Presentation Information
[P-4-01]Cultural Adaptation of the Community Informant Detection Tool for Detecting Suicidality in Pakistan
*Gul Aimen Saeed1, Shumaila Saleem2, Siham Sikander3,2, Ashley Hagaman1 (1.Yale University (United States of America), 2.Global Institute of Human Development (Pakistan), 3.University of Liverpool(UK))
Keywords:
Culturally grounded suicide prevention tool,Community-based detection,Qualitative research,Global mental health,Pakistan
Background: Suicide is a critical public health concern in Pakistan, with an estimated 15 to 35 individuals dying by suicide daily. However, most suicide detection tools are developed in Western contexts, limiting their cultural relevance and effectiveness in Pakistan. There is an urgent need for locally grounded approaches to early identification and intervention. This study aimed to culturally adapt the Community Informant Detection Tool (CIDT) for suicidality to better reflect the socio-cultural realities of Pakistan.
Methods: We adapted the CIDT for use in Islamabad Capital Territory (ICT), Pakistan, using qualitative adaptation methods. The CIDT is designed to help community members identify individuals at risk of suicide. Adaptation activities included focus group discussions (FGDs) with community stakeholders—such as Lady Health Workers (LHWs), men and women with lived experience, and religious leaders—to explore local expressions, perceived causes, and impacts of suicidality in Urdu. We embedded a free list activity within the FGDs to elicit and prioritize warning signs of suicide from participants’ lived experiences and community observations.
Results: Community members identified seven locally relevant warning signs of suicide: (1) easily angered and irritability, (2) isolation and lack of participation in daily activities, (3) hopelessness, (4) repeatedly expressing an inability to provide for one’s family, (5) perceived failure, (6) mood swings, and (7) changes in sleep patterns. Each sign was illustrated by an indigenous artist to enhance visual and cultural accessibility. FGDs also identified key community gatekeepers—such as LHWs, teachers, and Islamic religious leaders—as potential implementers of the CIDT.
Conclusion: This is the first indigenously co-designed CIDT for suicide in Pakistan. It bridges informal help-seeking pathways with formal mental health services and frames suicidality in a culturally and religiously sensitive way, reducing stigma and increasing community acceptance. Future work will focus on validating the tool.
Methods: We adapted the CIDT for use in Islamabad Capital Territory (ICT), Pakistan, using qualitative adaptation methods. The CIDT is designed to help community members identify individuals at risk of suicide. Adaptation activities included focus group discussions (FGDs) with community stakeholders—such as Lady Health Workers (LHWs), men and women with lived experience, and religious leaders—to explore local expressions, perceived causes, and impacts of suicidality in Urdu. We embedded a free list activity within the FGDs to elicit and prioritize warning signs of suicide from participants’ lived experiences and community observations.
Results: Community members identified seven locally relevant warning signs of suicide: (1) easily angered and irritability, (2) isolation and lack of participation in daily activities, (3) hopelessness, (4) repeatedly expressing an inability to provide for one’s family, (5) perceived failure, (6) mood swings, and (7) changes in sleep patterns. Each sign was illustrated by an indigenous artist to enhance visual and cultural accessibility. FGDs also identified key community gatekeepers—such as LHWs, teachers, and Islamic religious leaders—as potential implementers of the CIDT.
Conclusion: This is the first indigenously co-designed CIDT for suicide in Pakistan. It bridges informal help-seeking pathways with formal mental health services and frames suicidality in a culturally and religiously sensitive way, reducing stigma and increasing community acceptance. Future work will focus on validating the tool.