Home therapeutic gardening plus usual care versus health education plus usual care for recovery after a recent suicide attempt in adults in Caldas, Colombia

Arm 1: Home therapeutic gardening intervention plus usual care Participants allocated to the intervention arm will receive a manualised 16-week home therapeutic gardening programme delivered in addition to usual care. For this study, usual care is defined as the mental health care and follow-up ordinarily available through the participant's existing care pathway in Caldas, including clinical assessment or follow-up appointments, pharmacological or psychological treatment when indicated, crisis and safety management, referral to specialised services, and community or primary care follow-up according to local practice. Usual care will not be withheld or modified by study allocation. The intervention is interdisciplinary and integrates agronomy, psychology, and family development. It includes one initial set-up session to assess available space and install a home garden using containers, pots, or small ground plots as feasible; provision of a basic gardening kit including containers, substrate, seeds or seedlings, and a practical illustrated guide; structured follow-up sessions focused on garden care, behavioural activation, routine building, achievable weekly goals, observation of progress, and optional but bounded family support; brief weekly follow-up contacts by phone or WhatsApp over the 16-week intervention period to review progress, adherence, barriers, and safety; and a closing phase aimed at maintenance and continuation of the gardening routine beyond the intervention period. The intervention will be adapted to home conditions, including limited space and container-based gardening. Sessions and follow-up contacts will be delivered individually by trained staff from agronomy, psychology, and family development, at home and/or by telephone or WhatsApp according to participant circumstances and safety considerations. Adherence will be monitored using participant gardening diaries or brief activity checklists, phone or WhatsApp contact logs, records of completed contacts, and staff checklists documenting completed gardening tasks, barriers, adverse events, and safety concerns. Intervention fidelity will be monitored using a structured fidelity checklist assessing delivery, dose, comprehension, implementation in the home, adherence-monitoring procedures, and safety procedures.