Systems Approach for MAnagement of self-harm by integrating Surveillance with mental health Training in general Hospitals in South India (SAMASTH)

Though suicide is a major public health concern in India, self-harm patients who mostly present to state run general hospitals are frequently discharged without a mental health assessment. There is a lack of implementation guidance and no framework to deliver mental health training programmes. Staff face multiple challenges with limited capacity for mental health assessment and treatment.

We will examine if implementation of an integrated programme of self-harm registers, staff mental health training and digitally-assisted mental assessments strengthen health systems in general hospitals by increasing capacity for assessment and care-planning by non-specialists and improved care for self-harm patients?

We will test the feasibility of implementation of this programme across three state general hospitals and to measure changes in: rate of mental health assessment among selfharm patients, rate of engagement with mental health services and rate of repetition of self-harm; and mental health literacy and competencies of health care professionals in management of selfharm patients.

We will employ realist evaluation methods informed by Theory-of-Change processes.

Relevant policies will be reviewed and informed by this study, policy briefs and implementation guidance will be generated. This project has a framework to build, strengthen and sustain the research and training capacity in self-harm research.