicide risk, deliver crisis interventions, and implement prevention strategies, screening nearly 48,000 individuals and potentially saving countless lives.
Learning Objectives
On course completion, health providers should be able to:
- Identify the signs and symptoms of suicide
- Analyze the risk and protective factors of suicide
- Apply a detailed suicide risk assessment
- Design and implement psychotherapeutic interventions
- Develop strategies to work with patients and the community
- Document suicide assessment and patient care
Program Overview
| Aspect | Details |
|---|---|
| Duration | 5 months (July 2020 - November 2020) Total: 24 hours • 14 hours: Fortnightly Tele-ECHO clinics (Real-time) • 10 hours: Self-paced e-learning |
| Schedule | 2nd and 4th Friday of each month 2:30 PM to 4:00 PM (1.5 hours per session) |
| Target Audience | Nurses, Psychologists, Psychiatric/Medical Social Workers, Counselors Location: Chhattisgarh State |
| Method | Completely ONLINE - Blended Patient-Centric Learning • Real-time: Zoom video conferencing (20 min didactic + 1 hour case presentation) • Anytime: Self-paced e-learning (Google Classroom) |
| Program Fees | FREE Funded by NHM Chhattisgarh Commitment to time and participation is a must |
Benefits
- Training through collective input of multidisciplinary team and mutual sharing of experiences
- Enhancement of confidence in diagnosing, managing, and preventing suicide
- Familiarization with "best practice" guidelines in the field
- Join a supportive network of peers
- Completion Certificate on successful completion of the blended learning module
- Join the NIMHANS Digital Academy
- Lifelong access to e-learning content
Accreditation Criteria
To receive the Completion Certificate, participants must fulfill ALL of the following criteria:
- Attendance: >60% participation in fortnightly sessions with >60 minutes video presence per session (measured by software)
- Case Presentations: Presentation of 2 or more case summaries
- Self-Practice Tests: Completion of 2 self-practice tests
- Final Assignment: Score >80% (Three attempts allowed, each to be completed within 3 working days)
- Monthly Reports: Submit monthly reports of patients evaluated for mental health for 6 months after training starts
- Pre and Post Assessment: Mandatory completion on knowledge and self-efficacy
Important Notes:
- HIPAA compliant case intake form designed to protect patient privacy
- Within one month of last LIVE session, all submissions must be completed
- Three attempts allowed for final assignment
- Assignment includes multiple choice, case vignettes, audio/video clips
Evaluation Method
| Component | Marks | Passing Criteria |
|---|---|---|
| E-Assignments | 50 marks | >40 marks to pass |
| Case Presentations (2) | - | Active participation required |
| Self-Practice Tests (2) | - | Completion required |
11-Session Curriculum
Case Demo by Hub Team | Live Quiz: Facts and Myths
Reading: Pre-test, Case template, Learning video - Case intake
Didactic: Dr. Shabina | 2 Case presentations
Reading: APA reading material
Panel Discussion: Mr. Kiran, Mr. Atit, Mr. Prashanth, Mr. Tarachand | 3 Case presentations
Self Practice Test 1
Role Play Demonstration: Mr. Kiran, Mr. Roshan Lal, Ms. Adeeba | 3 Case presentations
Reading: Learning video - Interactive role play and risk assessment
Didactic: Ms. Tejdeepika | 2 Case presentations
Reading: Handouts from APA
Didactic: Dr. Anish Cherian | 3 Case presentations
Reading: Learning Video - Role play
Didactic: Ms. Apoorva Srivastav | 3 Case presentations
Self Practice Test 2
Reading: Learning Video - Role play
Didactic: Ms. Padmavathy | 3 Case presentations
Reading: Stress management
Didactic: Lekshmi Vimala | 3 Case presentations
Reading: Learning Video - Behavioral techniques
Didactic: Ms. Tejdeepika | 3 Case presentations
Post-test
Final Assignment
Additional case presentations: Roshan Yadav, Mamta Giri, Sanjaykumar Tiwari, Mitali Mesharam
Key Topics Covered
- Overview of Suicide: Facts and myths, global and national statistics
- Risk and Protective Factors: Identification and analysis
- Warning Signs: Early identification of suicidal ideation
- Psychological Perspectives: Understanding causes from different viewpoints
- Risk Assessment: Formulating low, moderate, and high-risk categories
- Safety Planning: Reducing accessibility to lethal means
- Crisis Intervention: Immediate psychotherapeutic responses
- Emotional Regulation: Teaching coping strategies
- Distress Tolerance: Building resilience skills
- Resilience and Connectedness: Long-term protective factors
- Community Resources: Linkages and referral pathways
- Documentation: Proper record-keeping and risk management
- Case Studies: Learning from Sneha Foundation and other organizations
Hub Team
Lead Facilitators and Specialists:
- Mr. Kiran Kumar CTL - M.Phil, Senior Research Officer (Clinical Psychologist) - Lead Facilitator
- Dr. Shabina Sheth - MD, Senior Resident, Project VKN NIMHANS Chhattisgarh ECHO (Co-facilitator Psychiatrist)
- Ms. Tejdeepika R - M.Sc, Psychologist (Co-facilitator)
Support Team:
- Mr. Kubenthiran N - Edutech Support
- Ms. Likhitha - Clinic Coordinator
- Ms. Akanksha Mathur - Program Analyzer
Mentoring:
- Dr. Prabhat Chand - Professor of Psychiatry, Officer-in-Charge NIMHANS Digital Academy
ECHO Principles
The VKN NIMHANS ECHO model is built on four core principles:
- Use technology to leverage scarce resources (i.e., content experts)
- Share "best practices" to reduce disparities
- Use case-based learning to master complexity
- Monitor outcomes using a web-based database
Reference Materials
- National suicide prevention strategies. Geneva: World Health Organization; 2018
- National Mental Health Survey of India 2015-2016. Ministry of Health and Family Welfare, Government of India; 2016
- Preventing suicide: A community engagement toolkit. Geneva: World Health Organization; 2018
- World Health Organization. Preventing suicide: A global imperative. Geneva: WHO; 2014
- Gender differentials and state variations in suicide deaths in India: The Global Burden of Disease Study 1990-2016
- Radhakrishnan R, Andrade C. Suicide: An Indian perspective. Indian J Psychiatry. 2018
Contact Information
For Content:
Mr. Kiran Kumar CTL - 9620953742
Centre for Addiction Medicine
NIMHANS Digital Academy
Project VKN NIMHANS ECHO
National Institute of Mental Health and Neurosciences
Building a Suicide Prevention Network
Empowering mental health professionals to become gatekeepers - identifying warning signs, assessing risk, delivering crisis interventions, and saving lives in their communities.
Nearly 48,000 individuals have been screened for suicide risk by our 37 accredited gatekeepers, creating a vital safety net in Chhattisgarh communities and potentially preventing countless tragedies.