Outlive

Reframing Suicide as a Public Health Crisis

Suicide is often framed as an individual, and not a public health concern. India accounts for about 30% of global suicides, with suicide being the leading cause of death among young people aged 15-29 in India. The causes of suicide are complex, involving environmental factors like physical violence, emotional and sexual abuse, and exam stress. The objectives of the programme were to:

• Increase awareness about suicide prevention and mental health for young people.
• Increase access to rights-based, peer-led suicide prevention and support services.
• Actively engage young people with policymakers and influence policy processes on suicide prevention.

In the research phase, the team spoke to young people across Mumbai, Pune, and Delhi, conducting several in-depth sessions in multiple Indian languages. The team also consulted experts working in suicide prevention and mental health. Outlive was an outcome of a partnership between Sangath, Centre for Mental Health Law and Policy (CMHLP) and Quicksand, with the project team including a nationally representative Young People’s Advisory Group (YPAG), which helped steer the project’s objectives, activities, evaluation, and public engagement.

The findings from the research were synthesised to support the design of the various interventions. The initial designs of the interventions were tested and reviewed by youth advisors and other stakeholders before being implemented over two years.

Sensitive Storytelling to Engage Youth

Outlive supports young people to be meaningfully involved in youth suicide prevention by promoting diverse public engagement activities. These include platforms that invite stories of individuals with lived experience, partnerships with organisations and individuals to encourage conversations on suicide prevention, mixed media resources for public consumption and dissemination, and awareness-building and outreach activities with educational institutes. Much of this came together on outlive.in, which served as a website repository of psychosocial resources and stories for suicide prevention and advocacy. Here are some of the strands of Outlive’s public engagement programme:

Stories of hope: Outlive showcases stories of lived experiences that underline the importance of talking openly about suicide, seeking help, challenging stigma and promoting recovery. These stories are in the form of short films, blogs, and artworks that explore some of the difficulties that young Indians face that may put them at risk of suicide. The emphasis on sharing lived experiences was anchored in the belief that stories can offer hope and remind us we’re not alone. Outlive’s collection of video, written, and graphic stories offer lessons in overcoming stigma, advocating for rights, and finding meaning in our lives.

Youth-centred Events: As part of community outreach, Outlive has hosted and organised several panel discussions, talks, film screenings, and art exhibitions. These events were aimed to facilitate dialogue and enhance awareness about young people’s mental health and suicide prevention. They also included interactive capacity-building and sensitisation workshops aimed at building participants’ literacy of suicide prevention strategies, how to cope with distress, and avenues for help-seeking during crises. All the learning resources, stories, and physical exhibition materials designed by Quicksand in partnership with Sangath and CMHLP were used across these events.

Understanding Suicide Poster Campaign: Suicide is preventable, and everyone has a role to play in preventing youth suicide. To engage students and educators and publicly disseminate creative resources that could be circulated at will, Quicksand envisioned the ‘Understanding Suicide Better’ poster campaign. This myth-busting poster campaign across colleges in India was designed to help break common misconceptions about suicide. These posters are free to download from the Outlive website and are available in Hindi, Marathi and English. Students were encouraged to print and share them in their school, college, or neighbourhood, or post them on social media to help spread awareness.

Leveraging Peer Support in Preventing Suicide

One of Outlive’s key objectives is to reduce the gap in youth suicide prevention services by improving young people’s access to rights-based and peer-led suicide prevention support. Research shows that online chat-based support from their peers is preferred by young people who are distressed since it is accessible and anonymous. Drawing on this evidence, and to improve access to suicide prevention support, a peer support intervention with young people was co-designed.

Peer Training Modules: As part of the peer support programme, Outlive trained a network of young volunteers across Delhi, Mumbai, and Pune as peer supporters to provide chat-based emotional support to youth experiencing distress or having thoughts of ending their lives. This included recruiting and training youth volunteers as peer supporters; youth volunteers comprised young people with lived experience, college students, youth leaders and social workers (with no required qualification in psychology or counselling). Outlive’s peer supporters are supported by peer mentors through individual and group mentoring sessions.

Outlive Chat: Outlive Chat was designed as a free-of-cost web platform that serves as a safe space where young people experiencing difficult life situations or thoughts of ending their lives can receive anonymous and chat-based emotional support from a trained peer supporter. This one-to-one chat-based emotional support is free of cost, and has two main interfaces; Peer interface, and Help Seeker interface.

Building a Platform for Youth Advocacy

In our engagement with young people, we found that there are unique and diverse perspectives on how policies – at the local, national, and global level – can have an impact on youth suicide prevention. Outlive believes it is crucial for young people to participate in the process of making government policies and programmes that impact their lives and the communities they live in, including suicide prevention.

Outlive’s Youth Advocacy Suicide Prevention (YASP) Fellowship Programme aims to build capacities of young people to enable systemic and policy-level changes to prevent youth suicides, and ensure that young people’s rights are protected and upheld. Outlive trained and mentored 10 youth advocates to design and implement their own youth advocacy plans to engage with policymakers on suicide prevention in their own communities. Youth advocates can nudge policymakers to focus on programme and policy solutions that address different causes of youth suicides such as academic stress discrimination, lack of access to suicide prevention resources, domestic violence, and other such factors. In Quicksand's decades-long experience in various public engagement projects, the work on Outlive demanded a diverse array of strategies and approaches. Ranging from visual storytelling and youth engagement to participatory research and a rights-based approach to mental health care, policy, and capacity-building, this program's multi-faceted model stands as a unique endeavor. The success of projects like Outlive hinges on the sense of ownership they cultivate among direct stakeholders, particularly youth in this case. The program's public engagement initiatives alone encompassed over 80 events, with over 5000 participants engaged in in-person workshops, training, and capacity-building sessions. Additionally, the psychosocial resources and multimedia multilingual campaigns were embraced and disseminated further by various youth groups at the college level.

Driving Ownership Among Stakeholders

In Quicksand's decades-long experience in various public engagement projects, working on Outlive demanded diverse skills, strategies, and approaches. From sensitive storytelling, youth engagement, to formulating participatory research and a rights-based approach to mental health care with our partners, Outlive’s multi-faceted model stands as a unique endeavour. The success of projects like Outlive hinges on the sense of ownership they cultivate among direct stakeholders. The program's public engagement initiatives alone encompassed over 80 events, with over 5,000 participants engaged in workshops, gate-keeper training sessions, and capacity-building modules. All resources such as the psychosocial resources and multimedia multilingual campaigns were embraced and disseminated further by various youth groups at the college level.