A Participatory Framework for Suicide Surveillance and Prevention: The Role of Family and Community in Moeiwadee Hospital, Roi Et Province

Abstract

Purposes: This study aimed to investigate existing problems, develop, and evaluate a participatory surveillance and suicide prevention approach involving families and communities at Moeiwadi Hospital, Roi Et Province.

Study design: This study employed a mutual collaborative action research design.

Materials and Methods: The study involved three groups of key informants: (1) service recipients diagnosed with depression and identified as being at risk of suicide, along with their family members (n = 24), divided equally between the situational analysis and development phases; (2) six healthcare providers from Moeiwadi Hospital directly involved in mental health and suicide prevention services; and (3) eleven stakeholders responsible for the hospital’s suicide surveillance and prevention program. Data were collected using validated instruments assessing knowledge, attitudes, and behaviors related to suicide surveillance, prevention, and patient referral. The instruments demonstrated strong psychometric quality, with a content validity index (CVI) ranging from 0.67 to 1.00. The knowledge test showed satisfactory reliability (KR-20 = 0.84) and item difficulty indices between 0.43 and 0.76, while the attitude and behavior questionnaires showed high internal consistency (Cronbach’s alpha = 0.92 and 0.89, respectively). Data were analyzed using descriptive statistics, including frequency, percentage, mean, standard deviation, and percentage difference.

Main findings:  The study was conducted through situation analysis, participatory planning, and implementation of a comprehensive suicide prevention program. Data were collected from service records and interviews covering four stages of care: pre-hospital, in-hospital, referral, and post-discharge follow-up. The developed model consisted of six key interventions: (1) training and resilience-building activities; (2) screening of target populations in schools, communities, and healthcare facilities; (3) referral of at-risk individuals according to the established system; (4) mental health care services by multidisciplinary teams; (5) discharge planning meetings involving patients, families, and community agencies; and (6) home visits for psychological assessment, family readiness evaluation, and ongoing counseling. After implementing the model, the proportion of individuals with mild depressive symptoms (scores 7–12) increased from 25.0% to 50.0% (percentage difference = 66.7), and those with moderate depression (scores 13–18) increased from 16.7% to 25.0% (percentage difference = 40.0). Conversely, severe depression (scores >19) markedly decreased from 58.3% to 25.0% (percentage difference = –80.0). Family knowledge regarding suicide surveillance and prevention increased by 38.31%, while attitudes and preventive behaviors improved by 39.35% and 39.88%, respectively.

Conclusion and Recommendations: The developed suicide surveillance and prevention model effectively reduced the proportion of individuals with severe depression and significantly enhanced family knowledge, attitudes, and behaviors toward suicide prevention. The findings support the integration of family and community participation in mental health surveillance systems as an effective strategy to strengthen suicide prevention in local contexts.