Culturally Adapted Manual-Assisted Psychological Intervention (CaMaPI) for Adolescents/Young People With a History of Self-Harm and Suicidal Ideation in Nigeria: A Randomised Controlled Feasibility Trial

Background
Globally, suicide is the second leading cause of death for adolescents/young people aged 15–30-years old. The mainstream care for these affected persons is mostly unsuccessful due to limited culturally appropriate care.

Methods
This is a mixed-methods randomised controlled feasibility trial design. A culturally adapted manual-assisted psychological intervention (CaMaPI) was utilised to treat adolescents/young people with histories of self-harm and suicidal ideation. CaMaPI is a manualised intervention consisting of 10 sessions, grounded in psychoeducation and cognitive behavioural therapy. Participants aged 18–29 were screened for self-harm and suicidal ideation. N = 20 participants were randomised into CaMaPI (n = 10) or Treatment as Usual (TaU) (n = 10) groups. One focus group with n = 8 participants, and n = 3 individual interviews were conducted with the experimental group.

Result
Satisfaction with intervention (CaMaPI, 100%; TaU, 50%). Reduction in self-harm and suicidal ideation was higher in CaMaPI on the suicide and self-harm scale at Md = 1.00 with z = −2.264, compared to TaU, Md = 3.00 with z = −0.378. Both groups showed no significant reduction in hopelessness. Emerging themes from the qualitative findings showed acceptance of self-harm and suicidal ideation as a treatable condition, mood management and behaviour modification, alongside cultural appropriateness and positive experience of the CaMaPI.

Conclusions
CaMaPI is feasible, culturally appropriate and acceptable in reducing self-harm and suicidal ideation in adolescents/young people with histories of self-harm and suicidal ideation in Nigeria. A fully powered randomised control trial is recommended to evaluate the clinical and cost-effectiveness of CaMaPI compared with TAU.