Development of a Community-Based Participatory Model for Suicide Prevention in Mae Hong Son Province
Article Sidebar
Main Article Content
Abstract
Background: Suicide is a major public health problem, particularly in remote and ethnically diverse areas where limitations in access to mental health services and sociocultural factors exist. This study aimed to investigate the suicide situation and community participation, develop a community-based participatory suicide prevention model, and implement, evaluate, and scale up the model in Mae Hong Son Province.
Methods: This research and development (R&D) study was conducted in Mae Hong Son Province between January 2024 and March 2025 and consisted of four phases: R1 situation analysis, D1 model development, R2 implementation and evaluation, and D2 refinement and scale-up. In phase R1, 400 adults aged 18 years and over and 30 qualitative informants participated in the study. The research instruments were validated by experts and demonstrated a reliability coefficient of 0.82. Phases R2 and D2 evaluated stakeholders and at-risk groups using a suicide prevention practice questionnaire, Resilience Quotient (RQ), Stress Test-5 (ST-5), and Thai Happiness Indicators (THI-15). Data were analyzed using descriptive statistics, paired t-test, and thematic analysis.
Results: Phase R1 revealed that public awareness regarding mental health and suicide was moderate, whereas access to mental health support and participatory decision-making remained low. Economic problems, social isolation, chronic illness, alcohol use, and depression were associated with suicide risk. In phase D1, the CARE-MHS Model was developed through a participatory co-design process. The model comprised Community Voice, Acceptance & Culture, Risk Screening, Empowerment, and Mental Health Support System. In phase R2, stakeholders demonstrated significantly improved suicide prevention practices (p < .001), while at-risk participants showed increased resilience and happiness scores and reduced stress levels. In phase D2, suicide prevention practice scores improved across all implementation areas, and the number of completed suicide cases showed a decreasing trend.
Conclusion: The CARE-MHS Model, integrating community participation, proactive risk screening, and multi-level mental health support systems, was associated with positive changes in suicide prevention practices and mental well-being in remote and culturally diverse settings. Long-term follow-up studies are recommended to evaluate the sustainability of the model.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
World Health Organization. Suicide in the world: global health estimates. Geneva: WHO; 2019 [cited 2025 Oct 1]. Available from: https://apps.who.int/iris/bitstream/handle/10665/341728/9789240026643-eng.pdf.
Department of Mental Health. Suicide situation report in Thailand 2023. Bangkok: Department of Mental Health; 2023.
Office of Health Region 1. Summary of health inspection, fiscal year 2023. Chiang Mai: Office of Health Region 1; 2023.
Mae Hong Son Provincial Public Health Office. Annual report 2023. Mae Hong Son: Mae Hong Son Provincial Public Health Office; 2023.
Marmot M. Social determinants of health inequalities. Lancet. 2005;365(9464):1099-104. https://doi.org/10.1016/S0140-6736(05)71146-6.
McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Q. 1988;15(4):351–377. https://doi.org/10.1177/109019818801500401.
Cohen JM, Uphoff NT. Rural development participation: Concept and measure for project design, implementation and evaluation. New York: Cornell University; 1981.
Israel BA, Schulz AJ, Parker EA, Becker AB. Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Public Health. 1998;19:173–202. https://doi.org/10.1146/annurev.publhealth.19.1.173.
Jansam S. The Development of a Community Participatory Model for Preventing Suicide of Yasothon Province [dissertation]. Nonthaburi: Sukhothai Thammathirat Open University; 2016.
Penglia Y, et al. Application of community participatory programs for suicide prevention: a case study at Jarim sub-district, Tha-Pla district, Uttaradit province. J Ment Health Thai. 2018;26(3):184-96. https://he01.tci-thaijo.org/index.php/jmht/article/view/149274.
Udthato A & Manoton A, et al. Development of community participation process is solving suicide problems successfully new normal in Maeteep Subdistrict, Ngao District, Lampang Province. Academic Journal of Community Public Health. 2023;9(1):69–83. https://he02.tci-thaijo.org/index.php/ajcph/article/view/258974.
Cochran WG. Sampling techniques. 3rd ed. New York: John Wiley & Sons; 1977.
Srisa-ard B. Introduction to research. 10th ed. Bangkok: Suwiriyasan; 2017.
Suwattanapongkul I. Educational research: concepts and applications. Bangkok: Department of Educational Measurement and Research, Faculty of Education, Srinakharinwirot University; 2019.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77-101. https://doi:10.1191/1478088706qp063oa.
Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-91. https://doi:10.3758/BF03193146.
Department of Mental Health. Mental Health Check In application. Nonthaburi: Ministry of Public Health; 2020.
National Statistical Office. Summary of key findings from the mental health (happiness) survey of Thai people, 2020. Bangkok: Bangkok Block Partnership; 2021.
World Health Organization. Preventing suicide: A community engagement toolkit. Geneva: WHO; 2018 [cited 2025 Oct 1]. Available from: https://apps.who.int/iris/handle/10665/272860.
Zimmerman MA. Psychological empowerment: Issues and illustrations. Am J Community Psychol. 1995;23:581-600. https://doi.org/10.1007/BF02506983.
Pongnanthakulkit P, et al. The Development of a Suicide Prevention Model in Depression Risk Groups in the Community, Chanthaburi Province. Journal of Health and Nursing Research. 2022;38(2):187–197. https://he01.tci-thaijo.org/index.php/bcnbangkok/article/view/249329/174281.
Kaewyasri K, et al. The Model Development of a Psychiatric patients, surveillance, screening, and caring in the community Loei Province. Research and Development Health System Journal. 2022;15(2):328–342. https://he02.tci-thaijo.org/index.php/RDHSJ/article/view/256834/176829.
Yodklang O, et al. Suicide Prevention and reduce Self harm in Thailand. Department of Mental Health; 2020 [cited 2025 Oct 5]. Available from: https://suicide.dmh.go.th/download/view.asp?id=299.
Rutter M. Psychosocial resilience and protective mechanisms. Am J Orthopsychiatry. 1987;57(3):316–331. https://doi.org/10.1111/j.1939-0025.1987.tb03541.x.
Tangkasemsamran K. Driving the Development of Repeated Suicide Prevention Model on Suicide Attempters in Uttaradit Province, Thailand. Journal of Health Science. 2022;31(4):638–647. https://thaidj.org/index.php/JHS/article/view/12556/10425.
