Strengthening Suicide Prevention: Evaluating a Capacity Building Program for Community Health Workers in India

Introduction:The study evaluates a Training of Trainers program, adapted from the WHO mhGAP 2.0 Self-Harm and Suicide Module, designed to enhance suicide prevention knowledge, attitudes, and confidence among Community Health Workers (CHWs) in India, who play a crucial role in identifying suicidal behaviour within resource-limited community settings. Methods:A pre-post intervention study involving 436 CHWs used a questionnaire to assess knowledge, attitudes, and confidence at four time points, analysed via General Linear Model repeated measures ANOVA.Results: Mean knowledge scores increased from 6.32 0.14 at baseline to 11.12 0.12 posttraining, levelled at 10.10 0.14 at 6 months, and 10.10 0.13 at 12 months.Mean confidence scores increased from 4.96 0.11 to 7.84 0.11, remaining at 7.28 0.10 and 7.44 0.10.Mean attitude scores changed slightly from 41.00 0.38 to 42.72 0.43 over 12 months, indicating increased negative attitudes.Post-training improvements in knowledge and attitudes were associated with CHW cadre and educational status.The mean knowledge and confidence scores across the time points (post-training, 6 months, 12 months relative to baseline) were statistically significant (p0.05). Conclusion: Post-training, CHWs demonstrated sustained improvements in knowledge, confidence for identifying, referring, and managing suicidal behaviour over 12 months.Lower baseline scores among CHWs with lower educational backgrounds and those without prior mental health training improved uniformly following the structured, tailored program.