None listed
Conditions
Brief summary
This school-based randomised controlled trial will evaluate whether a 16-week poetry mutual-aid group can reduce suicide risk in adolescents aged 12 to 17 years in Caldas, Colombia, who recently attempted suicide. Participants will be randomised to either a poetry mutual-aid group plus usual care or an attention-matched supportive psychoeducational group plus usual care. The primary outcome is suicide risk severity measured by the ERS. Secondary outcomes include depressive symptoms, subjective well-being, suicidal ideation and behaviour severity, and implementation outcomes such as acceptability, feasibility, appropriateness, fidelity, organisational readiness, reach, adoption, penetration, cost, and initial sustainability.
Interventions
Arm 1: School-based poetry mutual-aid groups plus usual care.
Participants allocated to the intervention arm will receive a manualised 16-week school-based group intervention in addition to usual care. The intervention will be delivered in participating schools by a psychologist, with support from a family development professional and clinical oversight by a general practitioner and child psychiatrist. The programme will include 12 structured group sessions delivered over 16 weeks (8 weekly ses
Arm 1: School-based poetry mutual-aid groups plus usual care. Participants allocated to the intervention arm will receive a manualised 16-week school-based group intervention in addition to usual care. The intervention will be delivered in participating schools by a psychologist, with support from a family development professional and clinical oversight by a general practitioner and child psychiatrist. The programme will include 12 structured group sessions delivered over 16 weeks (8 weekly sessions followed by 4 fortnightly sessions), with approximately 90 minutes per session. Groups will be closed and will ideally include 8 to 10 adolescents. The intervention is based on peer support and expressive writing/poetry activities. Core components include: 1. a brief opening and emotional check-in ritual; 2. guided reading of short poems or written texts related to emotions, identity, belonging, hopelessness, help-seeking, and future orientation; 3. brief structured poetry writing activities using accessible formats such as short verses, metaphors, lists, letters, and collective poems; 4. facilitated peer reflection and mutual aid; 5. explicit links between written material and coping, emotional regulation, problem-solving, help-seeking, and safety planning; 6. a brief closing ritual and session debrief. The intervention also includes three brief structured caregiver contacts during the programme to review attendance, safety, warning signs, and practical support. All participants remain linked to usual mental health care and school support services. For the purposes of this study, usual mental health care refers to the routine care and support available to adolescents after a suicide attempt through their health insurer/EPS (Entidad Promotora de Salud, in Spanish) , local mental health services, emergency services when required, school counselling/orientation services, and existing referral pathways. Usual care may include clinical assessment, outpatient psychological or psychiatric care, pharmacological treatment when indicated, crisis intervention, safety planning, emergency referral, and school-based support. The trial intervention will not replace or restrict usual care
Sponsors
Alcaldía de Manizales
Study design
Allocation
Randomised controlled trial
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
12 Years to 17 Years
Healthy volunteers
No
Inclusion criteria
Adolescents aged 12 to 17 years; currently enrolled in a participating secondary school in Caldas, Colombia; documented suicide attempt within the previous 12 months; clinically stable for outpatient and group-based participation at enrolment; written informed consent from a parent or legal guardian and assent from the adolescent; linked to usual care or willing to receive referral to usual mental health care; able to attend school-based group sessions during the study period.
Exclusion criteria
Acute suicide risk requiring immediate intensive intervention or inpatient care at the time of enrolment; current psychotic episode, acute mania, severe intoxication, or another acute mental state preventing meaningful participation; severe cognitive impairment or developmental condition requiring a substantially different intervention format; lack of a parent/legal guardian able to provide consent and participate in minimum safety contacts; planned withdrawal from school or relocation outside the study area during the intervention period.
Outcome results
None listed