PhD Studentship: Suicidal behaviour in South Asian young people: a global emergency
To explore the conceptualisation of self harm and suicidal behaviour in young people in Pakistan, and in the UK in those of Pakistani heritage.
This PhD project will address the global challenge themes of Mental Health and Migration and build on our UK expertise. We will establish an active cross-country research partnership of collaborators. Preliminary data collected will add to our existing body of research, extending this to an international data set, able to provide the platform for Global Challenge grant funding.
Suicide is a serious global public health concern, and one of the leading causes of death in many countries. Nearly one million people die by suicide each year across the globe and, given the varieties in reporting and stigma surrounding suicide, the actual figure is likely to be much higher. The rates of suicide word-wide have increased by 60% in the last 45 years. Nearly 75% of all suicides occur in in low- and middle-income countries (1, 2). Suicide is the second most common cause of death for young people worldwide (3). Two thirds of young people who die by suicide have a history of self harm, and this is the strongest predictor of later completed suicide (2).
Phase 1: The Context of Self harm. An evidence synthesis of existing literature on self harm and suicide in South Asian young people, together with a sample (approximately 6) interviews in each location with leading clinicians, school leaders, NGO’s to describe the country context.
Phase 2: Conceptualisations of Self harm: In-depth narrative qualitative interviews with young people (approximately 6 in each country) exploring experience and conceptualisations of self harm and suicide, mapping relationships amongst these and wider cultural, social and religious structures. Purposive sampling will recruit young people from schools and communities along a continuum from those at risk of developing self harm, such as following bereavement or being in care, through to those with self harm ideation; and those who have a clear history of self harm and suicidal behaviour. In doing so we will contextually address the knowledge gap regarding how self harm and suicide are conceptualised in Pakistan and in the UK amongst those of Pakistani heritage who will have been exposed to western, as well as South Asian, conceptualisations of mental health.
Phase 3: Preferences for Interventions: Using data from phase 2, a cross-sectional survey of school, NGO and patient populations will be conducted, charting views on place and time for different types of interventions (eg information giving, peer support, family interventions) mapped against different conceptualisations. Sampling approximately 200 young people per city, we will develop a cross-country comparison of the preferences for timing and type of interventions for self harm for young people.
Comparisons will be drawn within and between the two countries and related to different conceptualisations of self harm and suicide and preferences for interventions as well as the factors that will shape the access and acceptability of interventions.
By the project completion, we will have network of researchers formed for future larger grant funding. Our case-study design will allow methodology development and replication in further South Asian and European cities, and thus growth to fully scaled global interventions.
Tracing similarities and differences between each country will generate in-depth understandings of the impact of migration and acculturation and where targeted, culturally appropriate, interventions may be acceptable. We will have essential information for large grant applications for targeted interventions acceptable to young people at a preventative stage in suicide prevention.