ICMR-Led Multistate Study to Roll Out Structured Suicide Prevention Model in Indian Campuses

India currently faces the world's highest burden of suicide deaths, with a crude rate of 15.7 per 100,000 in the 15–29 age group; however, previous research has identified a significant gap in evidence-based prevention programs within the educational settings of Low- and Middle-Income Countries (LMICs). To address this crisis, Seema Mehrotra from the Department of Clinical Psychology at the National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, and her colleagues aim to co-develop and optimize an appropriate implementation model that reduces suicidal behavior and fosters active help-seeking among the youth.

Therefore, a multistate, concurrent mixed-methods study utilizes a three-year implementation design across eight Indian states and union territories, engaging school and college populations through multi-component interventions like gatekeeper training and youth advocacy. Targeting approximately 472 to 552 clusters and excluding distance learners or doctoral students, the analytical framework utilizes the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) model to measure primary endpoints such as a quantifiable decrease in Patient Health Questionnaire-9 (PHQ-9) and Perceived Stress Scale-10 (PSS-10) scores.

Key Clinical Findings of the Study Include:

• Heightened Help-Seeking: The research anticipates a significant rise in the proportion of students who actively engage with mental health services through optimized and structured referral pathways.
• Reduced Stress Levels: The study demonstrates a quantifiable decrease in the mean scores of the Perceived Stress Scale-10 (PSS-10) across diverse educational environments compared to baseline data.
• Enhanced Gatekeeper Efficacy: Training at least 30% of the teaching staff is expected to improve the early identification and first response for at-risk youth within the campus ecosystem.
• Economic Viability: The protocol includes a pragmatic assessment of the incremental financial cost required per unit reduction in depression severity to ensure the model's scalability.
• Institutional Integration: The model seeks to foster sustainability by establishing dedicated school wellness teams to maintain long-term mental health promotion activities.

The results suggest that by employing iterative cycles of refinement, this implementation model could effectively address the 25% increase in student psychological risk factors observed since the pandemic while helping India reach its Sustainable Development Goal (SDG) of reducing age-standardized suicide death rates by one-third by 2030.

The study concludes that the clinicians should view the integration of multi-sectoral suicide prevention strategies into non-healthcare environments as a critical step in fostering community resilience and ensuring earlier professional intervention for at-risk youth.

While the study is currently limited by its focus on specific districts and the potential for social desirability bias, it presents an attractive framework for future research to evaluate the enduring sustainability of these mental health models across the broader and more diverse student population of India.

Reference

Mehrotra S, Duggal C, Rustagi N, Ransing RS, Indu PS, Chakraborty S, Mene T, Sharma P, Prasad D, Prinja S, Verma P, Dhamija RK, Kataria K, Munivenkatappa M, Suthar N, Anilkumar TV, Dahiya N, and Grover A (2025) Multistate study on suicide risk reduction and improving mental well-being among school and college students in India—an implementation research study protocol. Front. Public Health 13:1708246.