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<p>Pakistan is witnessing an alarming rise in suicide rates among its youth. There is a lack of consolidated national-level data on suicide, and the available statistics are often&#xa0;disproportionate due to misclassification, underreporting, and the absence of surveillance systems to track the actual burden of youth mental health and suicide rates. This situation underscores the urgent need for&#xa0;evidence-based models. The Zero Suicide (ZS) model offers a replicable and targeted suicide prevention strategy to be implemented in healthcare settings. Given the high prevalence in youth, we adapted the ZS model for school settings to simultaneously reach youth and their&#xa0;gatekeepers to&#xa0;implement structured interventions. This paper presents a series of programmatic case vignettes to illustrate the implementation of Dareecha: a school-based ZS program to reduce suicidal ideations and behaviors among students in Ghizer district, Gilgit-Baltistan, and to&#xa0;improve their mental health outcomes. The program focuses on ensuring student safety by integrating and initiating suicide care pathways in schools through a collaborative and humanistic approach. The core components include suicide risk identification, collaborative assessment, safety formulation and planning, evidence-based psychotherapeutic approaches, reducing access to lethal means, and follow-up monitoring. The adapted school-based ZS approach bridges research-practice and data gaps, showing potential for improved clinical outcomes and a positive&#xa0;cultural shift across individual, family, school, and system levels. Sustained suicide risk mitigation relies on the&#xa0;application of best clinical practices, continuous quality improvement, and the&#xa0;active engagement of school leadership and gatekeepers. The approach, including arts-based methods integrated within socio-emotional learning modules, offers early evidence on the feasibility and sustainability of the Dareecha program and highlights key lessons and recommendations for future studies.</p>

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Case Studies from Dareecha Program: A Contextually Adapted Zero Suicide Implementation Process for Identification and Mitigation of Suicide Risk among Youth in Schools of Ghizer District, Pakistan

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年1月16日

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  • Banafsha Ali,
  • Anamta Ghur,
  • Rutaba Syed,
  • Maria Iqbal,
  • Jibran Sharif,
  • Maliha Fatima,
  • Simran Siraj,
  • Noshad Ali,
  • Ali Turab,
  • Brian K. Ahmedani,
  • Linda Kaljee,
  • M. Imran Khan

摘要

Pakistan is witnessing an alarming rise in suicide rates among its youth. There is a lack of consolidated national-level data on suicide, and the available statistics are often disproportionate due to misclassification, underreporting, and the absence of surveillance systems to track the actual burden of youth mental health and suicide rates. This situation underscores the urgent need for evidence-based models. The Zero Suicide (ZS) model offers a replicable and targeted suicide prevention strategy to be implemented in healthcare settings. Given the high prevalence in youth, we adapted the ZS model for school settings to simultaneously reach youth and their gatekeepers to implement structured interventions. This paper presents a series of programmatic case vignettes to illustrate the implementation of Dareecha: a school-based ZS program to reduce suicidal ideations and behaviors among students in Ghizer district, Gilgit-Baltistan, and to improve their mental health outcomes. The program focuses on ensuring student safety by integrating and initiating suicide care pathways in schools through a collaborative and humanistic approach. The core components include suicide risk identification, collaborative assessment, safety formulation and planning, evidence-based psychotherapeutic approaches, reducing access to lethal means, and follow-up monitoring. The adapted school-based ZS approach bridges research-practice and data gaps, showing potential for improved clinical outcomes and a positive cultural shift across individual, family, school, and system levels. Sustained suicide risk mitigation relies on the application of best clinical practices, continuous quality improvement, and the active engagement of school leadership and gatekeepers. The approach, including arts-based methods integrated within socio-emotional learning modules, offers early evidence on the feasibility and sustainability of the Dareecha program and highlights key lessons and recommendations for future studies.